diagnosis abses periodontal
TRANSCRIPT
![Page 1: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/1.jpg)
DIAGNOSIS, PROGNOSIS AND
TREATMENT PLAN
Hooman KhorshidiDepartment of PeriodonticsShiraz University of Medical Sciences
www.perio.ir
![Page 2: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/2.jpg)
Diagnosis
Diagnosis may be defined as identifying disease from an evaluation of the
history, signs and symptoms, laboratory tests, andprocedures
![Page 3: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/3.jpg)
l) patient interview2) medical consultation as indicated3) clinical periodontal examination4) radiographic examination 5) laboratory tests as needed
![Page 4: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/4.jpg)
Healthy periodontal tissues with minimal inflammation
![Page 5: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/5.jpg)
Systemic diseases with periodontal manifestations
Paroxysmal nocturnal hemoglobinuria with severe leukopenia and associated gingival necrosis
![Page 6: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/6.jpg)
Systemic diseases with periodontal manifestations
Wegner’s granulomatosis with gingival involvement
![Page 7: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/7.jpg)
Systemic diseases with periodontal manifestations
Acute monocytic leukemia with thrombocytopenic purpura; gingival enlargement is due to infiltrating leukemic cells, and necrosis
![Page 8: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/8.jpg)
![Page 9: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/9.jpg)
www.perio.ir
![Page 10: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/10.jpg)
www.perio.ir
![Page 11: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/11.jpg)
www.perio.ir
![Page 12: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/12.jpg)
www.perio.ir
necrotizing ulcerative gingivitis
![Page 13: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/13.jpg)
Interdental necrosis mesial and distal to the lateral incisor that is characteristic of
necrotizing ulcerative gingivitis
necrotizing ulcerative gingivitis
![Page 14: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/14.jpg)
www.perio.ir
![Page 15: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/15.jpg)
![Page 16: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/16.jpg)
www.perio.ir
![Page 17: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/17.jpg)
![Page 18: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/18.jpg)
Miller class III gingival recession
![Page 19: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/19.jpg)
Miller class II gingival recession
![Page 20: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/20.jpg)
www.perio.ir
![Page 21: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/21.jpg)
www.perio.ir
![Page 22: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/22.jpg)
www.perio.ir
![Page 23: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/23.jpg)
www.perio.ir
![Page 24: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/24.jpg)
![Page 25: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/25.jpg)
![Page 26: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/26.jpg)
CAL
![Page 27: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/27.jpg)
www.perio.ir
![Page 28: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/28.jpg)
www.perio.ir
![Page 29: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/29.jpg)
![Page 30: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/30.jpg)
www.perio.ir
![Page 31: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/31.jpg)
Furcation involvement
I-incipient or early suprabony pocket extension into the furcation area with slight loss of bone;II-extension of the pocket into the furcation leaving a portion of the alveolar bone and periodontal ligament intact allowing only partial penetration of the probe into the furcation areaIII-through and through extension of the pocket into the furcation with complete loss of inter-radicular bone without gingival recessionIV-through and through furcationinvasion with gingival recession
![Page 32: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/32.jpg)
www.perio.ir
![Page 33: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/33.jpg)
www.perio.ir
![Page 34: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/34.jpg)
www.perio.ir
![Page 35: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/35.jpg)
Class IV furcation involvement
![Page 36: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/36.jpg)
![Page 37: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/37.jpg)
www.perio.ir
![Page 38: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/38.jpg)
www.perio.ir
![Page 39: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/39.jpg)
![Page 40: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/40.jpg)
www.perio.ir
![Page 41: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/41.jpg)
![Page 42: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/42.jpg)
www.perio.ir
Restorative corrections
Open contactsOverhangsPoor marginsPoor contours
![Page 43: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/43.jpg)
www.perio.ir
![Page 44: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/44.jpg)
www.perio.ir
OverhangsPoor margins
![Page 45: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/45.jpg)
www.perio.ir
![Page 46: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/46.jpg)
Dental plaque-induced gingival diseases
