Tx Planning (can't get the planning?) (E3,L2) Flashcards
(101 cards)
1
Q
The _____ phase of care begins with a thorough review of the patient’s medical condition and history. This initial emergency appointment is to establish patient’s comfort.
A
URGENT
2
Q
In the URGENT Phase 2 examples of Tx can include:
A
- eliminating pain 2.Address emergency concern
3
Q
Which Phase: active pathological lesions (apical, periodontal abscess, primary occlusal trauma
A
CONTROL
4
Q
Which phase to we treat general caries?
A
Control
5
Q
Which phase do we perform oral surgery procedures?
A
control
6
Q
Which phase do we initiate endo tx?
A
control
7
Q
Which phase?? phase of treatment plan is to determine the response to our initial therapy before our definitive phase begins
A
Re-Evaluation Phase
8
Q
Which phase does DEFINITIVE PERIO surgery occur?
A
Re-Evaluation Phase
9
Q
After reassessing the initial treatment, the patient enters the corrective or definitive phase of treatment.
A
Definitive Phase
10
Q
This phase includes all therapies that restore function after the patient’s disease has been controlled
A
Definitive Phase
11
Q
What are 3 examples of the Difinitive Phase?
A
1.Pros (fixed/removable) 2.Implant Restoration 3.Ortho
12
Q
Which phase is Ortho usually done?
A
Definitive (pull teeth, fix cavities first)
13
Q
This includes regular re-care examinations
A
Maintenance Phase
14
Q
What are the 5 stages to a treatment plan??
A
1.Urgent 2.Control 3.Re-evaluate 4.Difinitve 5. Maintenance
15
Q
How you gonna treat gingivitis? (5)
A
- Med consult? 2.OHI 3.Full mouth SCALE and polish 4.Re-eval 4-6wks 5.Prophy every 6mon if resolved
16
Q
DIAGNOSE ME! What does this patient have??? Inflammation extending to bone–Bleeding on provocation—Attachment loss of 1-2 mm from CEJ—Probing depths of 3-4 mm—Radiographic bone loss of
A
Mild Chronic Periodontitis
17
Q
Mild Chronic Periodontitis- Attachment loss of __-__ mm from CEJ
A
1-2 mm
18
Q
Mild Chronic Periodontitis- Probing depths of __-__ mm
A
3-4 mm
19
Q
Mild Chronic Periodontitis-Radiographic bone loss of
A
less than 20%
20
Q
Mild Chronic Periodontitis- Class __ or no furcation involvement
A
Class I
21
Q
Mild Chronic Periodontitis- Class __ or no tooth mobility
A
Class I
22
Q
How you gonna treat Mild Chronic Periodontitis???(6)
A
1.med consult? 2.OHI 3.Quad/Half Mouth SRP w/ Anestesia 4.2-4 appointments 5.Re-eval (4-6 wks) 6. 3-4 mo maintenance
23
Q
How much attachment loss to be considered Moderate Chronic Periodontitis?
A
3-4mm from CEJ
24
Q
How deep of PD to be considered Moderate Chronic Periodontitis?
A
5-6mm PD
25
How much Radiographic bone loss to be considered Moderate Chronic Periodontitis?
20-40%
26
What Class of Furcation & Mobility are associated with Moderate Chronic Periodontitis?
Class I or II furcation & mobility
27
What are the only 32differences in treating moderate chronic perio as opposed to Mild chronic perio?
1.Locally delivered antimicrobials in the 5-6mm residual pockets 2.Refer to a periodontist!
28
ADVANCED Chronic Periodontitis-Attachment loss of > ____mm from the CEJ
>5mm
29
ADVANCED Chronic Periodontitis- Probing Depths of >__mm
> 7 mm
30
ADVANCED Chronic Periodontitis- Radiographic Bone loss >___%
> 40 %
31
ADVANCED Chronic Periodontitis- What class of furcation and mobility?
Class I, II, or III
32
What are the differences in initial therapy for Advanced Chronic Periodontitis compared to Moderate?
None!
33
What is Prognosis without treatment?
Diagnostic Prognosis
34
What type of prognosis--What effect will periodontal treatment have on the course of the disease?
