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determination of prognosis Flashcards

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1
Q

what is a prognosis?

A

prediction of the probable course, duration, and outcome of a disease

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2
Q

T/F a prognosis is dynamic

A

True

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3
Q

T/F prognosis is also called risk

A

False. prognosis is often confused with risk

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4
Q

what is risk?

A

the likelihood that an individual will develop a disease

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5
Q

what are risk factors?

A

environmental, behavior, or biologic factors that put an individual at increased risk for developing a disease

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6
Q

what are risk factors for periodontitis?

A

smoking
diabetes
pathogenic bacteria

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7
Q

what are examples of non-modifiable risk factors

A

genetic factors
age

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8
Q

what are risk indicators?

A

probable or putative risk factors (not confirmed through longitudinal studies; e.g. HIV/AIDS, osteoporosis, infrequent dental visits)

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9
Q

what are risk predictors?

A

assoc with inccreased risk for disease, but do not cause disease (e.g. bleeding on probing, previous history of periodontal disease)

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10
Q

what is a prognosis?

A

a rdiction of probable course of disease

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11
Q

what are prognostic factors?

A

characteristics that predict the outcome of disease once disease is present (e.g. furcation involvement)

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12
Q

sometimes something may be both a __________ and a __________

A

Risk factor, prognostic factor
e.g. smoking, diabetes (increased risk for aquiring periodontitis and worse prognosis once they have periodontitis)

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13
Q

what are the types of perio prognosis?

A

good
fair
poor
questionable
hopeless

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14
Q

what kind of attachment and bone loss is present is good prognosis?

A

no or slight attachement and bone loss

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15
Q

T/F with good prognosis there are no systemic or environmental factors

A

true

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16
Q

with good prognosis can you use the tooth as an abutment tooth?

A

yes

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17
Q

what kind of bone loss is present with a fair prognosis?

A

moderate (25%) attachment and bone loss

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18
Q

with a fair prognosis what kind of mobility is there?

A

CL I mobility

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19
Q

what kind of furcation involvement is assoc. with fair prognosis?

A

Degree I furcation involvement

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20
Q

T/F with a fair prognosis there is no systemic or environmental factors

A

False, (limited systemic or environmental factors)

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21
Q

with a fair prognosis can you use the tooth as an abutement tooth?

A

yes, but with caution

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22
Q

what type of attachment and bone loss is present with poor prognosis?

A

severe (50%)

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23
Q

what kind of crown root ratio would be present in poor prognosis?

A

poor (greater than 1:1)

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24
Q

what kind of mobility is present with a poor prognosis

A

CL II mobility

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25
what kind of furcation involvement is assoc with poor prognosis?
Degree II
26
T/F with a poor prognosis, systemic and environmental factors are not controlled
True
27
with a poor prognosis can you use the tooth as an abutment tooth?
NO
28
with questionable prognosis there is ________ attachment and bone loss
severe (>50%)
29
what kind of furcation involvement is present in questionable prognosis?
CL II or III
30
what kind of mobility is present in questionable prognosis?
CL II or III
31
what kind of mobility is present in hopeless prognosis?
CL III
32
what kind of bone loss is present in hopeless prognosis?
severe
33
T/F with a hopeless prognosis it may jeopardize the adjacent tooth
true
34
whta kind attachment is present in hopeless prognosis?
inadequate attachment to maintain health, comfort, function
35
T/F you can save a tooth with a hopeless prognosis with extreme tx measures
False. non-restorable, ext indicated
36
what 3 prognosises were est with reasonable degree of accuracy
good, fair, hopeless
37
what prognosises were likely to change and were more unpredictable?
poor, questionable
38
what are the big factors assoc with the overall prognosis?
disease severity (PD, furcation involvement, mobility, % bone loss) smoking
39
with individual tooth prognosis what are the influences?
same factors as overall prog. plus local factors tooth anatomical factors prosthetic and restorative factors
40
T/f you should determine the individual tooth prognosis first
false. overal prognosis first
41
what grades generally lead a good perio prognosises? what are the exceptions?
grades A/B except: severe perio non-compliant pt with systemic disease **these will downgrade to fair/poor**
42
molar-incisor pattern perio has a __________ prognosis if treated early with systemic antibiotics and regenerative therapy
good
43
generalized Grade C perio has _________ or _________ prognosis
poor, questionable do not respond well to conventional periodontal therapy
44
the _______ the stage and/or grade the ________ the individual and overall prog.
higher, poorer
45
with perio as a manifestation of systemic disease it has a ______ or _______ prog
poor, questionable
46
w/ necrotizing gingivitis there is a _________ prog
good with recurrent it downgrades prog.
47
what are clinical factors that determine prog?
pt age disease severity plaque control pt compliance
48
which has better prog. tooth A: 8 mm pocket, heavy calc in a 50 yr old pt tooth B: 8 mm pocket, no calc in a 30 yr old pt
A tooth has a slower rate of progression tooth b has grade C perio removal of local factors (calc) can improve the prog of tooth A
49
older pt vs young pt with the same amount of attachment loss. which pt has a better prog?
older pt b/c rate of progression is slower grade a perio has a better prog than grade c perio
50
what are the big local (tooth related) factors that determine prognosis?
probing depth mobility furcation involvement bone loss severity
51
__________% of molars have cervical enamel projections at the furcation
17-28%
52
what's the issue with cervical enamel projections?
ct fibers will not attach to enamel increases susceptibility to pocket formation increases susceptibility to furcation involvement
53
what's the issue with the mesial root concavity?
difficult access for scaling
54
which tooth is common for mesial root concavity?
max 1st premolars
55
what is the percentage of time that the M root of the mand 1st molar has a concavity? for the distal?
100%, 99%
56
on the max 1st molar which root is the most likely to have a concavity?
the MB root (94%)
57
the furcation entrance is smaller than the curette ________% of the time
58%
58
what tooth is most common to have palatogingival groove?
max incisors lateral most common (5%)
59
what prosthetic and restorative factors will determine prog?
abutment selection caries non-vital teeth root resorption
60
what's the key pt factor that affect prog.?
smoking -has the most negative impact on tooth survival -246% greater chance of tooth loss (compared to non-smoker)
61
what are the key local factors that affect prog.?
probing depth mobility furcation involvement % bone loss
62
what's the prog.? -56 yr old female -non-smoker -hypothyroid well-controlled synthroid -CL III mobility -11 mm pd's with suppuration -#25: non-vital
hopeless
63
what's the prog.? 34 yr old female non-smoker healthy -3 mm recession facial #25 with MGD
good b/c you can do a graft
64
what's the prog.? 58 yr old female depression controlled with paxil 4mm CAL on lingual deg I furcation involvement buccal and lingual CL I mobility
fair
65
what's the prog.? 58 year old female type 2 diabetes HbA1c = 8.6% smoker, 1pack/day 4mm CAL on lingual deg I furcation involvement buccal and lingual CL II mobility
poor (systemic diseases not well controlled)

24 perio (7 decks)

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