1. Gingivitis associated with dental plaque onlya. without other local contributing factorsb. with local contributing factors
2. Gingival diseases modified by systemic factorsa. associated with the endocrine system1) puberty-associated gingivitis2) menstrual cycle-associated gingivitis3) pregnancy-associated
a) gingivitisb) pyogenic granuloma
4) diabetes mellitus-associated gingivitis
b. associated with blood dyscrasias1) leukemia-associated gingivitis2) other
www.perio.ir
Classification of periodontal diseases and conditions
![Page 47: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/47.jpg)
Dental plaque-induced gingival diseases
3. Gingival diseases modified by medicationsa. drug-influenced gingival diseases
1) drug-influenced gingival enlargements2) drug-influenced gingivitisa) oral contraceptive-associated gingivitisb) other
4. Gingival diseases modified by malnutritiona. ascorbic acid-deficiency gingivitisb. other
www.perio.ir
Classification of periodontal diseases and conditions
![Page 48: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/48.jpg)
Non-plaque-induced gingival lesions
1. Gingival diseases of specific bacterial origina. Neisseria gonorrhea-associated lesionsb. Treponema pallidum-associated lesionsc. streptococcal species-associated lesionsd. other
2. Gingival diseases of viral origina. herpesvirus infections
1) primary herpetic gingivostomatitis2) recurrent oral herpes3) varicella-zoster infections
b. other
www.perio.ir
Classification of periodontal diseases and conditions
![Page 49: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/49.jpg)
Non-plaque-induced gingival lesions
3. Gingival diseases of fungal origina. Candida-species infections
1) generalized gingival candidosis
b. linear gingival erythemac. histoplasmosisd. other
4. Gingival lesions of genetic origina. hereditary gingival fibromatosisb. other
www.perio.ir
Classification of periodontal diseases and conditions
![Page 50: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/50.jpg)
Non-plaque-induced gingival lesions
5. Gingival manifestations of systemic conditionsa. mucocutaneous disorders
1) lichen planus2) pemphigoid3) pemphigus vulgaris4) erythema multiforme5) lupus erythematosus6) drug-induced7) other
b. allergic reactions1) dental restorative materials
a) mercuryb) nickelc) acrylicd) other
2) reactions attributable toa) toothpastes/dentifricesb) mouthrinses/mouthwashesc) chewing gum additivesd) foods and additives
3) other
www.perio.ir
Classification of periodontal diseases and conditions
![Page 51: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/51.jpg)
Non-plaque-induced gingival lesions
6. Traumatic lesions (factitious, iatrogenic, accidental)a. chemical injuryb. physical injuryc. thermal injury
7. Foreign body reactions8. Not otherwise specified (NOS)
www.perio.ir
Classification of periodontal diseases and conditions
![Page 52: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/52.jpg)
Chronic PeriodontitisA. LocalizedB. Generalized
Aggressive PeriodontitisA. LocalizedB. Generalized
Can be further classified on the basis of extent and severity.Extent :
Localized = ≤30% of sites involved Generalized = >30% of sites involved
Severity : Slight = 1 or 2 mm CAL
Moderate = 3 or 4 mm CAL Severe = ≥5 mm CAL
www.perio.ir
Classification of periodontal diseases and conditions
![Page 53: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/53.jpg)
Periodontitis as a Manifestation of Systemic Diseases
A. Associated with hematological disorders
1. Acquired neutropenia2. Leukemias3. Other
B. Associated with genetic disorders1. Familial and cyclic neutropenia2 Down syndrome3. Leukocyte adhesion deficiency syndromes4. Papillon-Lefèvre syndrome5. Chediak-Higashi syndrome6. Histiocytosis syndromes7. Glycogen storage disease8. Infantile genetic agranulocytosis9. Cohen syndrome10. Ehlers-Danlos syndrome (Types IV and VIII)11. Hypophosphatasia12. Other
C. Not otherwise specified
www.perio.ir
Classification of periodontal diseases and conditions
![Page 54: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/54.jpg)
Necrotizing Periodontal DiseasesA. Necrotizing ulcerative gingivitis (NUG)B. Necrotizing ulcerative periodontitis (NUP)
www.perio.ir
Classification of periodontal diseases and conditions
![Page 55: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/55.jpg)
Abscesses of the PeriodontiumA. Gingival abscessB. Periodontal abscessC. Pericoronal abscess
www.perio.ir
Classification of periodontal diseases and conditions
![Page 56: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/56.jpg)
Periodontitis Associated With Endodontic LesionsA. Combined periodontic-endodontic lesions
www.perio.ir
Classification of periodontal diseases and conditions
![Page 57: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/57.jpg)
Developmental or Acquired Deformities and Conditions
A. Localized tooth-related factors that modify or predispose to plaque-induced gingival diseases/periodontitis1. Tooth anatomic factors2. Dental restorations/appliances3. Root fractures4. Cervical root resorption and cemental tears
B. Mucogingival deformities and conditions around teeth1. Gingival/soft tissue recession
a. facial or lingual surfacesb. interproximal (papillary)
2. Lack of keratinized gingiva3. Decreased vestibular depth4. Aberrant frenum/muscle position5. Gingival excess
a. pseudopocketb. inconsistent gingival marginc. excessive gingival displayd. gingival enlargement (See I.A.3. and I.B.4.)
