This document discusses factors that are considered when determining a prognosis for periodontal disease. It outlines different types of prognoses from excellent to hopeless based on factors like bone loss and furcation involvement. Overall clinical factors like age, disease severity, plaque control, and patient compliance are discussed. Systemic factors like smoking and genetic factors are also outlined. Local factors like plaque, calculus, and subgingival restorations are covered. The relationship between prognosis and restorative and prosthetic needs is also summarized.
This document discusses factors involved in determining the prognosis of periodontal disease. It defines prognosis as the prediction of the probable course and outcome of a disease. Prognosis is determined after diagnosis and before treatment planning. It is influenced by the patient's history, risk factors, response to previous treatment, and the clinician's experience. The document outlines various factors to consider like patient age, disease severity, plaque control, systemic conditions, smoking, stress, anatomic factors, mobility, restorations, and response to initial therapy. Both overall prognosis for the dentition and individual tooth prognosis are important. The prognosis can be reevaluated after treatment.
DETERMINATION OF PROGNOSIS IN PERIODONTICS.pptxKanchanMane4
The document discusses the determination and classification of periodontal prognosis. Prognosis is made based on specific disease information, risk factors, and treatment history. It is classified as good, fair, poor, questionable or hopeless. Factors like attachment loss, bone loss, furcation involvement, and mobility affect individual tooth prognosis, while age, medical history and oral hygiene impact overall prognosis. A provisional prognosis allows reevaluation after initial treatment. Smoking, genetics and stress influence prognosis. Prognosis of specific diseases like chronic periodontitis and aggressive periodontitis are discussed. Reevaluation after treatment can update the original prognosis.
The document discusses the determination of prognosis and phases of periodontal treatment. It defines prognosis as a prediction of the probable course and outcome of a disease based on knowledge of pathogenesis and risk factors. Prognosis is determined by specific disease information and treatment options, and can be influenced by clinical experience. Prognosis is re-evaluated over time. Factors like attachment loss, furcation involvement, tooth mobility, and patient compliance impact the prognosis, which can be good, fair, poor, or questionable. Periodontal treatment involves preliminary, nonsurgical, surgical, restorative, and maintenance phases to eliminate etiological factors, control disease, and stabilize the periodontal condition. The response to initial therapy further informs the accuracy
Periodontal risk & making risk assessmentibrahimaziz15
Periodontal risk and risk assessment is very importnant in monitoring periodontally affected patients, this seminar will give you an idea about periodontal risk factors and how to make a periodontal risk assessment for patients.
This document discusses factors that determine prognosis in periodontal disease treatment. It defines prognosis as predicting the course and outcome of a disease based on general knowledge of pathogenesis and risk factors. Prognosis depends on overall factors like type and severity of periodontitis, age, systemic conditions, and individual factors like percentage of bone loss, pocket depth, and furcation involvement. A patient's prognosis can range from excellent to hopeless depending on these factors. The document provides details on how factors affect prognosis and clinical implications for determining prognoses as good, fair, poor, questionable or hopeless.
This document outlines the process and factors involved in diagnosing and determining the prognosis of periodontal diseases. Diagnosis involves a thorough medical and dental history, clinical examination including probing, radiographs, and other tests to determine the type, extent, severity and cause of periodontal disease present. The prognosis takes into account disease severity and extent, oral hygiene ability, systemic factors like smoking, genetic risks, and anatomic and restorative challenges that could impact treatment outcomes. Prognosis can range from excellent to hopeless depending on these various clinical factors.
The document discusses factors that determine the prognosis of periodontal disease and dental treatment. It identifies local factors like plaque, calculus and tooth anatomy as well as systemic factors like smoking and genetics. The prognosis can be excellent, good, fair, poor or questionable depending on the number of risk factors present and their severity. Overall prognosis influences the prognosis of individual teeth.
This document discusses prognosis in periodontal disease. Prognosis is the prediction of the probable course and outcome of a disease based on knowledge of pathogenesis and risk factors. It is determined before treatment based on disease characteristics and previous experience. Prognosis can be excellent, good, fair, poor, questionable or hopeless depending on factors like bone loss, furcation involvement, and patient compliance. Systemic factors like smoking and diabetes can affect prognosis. Anatomical root characteristics also influence prognosis. The relationship between diagnosis and prognosis is discussed.
