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Common Prognostic Systems adopted in RSDM clinic
Kwok and Caton, 2007: Favorable, questionable, unfavorable, hopeless (extraction needed)
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Length of the prediction:
- • short term < 5 years
- • long term > 5 years
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When is prognosis established?
- after the diagnosis is made
- before the treatment plan is established
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Prognosis is a prediction of the probable course, duration, and _______ of a disease based on a general knowledge of the pathogenesis of the disease and the presence of _______ for the disease.
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Deep probing depths > 5mm
- susceptible to future periodontal breakdown
- found after phase I, require surgical management (phase II)
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Most important single factor in prognosis:
- Osseous Defect Morphology
- 3 wall -> good prognosis
- 1 and 2 wall -> unfavorable
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Relationship between mobility and periodontal prognosis is still unclear.
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Smoking cause
- Systemical alteration of host response, impaired
- immune defense against pathogens and interferes w/ collagen metabolism
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Among all systemic conditions, periodontitis is most strongly associated with _______ and the end result usually is ______.
- neutrophil disorders
- tooth loss
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Severe aggressive periodontal breakdown is associated
- with Neutrophil Dysfunctions such as
- • Chediak-Higashi syndrome,
- • Chronic granulomatous disease,
- • Chronic neutropenias,
- • Papillon-Lefe`vre syndrome,
- • Down syndrome
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Phenytoin, Nifedipine, and Cyclosporin
- • induce gingival hyperplasia
- • not related directly to periodontal breakdown
- • cause deep pockets and interfere with plaque control.
- Recurrence is likely if the medication cannot be changed.
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Prosthetic Considerations
- Adequate amount of periodontal support for the overall prosthetic design
- Insufficient attachment & structural deficiencies – cannot be used for definitive prosthetics
- Hopeless situation - Tooth has to be extracted
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Therapeutic Prognosis
- Establishing after rendering treatment
- • Ability to control systemic factors
- • Ability to eliminate/control local factors
- • Reduction in inflammation after Phase I
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