Prognosis, Re-eval, and Maintenance

Question 1

A prediction of the course, duration and
outcome of a disease based on a general
knowledge of the risk factors for the disease
‣ It is established after the diagnosis is made and
before the treatment plan is established.

Answer 1

Prognosis

Question 2

an evaluation of the course of the

disease without treatment.

Answer 2

Diagnostic Prognosis:

Question 3

an evaluation of the course of

the disease with treatment.

Answer 3

Therapeutic Prognosis:

Question 4

T/F: The GOAL is to Deliver a predictable and long term stable comprehensive tx plan

Answer 4

True

Question 5

_______: the anticipated result of the

periodontal therapy with anticipated prosthetic treatment

Answer 5

Prosthetic Prognosis:

Question 6

In the studies, what combination of tx and maintenance showed the least number of teeth lost per year?

Answer 6

Tx and regular maintenance

Question 7

(KWOK AND CATON (2007) Prognosis)
: The periodontal status of the tooth can be stabilized with comprehensive periodontal
treatment and periodontal maintenance. Future loss of the periodontal supporting tissues is
unlikely if these conditions are met

Answer 7

Favorable

Question 8

(KWOK AND CATON (2007) Prognosis)
: The periodontal status of the tooth is influenced by local and/or systemic factors
that may or may not be able to be controlled. The periodontium can be stabilized with
comprehensive periodontal treatment and periodontal maintenance if these factors are
controlled; otherwise, future periodontal breakdown may occur

Answer 8

Questionable

Question 9

(KWOK AND CATON (2007) Prognosis)
: The periodontal status of the tooth is influenced by local and/or systemic factors that
cannot be controlled. Periodontal breakdown is likely to occur even with comprehensive
periodontal treatment and maintenance

Answer 9

Unfavorable

Question 10

(KWOK AND CATON (2007) Prognosis)

: The tooth must be extracted

Answer 10

Hopeless

Question 11

(PROGNOSIS (MCGUIRE ’96))

One or more of the following:  
‣ Etiologic factors can be controlled  
‣ Adequate periodontal support  
‣ Tooth or teeth can be adequately maintained by the professional 
and patient  
‣  Controlled systemic factors

Answer 11

GOOD:

Question 12

(PROGNOSIS (MCGUIRE ’96))
: One or more of the following:
• Up to 25% attachment loss measured clinically and radiographically
• Grade I furcation allows access for maintenance
• Tooth or teeth can be maintained with proper professional and
home care
• Limited systemic factors

Answer 12

FAIR

Question 13

(PROGNOSIS (MCGUIRE ’96))

\: One or more of the following:  
• Up to 50% loss has occurred      
• Grade II furcation with difficult access to the depth and position of the furcation  
• Greater than Miller class 1 mobility  
• Poor crown-to- root ratio  
• Lack of patient compliance  
• Presence of systemic factors

Answer 13

POOR

Question 14

(PROGNOSIS (MCGUIRE ’96))

One or more of the following:
• Greater than 50% attachment loss
• Grade II or III furcation involvement not accessible for maintenance
• Endodontically involved tooth that must be resolved before
periodontal treatment
• Tooth or teeth not easily maintained by professional and/ or patient

Answer 14

QUESTIONABLE:

Question 15

(PROGNOSIS (MCGUIRE ’96))

‣ One or more of the following:
‣ Inadequate attachment to support the tooth
‣ Grade III furcation involvement
‣ Miller class III mobility
‣ Tooth or teeth cannot be maintained by the professional and/ or the patient

Answer 15

HOPELESS:

Question 16

What is the most important determinant of prognosis for individual teeth/

Answer 16

Amount of attachment loss

Question 17

when present extend into 
furcation areas of ~20-30% of 
mandibular and maxillary molars. 
This clinical photo illustrates the 
most common location of CEPs 
(buccal surface of second 
maxillary molar)

Answer 17

CERVICAL-ENAMEL PROJECTIONS

Question 18

What teeth commonly hace CEPs?

Answer 18

Max 2nd molars

Question 19

Where do enamel pearls typically occur?

Answer 19

Max 2nd and 3rd molars

Question 20

The palatogingival groove is found on what teeth typically?

Answer 20

Max laterals

Question 21

Amount of bone loss is about 3.6 times higher

than normal in teeth that have more or less root proximity?

Answer 21

Teeth having roots closer together have more rapid bone loss

Question 22

Are max or mand molars most often loss to perio disease?

Answer 22

Max molars

Question 23

73% OF MANDIBULAR MOLARS
cementum extending from the mesial to the distal of a furcation opening
-Hinders professional cleaning
-More rapid bone loss

Answer 23

Furcation ridge

Question 24

DOES A SUCCESSFUL ENDODONTIC TX EFFECT PERIO PROGNOSIS?

Answer 24

Does not

Question 25

Re-evaluation of periodontal case should occur about __ weeks after completion of SRP. ‣ Allows time for healing of epithelium and CT ‣ Allows patient sufficient time to practice and improve OH ‣ Gingival inflammation is usually reduced or eliminated within 3-4 weeks after removal of calculus and local irritants

Answer 25

4-6 weeks

Question 26

Healing after STP: Formation of __________ ‣ this attachment epithelium appears 1-2 weeks after therapy ‣ Gradual reductions in inflammatory cell population, crevicular fluid flow, and repair of connective tissue will result in less inflammation, redness and swelling

Answer 26

LONG JUNCTIONAL EPITHELIUM

Question 27

Does healing after SRP tx involve hypersensitivity?

Answer 27

Yes for a few weeks; should go away

Question 28

Ideally: No pockets =/> ___ mm and none >___ mm with BOP

Answer 28

> or =5; none >4 mm with BOP

Question 29

if the pt has a loss of attachment of __ mm or greater at re- evaluation, should be referred

Answer 29

5 mm or more

Question 30

Treatment of advanced perio disease by a periodontist | usually successful if ___ to ____ mm pockets

Answer 30

5mm to 8 mm

Question 31

Does a pt need to have a good plaque score to be referred to a periodontist?

Answer 31

Yes ideally less than 20%

Question 32

includes all the procedures performed at selected intervals to assist the periodontal patient in maintaining oral health. • These usually consist of examination, an evaluation of oral hygiene and nutrition, scaling, root curettage, and polishing of teeth.

Answer 32

SPT or perio maintenance

Question 33

In a study where SPT wasn't performed, what happened to attachment loss over 2 years without maintenance?

Answer 33

1.2-1.9mm of attachment loss

Question 34

How often should SPT be delivered to a high risk patient?

Answer 34

Every 3 months

Question 35

(how often should pt be seen) Patients displaying a low- risk profile for periodontitis recurrence yield all risk factors in the low-risk category or, at most, one risk factor in the moderate risk category.

Answer 35

Once a year for SPT

Question 36

(How often should pt be seen) Patients presenting with at least two risk factors in the moderate-risk category and at most one risk factor in the high-risk category were classified as displaying a moderate-risk profile.

Answer 36

Twice a year

Question 37

(How often should pt be seen?) Patients showing at least two risk factors in the high- risk category are defined to belong to a high-risk profile for disease recurrence.

Answer 37

Every 3-4 months

Question 38

Maintenance is usually every __ months initially - WHY? —-> Clinical Studies show it is the right regiment to keep the clinical parameters stable.

Answer 38

3