04 Prognosis & treatment planning

Question 1

prognosis

Answer 1

prediction of duration, course, and termination of a disease and its response to treatment.
determine which treatment will be most effective.
develop recommendation and treatment plans
determine if treatment is worthwhile

Question 2

perio aspects of prognosis

Answer 2

age
disease severity
systemic/environmental factors: smoking, diabetes
patient cooperation

Question 3

individual tooth prognosis

Answer 3

consider all clinical data for each tooth and its place in overall plan
modified by overall prognosis

Question 4

factors influences individual prognosis

Answer 4

plaque/calculus
subgingival restorations
tooth mobility
attachment loss
bone loss
furcation involvement
caries, non-vital tooth, and root resorption
prosthetic/restorative factors

Question 5

good perio aspects

Answer 5

adequate bone support
possibilities to control etiologic factors
patient cooperation
absent or controlled systemic/environmental factors

Question 6

fair perio aspects

Answer 6

less than adequate bone support
good maintenance possible
good patient cooperation
presence of limited systemic/environmental factors

Question 7

phases of care

Answer 7

urgent
ODCT
evaluative
reconstructive
maintenance therapy

Question 8

ODCT

Answer 8

exam, dx and tx plan
systemic problems
plaque control measures/prophy
scaling & root planing
caries control measures
removal of defective restorations
evaluation of initial perio tx
extraction of teeth
fluoride treatment
operative procedures (remove decay, restore)
endodontics
provisional prosthetic tx

Question 9

non-surgical perio ODCT decisions

Answer 9

design hygiene education program
determine perio procedures:
- 1/2 quadrant scaling and root planing vs full quadrant scaling and root planing
occlusal therapy (mobility control/occlusal adjustment)
restorative to fix local perio etiology (overhangs, open contacts, etc.)

Question 10

evaluation of initial therapy

Answer 10

reassess clinical data
anticipated vs actual changes
patient compliance
effect of OHI
reassess prognosis
reevaluate proposed treatment

Question 11

surgical perio ODCT decisions

Answer 11

extractions
perio surgery goals: access for debridement, reduction of probing depths
prevent addition recession, rebuild bony support and perio support tissues

Question 12

evaluative phase

Answer 12

may be significant time to evaluate
careful evaluation of results of ODCT
retreat uncontrolled disease
move to reconstructive/maintenance phase