Therapeutic Prognosis
35
What type of Prognosis--Given the anticipated results of periodontal treatment, what is the forecast for the success
of the prosthetic restoration?
prosthetic prognosis
36
The prognosis given prior initial phase of treatment It may change according to the patient/tooth response
Provisional Prognosis
37
What can you divide prognosis into?
overall prognosis and individual tooth prognosis
38
Overall Prognosis can depend on two major factors:
1.life expectancy 2.systemic habits (smoking/diet/drugs)
39
Overall Prognosis: type of bone loss, pt attitude/_______ and furcation involvement. avail of care.
compliance
40
What is the SINGLE MOST important factor for overall prognosis concerning a Systemic Background?
SMOKING
41
Cigarette smokers are __-__ times more likely than non-smokers to develop severe periodontitis
5-8x
42
Don't Smoke!! Inhibits ______ following periodontal therapy
would healing
43
Don't Smoke!! Alters the quality of _______ in shallow and deep pockets
microbiota
44
Don't Smoke!! Decreases ________, chemotaxis, phagocytosis and oxidative burst
neutrophils
45
Don't Smoke!! Increases _________ production
collagenase
46
Don't Smoke!! _________ gingival venules, arterials and capillaries
Constricts
47
Don't Smoke!! Decreases ____ flow
GCF
48
Good DATA to tell Pt!!! How long does this take?? BP drops to normal,Pulse rate drops to normal, Peripheral body temperature increases to normal
20 minutes
49
Good DATA to tell Pt!!! How long does this take?? CO in blood drops to normal
8 hours
50
Good DATA to tell Pt!!! How long does this take?? Chance of heart attack decreases
24 hours
51
Good DATA to tell Pt!!! How long does this take?? Circulation improves Lung function increases up to 30%
2wks-3months
52
Good DATA to tell Pt!!! How long does this take?? Coughing, sinus congestion, shortness of breath decreases, Cilia re-grow in lungs thereby enhancing host defense against respiratory infections
1-9months
53
Good DATA to tell Pt!!! How long does this take?? Risk of coronary heart disease is 50% less than that of a smoker
1 year
54
Good DATA to tell Pt!!! How long does this take??Lung cancer death rate for average smoker (1 pack a day) decreases by almost 50%, Stroke risk is reduced to that of non-smoker in 5-15 year quit range, Risk of oral, pharynx and esophageal cancer is 50% less than that of a smoker’s
5 years
55
Good DATA to tell Pt!!! How long does this take?? Lung cancer death similar to nonsmoker, Risk coronary heart disease is that of nonsmokers

10-15 years
56
What is the bug increased in Type I Diaetes?
Cap-to-cyto-phaga Sp.
57
What is the bug increased in Type II Diabetes?
Porphyromonas Gingivalis
58
Not only are BUGS increased in Diabetes, the host defense is also ALTERED...decreased ____ function and increase in glucose in the ____
decreased PMN...increase glucose in GCF
59
What happens to vascular changes in Diabetes? ________ thickness of basement membrane and vessel walls therefore...
Increased Thickness....therefore....Decreased O2 diffusion and elimination of wastes
60
Also in Diabetes you have more _______ breakdown which leads to impaired wound healing and increased severity of peridontitis.
collagen
61
SHE LOVES THIS SHIZ---Untreated moderate to advanced periodontitis expect to lose ____ teeth per patient per year.
0.36 teeth
62
SHE LOVES THIS SHIZ--- Treated moderate to advanced periodontitis with no maintenance..expect ____ teeth lost per patient per year.
0.22 teeth
63
SHE LOVES THIS SHIZ---Treated moderate to advanced periodontitis with regular maintenance _____ teeth lost per patient per year
0.11 teeth
64
PERIO Tx WORKZ:::The aggregate data from these six studies show that untreated patients with chronic periodontitis lose 0.28 teeth/pt/yr whereas treated patients lose 0.08 teeth/pt/yr, a difference of x___. Thus, over a ten year period the untreated patient can expect to lose 3-4 teeth and the treated patient 0-1 teeth.