This document discusses factors involved in determining the prognosis of periodontal disease. It defines prognosis as the prediction of the probable course and outcome of a disease. Prognosis is determined after diagnosis and before treatment planning. It is influenced by the patient's history, risk factors, response to previous treatment, and the clinician's experience. The document outlines various factors to consider like patient age, disease severity, plaque control, systemic conditions, smoking, stress, anatomic factors, mobility, restorations, and response to initial therapy. Both overall prognosis for the dentition and individual tooth prognosis are important. The prognosis can be reevaluated after treatment.
DETERMINATION OF PROGNOSIS IN PERIODONTICS.pptxKanchanMane4
The document discusses the determination and classification of periodontal prognosis. Prognosis is made based on specific disease information, risk factors, and treatment history. It is classified as good, fair, poor, questionable or hopeless. Factors like attachment loss, bone loss, furcation involvement, and mobility affect individual tooth prognosis, while age, medical history and oral hygiene impact overall prognosis. A provisional prognosis allows reevaluation after initial treatment. Smoking, genetics and stress influence prognosis. Prognosis of specific diseases like chronic periodontitis and aggressive periodontitis are discussed. Reevaluation after treatment can update the original prognosis.
The document discusses the determination of prognosis and phases of periodontal treatment. It defines prognosis as a prediction of the probable course and outcome of a disease based on knowledge of pathogenesis and risk factors. Prognosis is determined by specific disease information and treatment options, and can be influenced by clinical experience. Prognosis is re-evaluated over time. Factors like attachment loss, furcation involvement, tooth mobility, and patient compliance impact the prognosis, which can be good, fair, poor, or questionable. Periodontal treatment involves preliminary, nonsurgical, surgical, restorative, and maintenance phases to eliminate etiological factors, control disease, and stabilize the periodontal condition. The response to initial therapy further informs the accuracy
Periodontal risk & making risk assessmentibrahimaziz15
Periodontal risk and risk assessment is very importnant in monitoring periodontally affected patients, this seminar will give you an idea about periodontal risk factors and how to make a periodontal risk assessment for patients.
This document discusses factors that determine prognosis in periodontal disease treatment. It defines prognosis as predicting the course and outcome of a disease based on general knowledge of pathogenesis and risk factors. Prognosis depends on overall factors like type and severity of periodontitis, age, systemic conditions, and individual factors like percentage of bone loss, pocket depth, and furcation involvement. A patient's prognosis can range from excellent to hopeless depending on these factors. The document provides details on how factors affect prognosis and clinical implications for determining prognoses as good, fair, poor, questionable or hopeless.
This document outlines the process and factors involved in diagnosing and determining the prognosis of periodontal diseases. Diagnosis involves a thorough medical and dental history, clinical examination including probing, radiographs, and other tests to determine the type, extent, severity and cause of periodontal disease present. The prognosis takes into account disease severity and extent, oral hygiene ability, systemic factors like smoking, genetic risks, and anatomic and restorative challenges that could impact treatment outcomes. Prognosis can range from excellent to hopeless depending on these various clinical factors.
The document discusses factors that determine the prognosis of periodontal disease and dental treatment. It identifies local factors like plaque, calculus and tooth anatomy as well as systemic factors like smoking and genetics. The prognosis can be excellent, good, fair, poor or questionable depending on the number of risk factors present and their severity. Overall prognosis influences the prognosis of individual teeth.
This document discusses prognosis in periodontal disease. Prognosis is the prediction of the probable course and outcome of a disease based on knowledge of pathogenesis and risk factors. It is determined before treatment based on disease characteristics and previous experience. Prognosis can be excellent, good, fair, poor, questionable or hopeless depending on factors like bone loss, furcation involvement, and patient compliance. Systemic factors like smoking and diabetes can affect prognosis. Anatomical root characteristics also influence prognosis. The relationship between diagnosis and prognosis is discussed.
