The association between periodontal disease and diabetes mellitus (DM) is well documented. Teeth with short, slender and tapering roots have a poorer prognosis than teeth with long and broad roots. If few teeth are missing, the remaining teeth must bear all the masticatory and parafunctional stresses, which is a bad prognostic factor. The guide used to determine the prognosis of the disease was developed by McGuire and is used to predict the survival of individual teeth. The authors elected to define prognosis based on residual bone levels and/or furcation involvement. When present, these factors downgrade the prognosis by one level as previous research has established that these factors are significantly associated with an increased risk of tooth loss. The alteration in the immune response results in inadequate defense against infection, which favors periodontal disease progression. Table 5. More the center of rotation, Tooth root morphology plays an important role in periodontal maintenance. In general, long root trunk, a wide furcation, and a crown fornix near cementum-enamel junction are poor prognostic factors for furcation involvement 8. The systemic condition of the patient is a very important factor in the determination of the overall prognosis. 50-75% attachment loss and/or class II inaccessible furcation involvement, class III furcation involvement, class II mobility. Background . Clinical diagnosis and treatment planning for periodontal diseases, Periodontal maintenance (Supportive periodontal therapy), Orthodontic-periodontal interrelationship, Piezosurgery in periodontics and oral implantology. Contents available in the book ……….. Faggion Jr CM, Petersilka G, Lange DE, Gerss J, Flemmig TF. Periodontal prognosis ... Miller PD (1985) A classification of marginal tissue recession. Also, the quality of remaining teeth is important. Various factors which determine overall tooth prognosis are, The remaining bone support is directly proportional to the prognosis of the tooth. One major problem encountered by the dentists is ………. The periodontium can be stabilized with comprehensive periodontal treatment and periodontal maintenance if these factors are controlled; otherwise, future periodontal breakdown may occur. :z#�X$��7�SЎV���a��;�-�A�x#�+6�fMg�c���"��ُ��eA0?��yn�'�rU�⪛v]�5太�&��6��xM��W�DG#�::?������wJ¾!��)���Q��]y�0f�l w$E�=,�� j |�5LF쒮�%!�Kb�|�l7it�iV�����STK�|�i��9�L�UE-��3�M�ԃ�҃=h����|BAJ_H�K���9�lo��%i������t��s� 0�9�!���x�!�Kz�o�k�}�Sǫ��0h���g�P⢷�c7����ɮS�6��8��m=B�e�=d�^0���U:�l��X8 `�+ͬ9ݯ���7�����dF�vR��t���Y��v���W�֘�6�[�j�H�&;=y�~2 �F�F���V�n�p���/UuE�[=���f���y~�-�b�&k�r������Z�$ܸ�:a���5�S0�Mk��)�~=�M�����|�{}m�Oյ�>�11�޵�tp�5 Fair prognosis: Approximately 25% attachment loss and/or Class I furcation involvement location and depth allow proper maintenance … The periodontal breakdown is likely to occur even with comprehensive periodontal treatment and maintenance. IV. The epidemiological studies have provided irrefutable evidence that smoking adversely affects the prognosis in a periodontally compromised patient and the mechanisms by which it does so, Stress is associated with an adverse prognosis in periodontal disease progression. Similarly, in a series of studies, McGuire and Nunn (1991, 1996) 2, 3 concluded that it is difficult to predict the prognosis of teeth with an initial prognosis of less than good. Further, difficult to reach areas such as maxillary and mandibular posterior-most areas are more difficult to maintain as compared to the anterior areas. When bone loss increases beyond 50%, tooth mobility increases rapidly with each millimeter of further bone loss. The participation of the patient in the treatment process and the extent of compliance with recommendations and returns for maintenance visits are key factors in achieving periodontal therapeutic success 29. It has been demonstrated by various studies (see chapter 35), that traumatic occlusal forces combined with inflammation can cause increased bone loss and attachment loss. The initial periodontal treatment can be well executed by a general dentist, but a strict referral protocol should be employed when advanced periodontal treatment is required. The epidemiological studies have provided irrefutable evidence that smoking adversely affects the prognosis in a periodontally compromised patient and the mechanisms by which it does so 23. McGuire MK (1991) Prognosis versus actual outcome: a long-term survey of 100 treated periodontal patients under maintenance care. The bone loss has to be seen in relation to root length. Endo-periodontal lesions are bacterial infectious diseases involving both the periodontal and pulp tissues with poor outcomes. In an effort to improve one’s prognostic skill, one should make a conscious effort to keep on re-evaluating the patient over a long period of time so that factors that influence the success or failure of therapy can be identified