6. Abnormal colorC. Mucogingival deformities and conditions on
edentulous ridges1. Vertical and/or horizontal ridge deficiency2. Lack of gingiva/keratinized tissue3. Gingival/soft tissue enlargement4. Aberrant frenum/muscle position5. Decreased vestibular depth6. Abnormal color
D. Occlusal trauma1. Primary occlusal trauma2. Secondary occlusal trauma
www.perio.ir
Classification of periodontal diseases and conditions
![Page 58: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/58.jpg)
www.perio.ir
![Page 59: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/59.jpg)
www.perio.ir
![Page 60: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/60.jpg)
www.perio.ir
![Page 61: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/61.jpg)
www.perio.ir
![Page 62: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/62.jpg)
![Page 63: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/63.jpg)
Evaluation of fremitus
![Page 64: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/64.jpg)
Class I½recession that does not extend to the mucogingivaljunction and is not associated with lossof bone or gingival tissue in the interdentalarea; Class II½recession that extends to the mucogingivaljunction and is not associated with loss ofbone or soft tissue in the interdental area;O Class III½recession that extends to or beyond themucogingival junction with loss of bone or softtissue in the interdental area; andO Class IV½recession extending to or beyond themucogingival junction with severe loss of interdentalbone and/or soft tissue and/or severe toothmalposition.
![Page 65: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/65.jpg)
![Page 66: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/66.jpg)
www.perio.ir
![Page 67: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/67.jpg)
www.perio.ir
![Page 68: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/68.jpg)
www.perio.ir
![Page 69: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/69.jpg)
![Page 70: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/70.jpg)
www.perio.ir
![Page 71: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/71.jpg)
M O S T D I F F I C U L T D E C I S I O N P R O C E S S
Developing a Prognosis
www.perio.ir
![Page 72: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/72.jpg)
Overall clinical factors :AgeDisease severityPlaque controlPatient compliance
![Page 73: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/73.jpg)
AGE
The more rapidly the
problem develops
The younger the
patient with a given
periodontal problem
the poorer the prognosis
www.perio.ir
![Page 74: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/74.jpg)
Disease severity
www.perio.ir
![Page 75: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/75.jpg)
Systemic, restorative, environmental and local factorPatient compliance and prosthetic possibilityFactors influencing individual tooth prognosis:Plaque and calculus, subgingivalrestoration, caries, non-vital teeth, root resorption
![Page 76: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/76.jpg)
skills and experience
A dentist with limited skills
should refer significant periodontal problems
www.perio.ir
![Page 77: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/77.jpg)
medical status of the patient
impaired immune system
poorly controlled diabetes
use of medicines that may induce hyperplasia
heart or blood pressure problems
clotting problems
use of anticoagulants
www.perio.ir
![Page 78: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/78.jpg)
Age of patientSkills and experience of dentistMedical status of the patient (general health)
Immunological statusForm of bone lossPossibility of removing etiologic factorPoor nutritional habits, smoking, alcohol abuse, and drug abuseDental conditions (eg, bruxism, malocclusion) Number, position and form of teeth present, Badly involved key abutment teeth, Severe furcationinvolvement, Poor root form, Root proximity
www.perio.ir
![Page 79: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/79.jpg)
Age of patientSkills and experience of dentistMedical status of the patient (general health)Immunological statusForm of bone loss
Possibility of removing etiologic factorPoor nutritional habits, smoking, alcohol abuse, and drug abuseDental conditions (eg, bruxism, malocclusion) Number, position and form of teeth present, Badly involved key abutment teeth, Severe furcationinvolvement, Poor root form, Root proximity
www.perio.ir
![Page 80: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/80.jpg)
Habits
Poor nutritional habits,
smoking,
alcohol abuse, and
drug abuse • have negative effects on the
prognosis
www.perio.ir
![Page 81: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/81.jpg)
psychologic makeup
The ability of the patient to manage stress, follow through with a demanding oral hygiene regimen, and recognize and manage the periodontal problem affect the prognosis
either positively or negatively.