The document discusses factors involved in determining the prognosis and treatment plan for periodontal disease. It defines prognosis as a prediction of the course and outcome of a disease based on risk factors. Several types of prognoses are described from excellent to poor based on remaining bone support, tooth mobility, furcation involvement, maintenance difficulties, and presence of systemic/environmental factors. Both overall and individual tooth prognoses are considered based on patient age, disease severity, plaque control, compliance, smoking, systemic disease, genetic factors, subgingival restorations, and anatomic root factors. A favorable prognosis requires adequate bone support, control of etiologic factors, patient cooperation and absence of negative systemic influences.
This document provides an overview of periodontal prognosis, including definitions, types of prognosis, and factors that influence prognosis determination. Key factors include overall clinical factors like age, disease severity and plaque control; systemic/environmental factors like smoking and systemic diseases; local factors like plaque, calculus and tooth anatomy; and prosthetic/restorative factors. The relationship between diagnosis and prognosis is also discussed. Prognosis depends on the diagnosis and condition, with generally good prognosis for gingivitis if plaque is removed, and varying prognosis for periodontitis depending on additional risk factors.
This document provides an overview of risk assessment for periodontal disease. It defines key terms like risk factors, risk indicators, and risk predictors. It discusses several accepted risk elements for periodontal disease like tobacco smoking, diabetes, pathogenic bacteria, tooth deposits, and genetic factors. For each risk element, it provides details on how they increase the risk of periodontal disease based on clinical studies and biological mechanisms. The goal of risk assessment is to help predict a patient's risk and allow early identification and targeted treatment.
This document discusses factors that determine the prognosis of periodontal diseases. It outlines several categories of factors: overall clinical factors like patient age and disease severity; systemic/environmental factors like smoking and genetic predispositions; local factors like plaque, subgingival restorations, and anatomic considerations; and prosthetic/restorative factors. Within each category, specific factors are described in detail and their impact on prognosis is explained. The relationship between diagnosis and prognosis is also addressed. Different periodontal diseases like chronic periodontitis and aggressive periodontitis are discussed in terms of their typical prognosis.
This document discusses personalized periodontology and precision medicine approaches in periodontal treatment. It makes the following key points:
1. Precision or personalized medicine in periodontics uses biomarkers to predict periodontal disease susceptibility, determine optimal treatment, and enhance outcomes. This stratifies patients based on risk factors and biological markers.
2. Various genetic and inflammatory biomarkers can predict risk, diagnose disease severity, and monitor treatment effectiveness. Combinations of multiple biomarkers are more accurate than single biomarkers.
3. A study by Giannobile stratified over 5,000 patients by risk factors like smoking and diabetes to predict tooth loss outcomes over 16 years. High-risk patients had worse outcomes.
4. Personalized approaches show promise
This document discusses prognosis in periodontics. It begins by defining prognosis and distinguishing it from related terms. It describes different types of prognoses, such as short-term versus long-term, and classifications like good, fair, poor, and hopeless. The document outlines factors that determine prognosis, including overall clinical factors, local anatomic factors, systemic/environmental factors, and restorative factors. Specific examples like age, disease severity, plaque control, smoking, and furcation involvement are provided. The relationship between diagnosis and prognosis is also addressed.
Valoracion del riesgo en enfermedad periodontalOscar Aparco
This document discusses risk assessment for periodontal disease. It begins by defining risk assessment and identifying its importance in clinical decision making. It then describes various risk factors that can increase one's risk of developing periodontal disease, including age, tobacco use, diabetes, stress, genetics, pregnancy, cardiovascular disease, and poor oral hygiene. The document outlines approaches to performing risk assessment at the patient, mouth, tooth, and site levels. It discusses some tools that can aid in risk assessment, such as the Oral Health Information Suite and Periodontal Risk Calculator.
This document summarizes various risk factors associated with periodontal disease. It discusses both modifiable and non-modifiable risk factors such as smoking, diabetes, stress, drugs, systemic diseases, nutrition, genetics, socioeconomic status, and gender. Specific conditions like type 1 and type 2 diabetes are explained in more detail. The relationship between periodontal disease and various systemic conditions is also covered briefly.
