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FP Ch. 10 Clinical Decision-Making for Periodontal Care (ADA Case Type…
FP Ch. 10 Clinical Decision-Making for Periodontal Care
Clinical decision- making
process where all members of the dental team use the information gathered during the comprehensive periodontal assessment to arrive at tn appropriate diagnosis and identify treatment strategies that meet the needs of the patient
1st step in planning periodontal treatment: assigning correct diagnosis
Signs of Periodontal Disease
features of a disease that can be seen or measured by clinicians
Ex: Gingival erythema
gingival edema
bleeding on gentle probing
loss of attachment
tooth mobility
loss of alveolar bone support
Symptoms of Periodontal Disease
features of a disease as described by the patient
Silent Disease
lack of early symptoms that are not obvious to the patient until the disease has progressed to cause considerable damage
Overt signs
signs that are readily visible
color changes in the gingiva
contour changes in the gingiva
changes in consistency in the gingiva
Hidden signs
signs that are not readily visible
Bone loss
Purulence (exudate)
Bleeding on Probing
Master treatment plan
sequential outline of the measures to be carried out by the dentist, the DH, or the patient to eliminate disease
Natural level of gingival attachment
tooth is slightly coronal to the level of cementoenamel junction
Clinical attachement loss
migration of the JE to a position that is apical the level of the CEJ
CAL
used to underscore that these measurements are clinical measurements and may not coincide exactly with precise histologic measurements
ADA Case Type System for Periodontal Patients
Case Type I
Patients with gingivitis only
Case Type II
Patients with mild periodontitis
Case Type III
Patients with moderate periodontitis
Case Type IV
Patients with severe periodontitis
Disease Grading
Grade A
slow rate of anticipated disease progression
Grade B
Moderate rate of anticipated disease progression
Grade C
Rapid rate of anticipted diseased progression
Disease Extent
Localized
30% or less of teeth in the mouth are involved
Generalized
More than 30% of the teeth in the mouth are involved
Molar/ incisor pattern
only molars and incisor exhibit periodontal breakdown
Assessment and preliminary therapy phase
assessment data collection
urgent care for an acute condition
Non surgical periodont therapy phase
includes all of the nonsurgical measures used t control gingivitis and periodontitits
also called:
initial perionotal therapy
Phase I therapy
bacterial control
anti-infective therapy
Surgical therapy phase
treatment includes any needed periodontal surgery to control or eliminate periodontal disease that can't be managed by nonsurgical therapy alone
Restorative therapy phase
treatment includes placement of dental restorations and replacements of missing teeth by fixed or removable prostheses
periodontal maintentance phase
treatment includes all measures used by the dental team and the patient to keep periodontists from recurring