Patients should be clearly informed ot the important role they must play tor treatment to succeed. Hopeless: These teeth have Pd’s greater than 8mm, advanced furcation involvement, (Note: If you cannot read the numbers in the above 3.4 Referral to a periodontal specialist. The prognosis also can be related to the height of remaining bone. 33-1) or when bone loss is so severe that the remaining bone is obviously insufficient for proper tooth support d ig 33-2). Prognosis. PDF. 3.3 Treatment planning: periodontal problems in children and young adults. Ficj. A, Gingival inflammation, poor oral hygiene, and pionounced anterior overbite in a systemically healthy, nonsmoking 42-year-old man B, Although local lac tors are present, the patient presents with adequate remaining bone support and a good prognosis, provided local factors can be controlled. Fair: Teeth with pocket depths in the 5-7mm range with limited mobility. (i) the prevalence of residual periodontal pockets, (ii) tooth loss, (iii) the systemic conditions in each patient, and (iv) environmental or behavioral factors such as smoking (12). However, it should be emphasized that smoking cessation can affect the treatment outcome and therefore the prognosis.1,4 Patients with slight to moderate periodontitis who stop smoking can often be upgraded to a good prognosis, whereas those with severe periodontitis who stop smoking may be upgraded to a lair prognosis. (îenetic polymorphisms in the interleukin-l (II-I) genes, resulting in increased production of II. 3.2 The management of gingival recession. INTRODUCTION. Evaluation of potential periodontal systemic inter- relationships. PLMs must be considered when determining the prognosis of a tooth with periodontal disease. In general, a tooth with deep pockets and little attachment and bone loss has a better prognosis than one with shallow pockets and severe attachment and bone loss. for any needed restorative care (fillings, crowns, bridges, etc). The charts below provide an overview. Conclusions: PLMs must be considered when determining the prognosis of a tooth with periodontal disease. etc. Epidemiologic evidence suggests that smoking may be the most important environmental risk factor impacting the development and progression ot periodontal disease (see Chapter 5). The American Academy of Periodontology defines periodontitis (periodontal disease) as “Inflammation of the periodontal tissues resulting in clinical attachment loss, alveolar bone loss, and periodontal pocketing.” 1 The disease is the leading cause of tooth loss in the United States. Plaque Control. To determine whether you have periodontitis and how severe it is, your dentist may: 1. Review your medical history to identify any factors that could be contributing to your symptoms, such as smoking or taking certain medications that cause dry mouth. smokers had a 246% greater chance of loosing their teeth compared to The prognosis is questionable when surgical periodontal treatment is required but cannot be provided because of the patient's health (see < hapter W). Things do not heal as quickly in older patients. STEP THREE: Periodontal Maintenance (click for more information) The two most important factors in determining long-term success are patient home care, and regular periodontal maintenance (cleanings). Grade I: The enamel projection extends from the cementoenamel junction of the tooth toward the furcation entrance. treatment. The prognosis is questionable when surgical periodontal treatment is required but cannot be provided because of the patient's health (see < hapter W). Overall Clinical Factors, Patient Age. Prognosis: Should be updated yearly I he height of remaining bone is usually somewhere in between, making bone level assessment alone insufficient for determining the overall prognosis. restore these teeth with clear and written expectations about longevity, costs, benefits, nonsmokers! 3.1 Treatment planning - gingivitis and periodontitis. [] Studies suggest that there is a link between DM, tooth loss, and periodontal prognosis. 2. Similarly, patients diagnosed with diabetes must be informed ol the impact ol diabetic control on the development and progression of periodontitis. The model proposed in this report is based on the best available evidence for factors affecting tooth survival and has been designed to be as simple and objective as … Determination of periodontal prognosis is an integral part of periodontal practice and it influences treatment planning directly whether to treat, retain or remove periodontally involved teeth.1,2 The prognosis of whole dentitions or individual teeth is “dynamic” and may require alteration of projections as health status or dental initiatives (e.g., oral hygiene) change. Tig. Prognosis is adversely affected if the base of the pocket (level of attachment) is close to the root apex. They found that last resort and plan to extract them if they continue to be infected. Good: Teeth that have pocket depths of 4-5mm and no mobility. Questionable: These teeth have a questionable outlook beyond 5-7 years because the If patients are unwilling or unable to perform adequate plaque control and to receive the timely periodic maintenance checkups and treatments deemed necessary by the dentist, then the dentist can (1) refuse to accept the patient for treatment or (2) extract teeth that have a hopeless or poor prognosis and perform scaling and root planing on the remaining teeth, fhe dentist should make it clear to the patient and in the patient record that further treatment is needed but will not be performed because of a lack of patient cooperation. The 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions resulted in a new classification of periodontitis characterized by a multidimensional staging and grading system. The present chapter will review all prognosis-related factors while at the same time trying to suggest a chart that might help in determining tooth prognosis for every single case. PROGNOSIS FOR PATIENTS WITH PERIODONTITIS CHRONIC PERIODONTITIS