This document summarizes various risk factors associated with periodontal disease. It discusses both modifiable and non-modifiable risk factors such as smoking, diabetes, stress, drugs, systemic diseases, nutrition, genetics, socioeconomic status, and gender. Specific conditions like type 1 and type 2 diabetes are explained in more detail. The relationship between periodontal disease and various systemic conditions is also covered briefly.
This document discusses prognosis and treatment planning in periodontology. It defines prognosis as the prediction of the course and outcome of a disease based on risk and prognostic factors. Prognosis is determined after diagnosis and before establishing a treatment plan. A treatment plan outlines the short, intermediate, and long-term goals of therapy to eliminate infection, restore tissue, and maintain oral health through prevention and supportive care over many years. The prognosis and success of treatment depends on factors like disease severity, biofilm control, patient compliance, systemic health, and local anatomical considerations.
The document discusses the history and evolution of periodontal prognosis systems. Traditional systems assigned prognosis based on anatomical factors like bone loss and mobility, but did not consider systemic factors. More recent systems provide more detailed classifications of individual tooth prognosis as favorable, questionable, unfavorable or hopeless based on probability of maintaining periodontal stability. Prognosis is influenced by local factors like attachment loss and furcation involvement as well as patient compliance with maintenance and systemic factors like smoking and diabetes.
This document discusses various risk factors and determinants for periodontal disease, including smoking, diabetes, pathogenic bacteria, dental deposits, genetic factors, and age. It provides details on how each of these can increase the risk of developing periodontal disease, such as by inhibiting immune response, altering inflammation, or increasing exposure to risk factors over a lifetime. The rationale for assessing risk is to help predict disease development, focus on early identification and treatment of at-risk patients, and inform clinical decision making.
This document discusses prognosis determination in periodontics. Prognosis is the prediction of disease outcome based on knowledge of risk factors and pathogenesis. It is determined before treatment and based on specific disease information, previous experience, and presence of local and systemic risk factors. Prognosis can be excellent, good, fair, poor, questionable or hopeless depending on factors like bone loss, patient cooperation, and control of etiologic factors. Both overall and individual tooth prognosis are affected by clinical, systemic/environmental, local, and prosthetic/restorative factors. Reevaluation of prognosis after initial therapy can provide a better prediction of treatment success or failure.
This document provides information on risk assessment for periodontal disease. It defines risk assessment and identifies various elements of risk, including risk factors, determinants, indicators, and predictors. Major risk factors discussed include tobacco use, diabetes, and specific pathogenic bacteria. Other risk determinants addressed are genetic factors, age, gender, socioeconomic status, and stress. The document also discusses models for clinical risk assessment, including assessing risk at the patient, mouth, tooth, and site levels. Current methods for risk assessment mentioned are the Periodontal Risk Calculator, Health Information Suite, Periodontal Assessment Tool, and Hexagonal Risk Diagram for Periodontal Risk Assessment.
This document discusses risk factors, determinants, indicators, and predictors for periodontal disease. It identifies the major risk factors as smoking, diabetes, and pathogenic bacteria. It also discusses genetic factors, age, gender, socioeconomic status, and stress as risk determinants. HIV/AIDS, osteoporosis, and infrequent dental visits are provided as examples of risk indicators. Previous history of periodontal disease and bleeding on probing are given as examples of risk predictors. The document concludes by noting that clinical risk assessment involves collecting data on a patient's medical history, dental history, and clinical presentation and analyzing this using a computer-based tool to identify patients at risk of periodontal disease.
This document discusses risk assessment in periodontal disease. It defines risk factors, determinants, indicators, and markers. Major risk factors discussed include smoking, diabetes, pathogenic bacteria, genetic factors, age, gender, and socioeconomic status. It also covers risk indicators like HIV/AIDS, osteoporosis, and infrequent dental visits. Recent advances in risk assessment tools are introduced, including the Oral Health Information Suite, Periodontal Risk Calculator, and the Hexagonal Risk Diagram for Periodontal Risk Assessment. Risk is assessed at the patient, mouth, tooth, and site levels.