and analyzed. Increasing bone loss is associated with an increase in tooth mobility. It has been generally assumed that there is a paucity of knowledge on periodontal prognosis. The periodontal status of the tooth is influenced by local and/or systemic factors that cannot be controlled. Let us now discuss in detail the factors affecting the prognosis of teeth. J Periodontal 62:51–58 Google Scholar 21. It is estimated that 47% of people older than age 30 have some form of periodontal […] Prognosis. As we know that periodontal disease progresses in an episodic manner, the active period is associated with signs and symptoms of disease activity, whereas the inactive period does not demonstrate signs and symptoms of the disease. These percentages were much higher for questionable prognosis: the TLPD prediction failed in between 37% and 74% of cases (Becker et al., 1984; McFall, 1982; McGuire & Nunn, 1996). Patients who show a severe response to the minimal amount of plaque accumulation have a poor prognosis. 10. A tooth with an endodontic-periodontal lesion can be categorized as having a hopeless, poor, or favourable prognosis. The tradition-al systems were based on tooth mortality19 and did not look at the possibility of classify-ing a tooth’s prognosis, based on the ability to control the disease process and success- The bone loss has to be seen in relation to root length. It refers to the prognosis of the teeth based on the sum of various local, systemic, environmental and other factors which may affect the overall periodontal health of the teeth. Initial furcation involvement can be treated with non-surgical and surgical periodontal therapy and responds well to the treatment. Contents available in the book ……….. It is the prognosis of the teeth after an appropriate periodontal treatment is provided. Five sub categories. One classification of prognosis classifies it as diagnostic, therapeutic or prosthetic prognosis and the other classification classifies it as the individual and overall prognosis. In general, teeth with shallow periodontal pockets have a better prognosis than teeth with deep pockets (8 mm or more). Int J Periodontics Restorative Dent 2:65–70 PubMed Google Scholar. Very Good Good Fair Poor ... effective removal of ___ on a daily basis by the patient is critical to the success of periodontal therapy and to the prognosis. The presence of complex pockets encompassing multiple root surfaces is a poor prognostic factor than the presence of simple pockets. In addition, assignment of good, long-term prognoses is critical to reliably determining an appropriate restorative treatment plan following periodontal therapy, particularly if major prosthetic reconstruction or placement of dental implants is under consideration. I. The presence of pseudo-pockets is a good prognostic factor as these represent increase in the size of soft tissue only . Appropriate endodontic treatment improves the prognosis of the tooth. Contents available in the book …….. Prognosis is an integral part of the periodontal practice because it directly influences treatment planning. Categories of prognosis proposed by McGuire (1991) 2 and Kwok and Caton (2007) 32 are given in the following tables. Contents available in the book …….. … Contents available in the book …….. … Contents available in the book …….. Contents available in the book …….. Simple periodontal treatments can halt the progression of periodontal diseases and in a well-motivated patient, the prognosis becomes favorable. The broad occlusal surface is a bad prognostic factor as it may cause increased tooth mobility. The classification includes systemic modifying factors thus recognizing the role of factors such as diabetes and smoking on the onset and progression of periodontal disease. Recently, McGowan et al. The treatment may vary from primary periodontal treatment for stopping the disease progression to regenerative procedures. Patient keeping tooth or not. Contents available in the book ……….. Methods . Endodontic examination serves to improve treatment planning, performance, and prognosis. Contents available in the book …….. 2004 Feb;34(1):165-203. It also refers to the determination of whether the prosthesis to be planned shall be therapeutic or detrimental. Background . Periodontal Prognosis Friday, January 16, 2015 1:00 PM Exam 2 Page 1 ... McGuire Nunn Classification - based on tooth loss. Very Good Good Fair Poor Hopeless. Multi-rooted teeth with flared roots have a better prognosis than teeth with close together or fused roots. The effectiveness of clinical parameters in developing an accurate prognosis. The presence of developmental structures such as enamel projections and developmental grooves worsen the prognosis of the involved tooth. It has been demonstrated by various studies (see chapter 35), that traumatic occlusal forces combined with inflammation can cause increased bone loss and