Guidelines for periodontal therapy
Development of a treatment plan
Periodontal and Diseaes conditions
Periodontal examination
Scope for periodontics
encompasses prevention, diagnosis, treatment of disease and support of surrounding tissues
Speciality includes: maintence of health, function, and esthetic of all supporting structres and tissues (gingiva, periodontal ligament, cementum, alveolar bone
Goals are to preserve the natural dentition, periodontium and peri-implant tissues- maintain and improve periodontal and peri-implant health, comfort, esthetics and function.
Clinical signs of healthy periodontium: absence of redness, swelling, suppuration, BOP, maintence of a functional periodontal attachment level, minimal or no recession, absence of interproximal bone loss and functional dental implants
Includes: discussion regarding cheif complant, medical and dental history review, clinical examination, radiographic exam, microbiologic, genetic, biochemical diagnostic assesments
EOIO, probing depth, recession, attachment level, BOP, supporation, assesment of plaque, calculus and gingival inflammation, caries assesment, contact relationship, restorations, occlusion, systemic interrelationships
Gingival, periodontitis, necrotizing periodontal diseases, absceses, developments or acquired deformaties and conditons.
chronic periodontisits, aggresive periodontitis, periodontitis associated with endodontic lesions
Slighlt, moderate, severe - localized/ generalized
Prevelance increases with age and adults over 50 have the greatest degree of involvement
Edentulous ridge defects result from loss of osseous tissue and can compromise esthetics or complicate future implant placement
medical consult or referall
periodontal procedures to be preformed
adjunctive restorative, prosthetic orthodontic treatment
reevaluation
diagnostic testing
periodontal maintence
Treatment procedures
Patient education
training in personal oral hygiene, smoking cessation, control of risk factors
Removal of supragingival plaque, root planing
post treatment evaluation, review and enforcment
chemotherapeutic agents, reduce eliminate or change quality of microbial pathogens
Factors modifying results
inadequate plaque control by the patient, unknown or undeterminable etiologic factors, pulpal periodontal therapy has not controlled; inability or failure of the patient to follow maintence programs
Compromised when: pt refuses to have recommended tx, practicioner elects to retain a hopeless tooth, patients who are unable or unwilling to undergo procedures
Evaluation of therapy
pt has been counseled on why and how to perform an effective daily personal oral hygiene program
accepted therapeatic procedures
periodontal root debridement
gingival crevices are generally without bleeding
tooth corrections have been preformed
an appropriate periodontal maintenance program has been implemented