The document discusses a risk-based approach to periodontal treatment planning and management. It advocates assessing patient, tooth, and site-specific risk factors to determine the appropriate level of treatment. These include factors like smoking, diabetes, probing depths, bleeding, inflammation, root anatomy, tooth function and importance. The approach aims to more aggressively treat high risk patients and sites in order to better resolve inflammation and prevent further tissue destruction and systemic impacts. Multiple debridement methods and more frequent maintenance are suggested for higher risk cases to maximize the chances of controlling inflammation.
Risk factors for periodontal disease can be divided into modifiable risk factors like smoking and diabetes, and non-modifiable risk determinants like genetics. The development of periodontitis depends on both the specific bacteria involved and an individual's risk factor profile. Major risk factors include smoking, diabetes, stress, certain drugs, systemic diseases, and nutrition. Genetics, socioeconomic status, and gender can also influence risk. A thorough patient history is important to identify all relevant risk factors to guide treatment planning and prognosis.
This document provides information on epithelial tissue and cell junctions. It discusses the general features of epithelial tissue, including that epithelial cells are closely packed with many cell junctions. It also describes the different types of epithelial tissue (simple vs stratified), the cell shapes (squamous, cuboidal, columnar), and locations in the body. The document further explains the structure and functions of the basement membrane and cell junctions, including occluding junctions, anchoring junctions, and communicating junctions. Key cellular adhesion molecules and proteins involved in different junction types are also outlined.
This document provides information about lymph nodes and the lymphatic system. It discusses the anatomy, embryology, histology, and physiology of lymph nodes and lymphatic drainage. Key points include:
- Lymph nodes act as filters for the lymphatic system and help fight infection. They are located along lymphatic vessels.
- The primary lymphoid organs are the bone marrow and thymus, where lymphocytes develop. Secondary lymphoid organs include the spleen, lymph nodes, tonsils, and skin.
- Lymph nodes have an outer cortex and inner medulla. Lymph enters through afferent vessels and exits through efferent vessels. High endothelial venules are found
The document discusses factors involved in determining the prognosis and treatment plan for periodontal disease. It defines prognosis as a prediction of the course and outcome of a disease based on risk factors. Several types of prognoses are described from excellent to poor based on remaining bone support, tooth mobility, furcation involvement, maintenance difficulties, and presence of systemic/environmental factors. Both overall and individual tooth prognoses are considered based on patient age, disease severity, plaque control, compliance, smoking, systemic disease, genetic factors, subgingival restorations, and anatomic root factors. A favorable prognosis requires adequate bone support, control of etiologic factors, patient cooperation and absence of negative systemic influences.
This document provides an overview of periodontal prognosis, including definitions, types of prognosis, and factors that influence prognosis determination. Key factors include overall clinical factors like age, disease severity and plaque control; systemic/environmental factors like smoking and systemic diseases; local factors like plaque, calculus and tooth anatomy; and prosthetic/restorative factors. The relationship between diagnosis and prognosis is also discussed. Prognosis depends on the diagnosis and condition, with generally good prognosis for gingivitis if plaque is removed, and varying prognosis for periodontitis depending on additional risk factors.
This document provides an overview of risk assessment for periodontal disease. It defines key terms like risk factors, risk indicators, and risk predictors. It discusses several accepted risk elements for periodontal disease like tobacco smoking, diabetes, pathogenic bacteria, tooth deposits, and genetic factors. For each risk element, it provides details on how they increase the risk of periodontal disease based on clinical studies and biological mechanisms. The goal of risk assessment is to help predict a patient's risk and allow early identification and targeted treatment.
This document discusses factors that determine the prognosis of periodontal diseases. It outlines several categories of factors: overall clinical factors like patient age and disease severity; systemic/environmental factors like smoking and genetic predispositions; local factors like plaque, subgingival restorations, and anatomic considerations; and prosthetic/restorative factors. Within each category, specific factors are described in detail and their impact on prognosis is explained. The relationship between diagnosis and prognosis is also addressed. Different periodontal diseases like chronic periodontitis and aggressive periodontitis are discussed in terms of their typical prognosis.
