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DETERMINATION OF PROGNOSIS
Prediction of duration, course, and termination of a disease and its response to
treatment.
Must be determined after the diagnosis is made and before
treatment is planned.
PERIODONTAL PROGNOSIS
Overall
and
Individual teeth
OVERALL PROGNOSIS
Should treatment be undertaken?
Is it likely to succeed?
Are the remaining teeth able to support the added burden
of needed prosthetics?
SLOWLY PROGRESSIVE PERIODONTITIS
directly related to severity of inflammation and the height
of remaining bone.
Better prognosis for the patient with greater
inflammation
RAPIDLY PROGRESSIVE PERIODONTITIS
difficult to form prognosis
leukocyte defects
some cases respond to conventional therapy plus
antibiotics
No methods to predict
REFRACTORY PERIODONTITIS
Usually resistant to treatment
JUVENILE PERIODONTITIS
Prognosis is usually poor
AGE
Two patients with the same amount of destruction -
prognosis is better for older patient.
SYSTEMIC BACKGROUND
Prognosis improves with correction of systemic
problem
MALOCCLUSION
interferes with plaque control
SMOKING
direct relationship exists between smoking and
gingivitis and periodontitis
Smoking cessation improves prognosis and
predictability of treatment
PATIENT COOPERATION
Patient must desire to retain natural teeth and have
willingness and ability to maintain oral hygiene
PROGNOSIS FOR INDIVIDUAL TEETH
Determined after overall prognosis
Consider the following for prognosis of individual
teeth:
MOBILITY
Caused by bone loss
trauma from occlusion and inflammation
Prognosis is worse if mobility is from bone loss
PERIODONTAL POCKETS
level of attachment
degree of bone loss
type of pocket
MUCOGINGIVAL PROBLEMS
lack of attached gingiva
prognosis is poor unless corrected
FURCATION INVOLVEMENT
difficulty of access by operator and patient
if these can be corrected then prognosis is similar to
single rooted tooth
TOOTH MORPHOLOGY
Prognosis is poor for teeth with short tapered roots and
large crowns
Root concavities
Developmental grooves
Enamel projections
TEETH ADJACENT TO EDENTULOUS AREAS
abutments have more functional demands
special oral hygiene
EXCELLENT PROGNOSIS - no bone loss, excellent gingival condition, adequate patient
cooperation
GOOD PROGNOSIS - one or more of the following:
adequate remaining bone support; adequate
possibilities to control etiologic factors and
establish a maintainable dentition; adequate patient cooperation
FAIR PROGNOSIS - one ore more of the following; less than adequate remaining bone support, some tooth mobility, grade I furcation
involvement, adequate maintenance possible,
acceptable patient cooperation
POOR PROGNOSIS - one or more of the following: moderate to advanced
bone loss, tooth mobility, grade I and II furcation
involvements, difficult-to-maintain areas and/or
doubtful patient compliance
QUESTIONABLE PROGNOSIS - one or more of the following: advanced bone loss, grade II
and III furcation involvements, tooth mobility,
inaccessible areas.
HOPELESS PROGNOSIS - one or more of the following:
advanced bone loss, nonmaintainable areas, extractions indicated