Perio 18 - Periodontal Maintenance (Dr. Shaikh)

phase I

These are objectives to check at the re-evaluation appointment following which phase?

- Assess tissue response to therapy

- Gingival condition

- Pocket depths etc.

- To asses patients compliance with OHI

- Plaque and bleeding index

- Review OHI

- To assess need /advisability for further periodontal therapies

4-6 weeks

A re-evaluation appt is needed how many weeks after SRP?

2 weeks

A re-evaluation appt is needed how many weeks after prophylaxis?

surgical

These are indications that which phase is needed?

- Inflammation subsequent to initial therapy

- Pocket depth

- Osseous and furcation defects

- Gingival enlargement

- Inadequate bop logic width Mucogingival defects

surgery

After evaluation of initial therapy, if there are deep pockets remaining, what is most likely needed?

recall appt

After evaluation of initial therapy, everything looks good and no surgery or retreatment are needed, what is the next step?

retreatment (potential SRP)

After evaluation of initial therapy, there is still calculus remaining, what is the next step?

periodontal maintenance

Which stage of periodontal treatment?

- Procedures performed at selected intervals to assist periodontal pt maintain oral health

true

T/F: As part of periodontal therapy, an interval is established for periodic ongoing care. Maintenance procedures are under the supervision of the dentist and typically include an update of the...

- Medical and dental histories

- Radiographic review

- Extra oral and intra oral soft tissue examination

- Dental examination

- Periodontal evaluation

- Removal of bacterial flora from crevicular and pocket areas

- Scaling and root planing where indicated

- Polishing of the teeth

- A review of the patients plaque control efficacy

- Assessment of disease status

- Treatment

- Communication and planning future maintenance visits

False - not the same as prophylaxis

T/F: Periodontal maintenance appts following active periodontal therapy are synonymous with prophylaxis

SRP

An __________ is only done every 2 years on an active periodontitis patient

SRP (NEED a history of SRP for periodontal maintance)

What must happen before a patient is in periodontal maintenance stage?

periodontal maintenance

This is the main goal of what?

- To prevent or minimize the recurrence and progression of periodontal disease in patients who have been previously treated for periodontal diseases

periodontal maintenance

These are other goals of what?

- To prevent or reduce the incidence of tooth loss by monitoring the dentition and any prosthetic replacements of the natural teeth

- To increase the probability of locating and treating, in a timely manner, other diseases or conditions within the oral cavity

inversely

Is tooth loss inversely or directly proportional to frequency of periodontal maintenance?

true

T/F: These are all procedures that can occur at a PM appt

- Removal of supra and sub gingival plaque and calculus

- Behavior Modification

- Selective scaling or root planing

- Occlusal Adjustment

- Root Desensitization

- Use of systemic antibiotics

- Surgical Therapy

no treatment

When re-treating during a PM appt, if there is poor plaque control, what is the treatment option?

non-surgical treatment

When re-treating during a PM appt, if there is a single site that needs tx, what is the treatment option?

surgical treatment

When re-treating during a PM appt, if there is continued inflammation, what is the treatment option?

SRP and antibiotics OR surgery

When re-treating during a PM appt, if there is attachment loss, what is the treatment option?

occlusal adjustment

When re-treating during a PM appt, if there is increased mobility, what is the treatment option?

1-3 months (4x per year)

How often are you seeing this patient for PM appts?

- Generally poor results after periodontal therapy and/or several negative factors are present

4-6 months (2-3x per year)

How often are you seeing this patient for PM appts?

- Good results maintained reasonably well for 1 year or more but pt displays some of the negative factors

- Patients with history of periodontitis

6-12 months (2x per year)

How often are you seeing this patient for PM appts?

- Excellent results well maintained for 1 year or more

- Most patients present with gingivitis with no history of attachment loss

- Is there recurrence or progression of periodontal disease?

- Is patient compliant?

- Is home care effective?

- Has patient refused proposed treatment plan?

- Are risk factors present?

- Are negative factors present?

How can you determine the frequency of a PM?

Negative factors

What are all of the following?

- Inconsistent or poor oral hygiene/ heavy calculus formation

- Systemic disease that predisposes to periodontal breakdown

- Many remaining pockets

- Occlusal problems

- Complicated prosthesis

- Recurrent dental caries

- Periodontal surgery indicated but nor performed

- Many teeth with

16%

What percent of patients comply with PM?

49%

What percent of patients comply erratically (miss 1-2 appts) with PM?

34%

What percent of patients never reported for PM?