Prognosis Flashcards
(49 cards)
Prognosis definition
Prediction of course, duration, outcome of a disease
What is prognosis based on?
The pathogenesis of the disease and presence/absence of risk factors (specific to that disease)
When is prognosis established?
After diagnosis, but before the treatment plan
What are the 2 types of of prognosis
Overal prognosis
Individual tooth prognosis
If a patient has a hopeless overall prognosis, what should you do or not do?
Do not have to do the prognosis of individual teeth
What effect the overall prognosis?
Patient age (older is better) Current severity of disease, systemic factors, smoking Local factors (calculus, plaque, etc) Patient compliance Prosthetic possibilities
When is individual tooth prognosis made?
After overall prognosis (don’t do if overall is hopeless)
T/F - individual prognosis is effected by the overall prognosis
True
What is taken into account for individual tooth prognosis?
Mobility Pocket depths Bone loss Furcations Local factors
What are the two types of Prognosis Classification systems?
Becker, Berg, and Becker
McGuire and Nunn
Becker, Berg, and Becker Prognosis classification system
Good –> Questionable –> Hopeless
Cannot use this system without radiographs -need to assess bone levels
Use bone levels/probe depths as primary basis
McGuire and Nunn Prognosis classification system
Good –> Fair –> Poor –> Hopeless
Used at OSU
CAL is used as the primary basis
BB+B’s Good Classification
Need 2 of the following:
Where does the bone loss percentage come from for the BB+B Classification
Bone loss levels are the average around the entire tooth
BB+B’s Questionable Classification
Need 2 of the following:
50% bone loss
6-8 mm probe depths
Class 2 furcation
Anatomical variables (any anatomy that can promote perio problems - deep palatal groove on max incisors, furcation of max 1st PMs)
BB+B’s Hopeless Classification
>75% bone loss > 8mm probe depth Class III Furcation Poor crown:root ratio (1:1 is minimally acceptable) Unfavorable root proximity Repeated perio abscess formation
Which teeth are most likely to have unfavorable root proximity?
Maxillary 1st and 2nd molars
McGuire and Nunn Good Prognosis
“Adequeate” Remaining bone support
“Adequate” possibilities to control etiologic factors/create a maintainable dentition
“Adequate” patient cooperation
NO systemic factors or well-controlled systemic factors (diabetes)
McGuire and Nunn Fair Prognosis
25-50% CAL
Class I or “easily accessible” Class II furcations
“Adequate” possible maintenance present
Few systemic factors
McGuire and Nunn Poor Prognosis
> 50% CAL
Class I or Class II furcations
Difficult areas to maintain and/or poor patient compliance
Presence of systemic (environmental factors)
McGuire and Nunn Hopeless Prognosis
>75% CAL Mobility (2+) Class II or Class III furcations Difficult areas to maintain and/or poor patient compliance Unfavorable Root Proximity
How does patient age effect prognosis?
If two patients (one older, one younger) have the same levels, the older patient has a better prognosis
- longer time frame for destruction
- this is because if it’s a younger patient, it’s a more aggressive disease
What helps us determine Disease severity?
CAL - for approximate extent of root surface w/o PDL
Radiographic exam - for amount of root surface still enveloped by bone
Why is CAL better to use than PD?
PD is subject to hyperplasia