3.5x
65
Well Maintained: _____% of patients lost 0-3 teeth Downhill: 12.6% of patients lost 4-9 teeth Extreme Downhill: 4.2% lost 10-23 teeth
Well maintained: 83.2% of patients lost 0-3 teeth Downhill:12.6% of patients lost 4-9 teeth Extreme Downhill-4.2% lost 10-23 teeth
66
Interesting! The level of oral hygiene at the 1st treatment
| appointment is not as important as the level of oral hygiene at completion of the _____ phase of treatment (_____).
initial phase of treatment (Phase I)
67
Overall Prognosis: Who wins? Aggressive “juvenile” vs Chronic “adult”
Chronic “adult” is better prog
68
Overall Prognosis: Who wins? Inflammation: Present vs Not present despite the disease severity
Present actually has a better prognosis! huh!
69
Overall Prognosis: Who wins? Plaque/Calc-Almost absent vs Abundant
Abundant is better prog..go figure!
70
Overall Prognosis: Who wins? Chronic infection vs. Periodontal abscess
Periodontal abscess is better prog
71
INDIVIDUAL TOOTH PROGNOSIS! Pocket Depth....______: 1-3 mm..._______: 4-6 mm......_______: ≥ 7 mm
shallow, moderate, SEVERE
72
She loves these numbers----INDIVIDUAL TOOTH PROGNOSIS! SRP-Following SRP at PD >5 mm residual calculus will remain ___% of the time. This can be blamed on the instruments! The curet is only efficient to ____mm and the best ones we have go to ___mm
85% of time...curet-3.73mm..others 5.52mm
73
Whats more important? PD or CAL? So which do we base our prognosis on?
CAL!!! and CAL!!!
74
What is the optimal crown to root ratio again? You bet your bottom dollar this has a factor in prognosis!
1:2 ratio. shorter the root the worse the prognosis! duh!
75
SHE SAID TO FOCUS ON THIS AVERAGE!!! Loss of teeth w/ furcation involvement following Tx-Average % lost ___% over and average of 20 years.
35.7% NOOOOOO!!!!
76
Furcation involvement- Class I – ____ Prognosis
FAIR
77
Furcation involvement- Class II – _______ Prognosis. _______ furcations and ______ maxillary furcations have the best predictability for regenerative procedures! umm you think that'll come up? :)
Questionable...mandibular and buccal
78
Furcation involvement- Class III/IV – ________ Prognosis
Poor/Hopeless
79
Tooth Mobility- Class 1: _______ prognosis (slight mobility)
fair
80
Tooth Mobility- Class 2: _______ prognosis (moderate more than normal)
questionable
81
Tooth Mobility- Class 3: _______ prognosis (severe mobility + depressive)
hopeless
82
WHAT ARE the 5 Classifications of Prognosis?
1.Good 2.Fair 3.Poor 4.Questionable 5.Hopeless
83
Overall, _______ molars are lost more frequently than _______ molars
maxillary...mandibular
84
Interesting....Patients do fine with _______ occlusion
bicuspid
85
Classes of Prognosis- Adequate bone loss
good
86
Classes of Prognosis-Acceptible pt cooperation
fair
87
Classes of Prognosis- present and controlled systemic diseases
poor or Questionable
88
Classes of Prognosis-grade 2 mobility
Questionable
89
Classes of Prognosis- Class III furcation involvement
Hopeless
90
Classes of Prognosis- advanced bone loss
Advanced OR Hopeless
91
Classes of Prognosis-doubtful patient cooperation
Questionable
92
Classes of Prognosis-Grade I mobility
Fair or poor
93
Classes of Prognosis- no furcation involvement
good
94
Classes of Prognosis- physiologic mobility
good
95
Classes of Prognosis-less than adequate bone loss
fair
96
Classes of Prognosis- doubtful pt cooperation
poor, questionable, OR hopeless
97
Classes of Prognosis-grade 3 mobility
hopeless
98
Classes of Prognosis-adequate Pt cooperation
good
99
Classes of Prognosis-limited systemic diseases
fair
100
Classes of Prognosis-grade 1 OR 2 mobility
poor
101
Classes of Prognosis- uncontrolled systemic diseases
hopeless
