Prognosis Flashcards
(36 cards)
What types of prognoses are there?
2: overall and individual
What determines an overall prognosis?
Age of patient current severity of disease systemic factors smoking plaque, calculus, other local factors patient compliance prosthetic possibilities
What determines the individual prognosis?
overall prognosis mobility probe depth bone loss furcation involvement local factors
What are the classifications of the Becker system?
good
questionable
hopeless
What are the classifications of the McGuire and Nunn system?
Good
Fair
Poor
Hopeless
What does a prognosis of “good” under the Becker system mean?
less than 50% bone loss
no furcation involvement
What does “questionable” mean under the Becker system?
50% bone loss
6 to 8 mm PD
Class II furcation
anatomic variables such as a deep palatal groove on the maxillary incisors or a mesial furcation involvement of the maxillary first premolar
What does “hopeless” under the Becker system mean?
More than 75% bone loss more than 8 mm PD Class III FI Class 3 mobility poor crown-root ratio unfavorable root proximity repeated periodontal abscess formation
T/F: You do not need radiographs to make an accurate prognosis using the Becker classification.
False. You ABSOLUTELY need radiographs. A huge component of this system involves evaluating bone levels!
What would be considered “good” on the McGuire and Nunn system?
adequate remaining bone support
adequate possibilities to control etiologic factors and establish maintainable dentition
no systemic environmental factors or well controlled systemic factors
25% attachment loss and/or class I FI
What is a “fair” prognosis under the McGuire and Nunn system?
25-50% AL
grade I or easily accessible Grade II FI
adequate maintenance possible
few systemic complications
What is “poor” prognosis under the McGuire and Nunn system?
over 50% AL
tooth mobility
Class I and II FI
difficult to maintain areas and/or doubtful patient cooperation
presence of systemic/environmental factors
What is a “hopeless” prognosis under the McGuire and Nunn system?
Over 75% AL tooth mobility 2+ Class II and III FI difficult to maintain areas and/or doubtful patient cooperation root proximity
T/F: radiographs are not necessary for McGuire and Nunn classification.
True. This classification is heavily depended upon evaluation of CAL
If two patients of different ages have the same level of remaining attachment and alveolar bone, which has the better prognosis?
The older patient.
Younger patient suffers from aggressive disease
shorter time frame in which destruction has occurred in the younger patient
What are the two main parameters for determining disease severity?
CAL
alveolar bone loss - how much of the root is still invested in bone
Which is more important: CAL or deep periodontal pockets?
CAL. A deep DP does not necessarily indicate destruction of structures. Better prognosis for a patient with deep pockets and little CAL than one with shallow pockets and marked CAL.
What do you do in a situation in which bone loss has occurred on one surface of a tooth? How do you go about developing the prognosis?
You should take into consideration the bone height on the less involved surfaces as well to make your prognosis.
T/F: the prognosis is independent of the patient’s attitude, desire to retain natural teeth and willingness to maintain good oral hygiene.
FALSE. The prognosis is completely dependent upon those things.
A smoker is diagnoses with slight to moderate chronic periodontitis. Immediately, he stops smoking. How might this effect his prognosis?
Prognosis may go from fair-poor to good.
If he was diagnosed with severe chronic perio and stopped smoking, his prognosis could be “fair”
On which teeth are root cavities very pronounced?
the maxillary first premolars and mesiobuccal root of maxillary first molar
What are the principal causes for tooth mobility?
loss of alveolar bone
changes (inflammation) of PDL attachment
trauma from occlusion
What is the typical prognosis for aggressive periodontitis?
poor
What is the typical prognosis for someone with periodontitis as a result of systemic disease?
fair to poor