Skill in identifying and assessing these nondental factors is a key to the dentist’s success as a prognostician
www.perio.ir
![Page 82: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/82.jpg)
dental factors
occlusal problems such as bruxism or malocclusion must be resolvable, or they will negatively affect the prognosis. Key teeth must be restorable
www.perio.ir
![Page 83: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/83.jpg)
Extent of the disease Its rate of progression Status of key abutment teeth Severity of furca involvements Root formRoot proximity
Dental conditions (bruxism, malocclusion)Number, position and form of teeth present,
www.perio.ir
![Page 84: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/84.jpg)
An extensive problem with rapid loss of support, especially with few remaining solid teeth or teeth with short or crowded roots or severe furcation involvements, has a poorer prognosis than that for a case in which fewer of these factors are negative.
www.perio.ir
![Page 85: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/85.jpg)
Type of prognosis
Hopeless
Questionable
Poor
Fair
Good
Excellent
www.perio.ir
![Page 86: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/86.jpg)
TREATMENT PLAN
Hooman KhorshidiDepartment of PeriodonticsShiraz University of Medical Sciences
www.perio.ir
![Page 87: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/87.jpg)
Objectives of treatment plan:
Elimination of disease
Restoration of efficient function
Production of satisfactory appearance
![Page 88: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/88.jpg)
Preliminary phase
Non-surgical phase
Surgical phase
Restorative phase
SPT phase
www.perio.ir
![Page 89: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/89.jpg)
Emergency
Extraction of hopeless teeth
OHI and patient information
Plaque control and SRP (supra & sub)
Initial occlusion adjustment
Reevaluation after phase І
Surgical phase
Reconstruction (restorative phase)
Maintenance (supportive periodontal
treatment SPT)
![Page 90: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/90.jpg)
Preliminary phase
Pain
Discomfort
Emergencies
www.perio.ir
![Page 91: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/91.jpg)
Hopeless teeth
www.perio.ir
![Page 92: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/92.jpg)
Non-surgical phase
Phase 1
Plaque control
Cause related
Patient education
www.perio.ir
![Page 93: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/93.jpg)
Phase one therapy
Control of plaque
Control of diet
Control of systemic factors
Control of oral malodor and taste
abnormalities
Control of tobacco smoking
![Page 94: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/94.jpg)
CONTROL OF SYSTEMIC FACTORSCONSULT WITH PATIENT’S M.D.
Control of Hemostasis
Control of Bacteremia
Control of Diabetes
Control of Medications
![Page 95: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/95.jpg)
Patient with plaque induced gingivitis
Three weeks following compliance with excellent oral hygiene and plaque control
![Page 96: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/96.jpg)
www.perio.ir
Before phase 1
After phase 1
![Page 97: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/97.jpg)
www.perio.ir
![Page 98: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/98.jpg)
Removal of pathologic tissue for biopsy
Removal of caries-endodontic therapy
Removal of hopeless teeth
Removal of calculus
![Page 99: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/99.jpg)
Removal of cariesEndodontic therapy
![Page 100: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/100.jpg)
PHASE ONE EVALUATION
Pocket depthPlaque scoreBleeding on probingCariesOcclusal stabilityMobility, fremitusMucosal health statusMucogingival statusSystemic statusRadiographic evaluationOral malodor and tasteEstheticsModification of phase two treatment plans
![Page 101: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/101.jpg)
Surgical phase
Periodontal
Implant
Endodontic
Impacted teeth
…
www.perio.ir
![Page 102: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/102.jpg)
Restorative phase
Cast restoration
No conventional filling
www.perio.ir
![Page 103: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/103.jpg)
maintenance
SPT (supportive periodontal therapy )
www.perio.ir
![Page 104: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/104.jpg)
![Page 105: diagnosis abses periodontal](https://reader030.vdocuments.net/reader030/viewer/2022013108/553fa6444a7959f8128b480c/html5/thumbnails/105.jpg)