attachment loss. El pronóstico es una predicción del curso de la enfermedad. Currently, there is no accepted comprehensive, standardized, and meaningful classification system for the evaluation of individual teeth that offers a common language for dental professionals. Several studies 10-17 reported the prevalence of cervical enamel projections ranging from 8.6 % to 85 %. The classification includes systemic modifying factors thus recognizing the role of factors such as diabetes and smoking on the onset and progression of periodontal disease. (adsbygoogle = window.adsbygoogle || []).push({}); Individual tooth prognosis referrers to the prognosis of an individual tooth, based on local and prosthetic/restorative factors that have a direct effect on its prognosis. The AAP states that clinical attachment loss (CAL) should be used to initially stage periodontal disease, but, if not available, then radiographic bone loss can be used in its place. Contents available in the book ……….. <> Other systemic factors which affect the overall prognosis include multi-vitamin deficiency, hyperthyroidism, hyperparathyroidism, Parkinson’s disease, autism and other conditions related to mental retardation. As already stated, the overall prognosis is the sum of multiple factors that have a direct or indirect relationship with periodontal disease progression. Problem List- Systemic Conditions (diabetes), risk factors (smoking), clinical findings, secondary finding (overhangs, etc) SJ 31/32 Posterior proximal 5. If the cause of tooth mobility can be eliminated (such as, trauma from occlusion) the mobility reduces and the, Furcation involvement is usually seen in the first upper and lower molars. Abnormal occlusal forces and parafunctional habits may cause injury to the periodontal apparatus. In teeth, with short roots, a small amount of bone loss may create a significant difference, whereas a large amount of bone loss around long roots may not result in significant loss of support. This website is a small attempt to create an easy approach to understand periodontology for the students who are facing difficulties during the graduation and the post-graduation courses in our field. Hence, it is difficult to establish a prognosis for the patient. Category Definition very good <25% attachment loss good 25% attachment loss and/or class I furcation involvement Periodontal diseases are disease processes involving the periodontium, a term used to describe the supportive apparatus surrounding a tooth, which includes the gums (gingiva), alveolar bone, cementum, and periodontal ligament. In teeth, with short roots, a small amount of bone loss may create a significant difference, whereas a large amount of bone loss around long roots may not result in significant loss of support. Contents available in the book …….. … Contents available in the book …….. … Contents available in the book …….. Periodontol 2000, 58 (1) (2012), pp. The tooth level factors include ratio of bone loss: age, periodontal pocket depth, extent of furcation involvement, presence of an infrabony defect, compromising anatomical factors and the extent of tooth mobility. In patients who respond well to the treatment the prognosis improves, whereas in patients where results of treatment are not as expected, the prognosis may worsen. What does good mean in the Becker, Berg, and Becker include? Contents available in the book ……….. Start studying (2) Perio--Periodontal Prognosis. Long-standing endodontic involvement may result in the formation of a periapical lesion. Categories of prognosis proposed by, Whether to retain or extract the involved tooth, After critically analyzing the tooth-related and patient-related factors, the decision about retaining or extracting a tooth should be made. When comparing two patients, one 30 years old and another 65 years old having a similar periodontal bone loss, the younger patient has a poor prognosis as compared to the older patient. Journal of periodontology. Optimal management of periodontally diseased molar requires precise and reliable means to assess their prognosis. Although it is very difficult to predict the exact prognosis of the tooth, but if careful examination of the dentition and patient as a whole is done, one can establish a quite accurate prognosis. ... A system for assigning periodontal prognosis. Center of tooth rotation should also be considered along with crown-root ratio. Quizlet flashcards, activities and games help you improve your grades. Table 1 Classification of prognosis after McGuire (1991). }���5\�5T����� Both diseases are thought to share a common pathogenesis that involves an enhanced inflamma-tory response that can be observed at the local and systemic level 18-21. In patients with slow disease progression, the prognosis of teeth is always better than those with rapid disease progression. J. Periodontol. 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