This document discusses personalized periodontology and precision medicine approaches in periodontal treatment. It makes the following key points:
1. Precision or personalized medicine in periodontics uses biomarkers to predict periodontal disease susceptibility, determine optimal treatment, and enhance outcomes. This stratifies patients based on risk factors and biological markers.
2. Various genetic and inflammatory biomarkers can predict risk, diagnose disease severity, and monitor treatment effectiveness. Combinations of multiple biomarkers are more accurate than single biomarkers.
3. A study by Giannobile stratified over 5,000 patients by risk factors like smoking and diabetes to predict tooth loss outcomes over 16 years. High-risk patients had worse outcomes.
4. Personalized approaches show promise
This document discusses prognosis in periodontics. It begins by defining prognosis and distinguishing it from related terms. It describes different types of prognoses, such as short-term versus long-term, and classifications like good, fair, poor, and hopeless. The document outlines factors that determine prognosis, including overall clinical factors, local anatomic factors, systemic/environmental factors, and restorative factors. Specific examples like age, disease severity, plaque control, smoking, and furcation involvement are provided. The relationship between diagnosis and prognosis is also addressed.
Valoracion del riesgo en enfermedad periodontalOscar Aparco
This document discusses risk assessment for periodontal disease. It begins by defining risk assessment and identifying its importance in clinical decision making. It then describes various risk factors that can increase one's risk of developing periodontal disease, including age, tobacco use, diabetes, stress, genetics, pregnancy, cardiovascular disease, and poor oral hygiene. The document outlines approaches to performing risk assessment at the patient, mouth, tooth, and site levels. It discusses some tools that can aid in risk assessment, such as the Oral Health Information Suite and Periodontal Risk Calculator.
This document summarizes various risk factors associated with periodontal disease. It discusses both modifiable and non-modifiable risk factors such as smoking, diabetes, stress, drugs, systemic diseases, nutrition, genetics, socioeconomic status, and gender. Specific conditions like type 1 and type 2 diabetes are explained in more detail. The relationship between periodontal disease and various systemic conditions is also covered briefly.
This document summarizes various risk factors associated with periodontal disease. It discusses both modifiable and non-modifiable risk factors such as smoking, diabetes, stress, drugs, systemic diseases, nutrition, genetics, socioeconomic status, and gender. Specific conditions like type 1 and type 2 diabetes are explained in more detail. The relationship between periodontal disease and various systemic conditions is also covered briefly.
This document discusses prognosis and treatment planning in periodontology. It defines prognosis as the prediction of the course and outcome of a disease based on risk and prognostic factors. Prognosis is determined after diagnosis and before establishing a treatment plan. A treatment plan outlines the short, intermediate, and long-term goals of therapy to eliminate infection, restore tissue, and maintain oral health through prevention and supportive care over many years. The prognosis and success of treatment depends on factors like disease severity, biofilm control, patient compliance, systemic health, and local anatomical considerations.
The document discusses the history and evolution of periodontal prognosis systems. Traditional systems assigned prognosis based on anatomical factors like bone loss and mobility, but did not consider systemic factors. More recent systems provide more detailed classifications of individual tooth prognosis as favorable, questionable, unfavorable or hopeless based on probability of maintaining periodontal stability. Prognosis is influenced by local factors like attachment loss and furcation involvement as well as patient compliance with maintenance and systemic factors like smoking and diabetes.
This document discusses various risk factors and determinants for periodontal disease, including smoking, diabetes, pathogenic bacteria, dental deposits, genetic factors, and age. It provides details on how each of these can increase the risk of developing periodontal disease, such as by inhibiting immune response, altering inflammation, or increasing exposure to risk factors over a lifetime. The rationale for assessing risk is to help predict disease development, focus on early identification and treatment of at-risk patients, and inform clinical decision making.
This document discusses prognosis determination in periodontics. Prognosis is the prediction of disease outcome based on knowledge of risk factors and pathogenesis. It is determined before treatment and based on specific disease information, previous experience, and presence of local and systemic risk factors. Prognosis can be excellent, good, fair, poor, questionable or hopeless depending on factors like bone loss, patient cooperation, and control of etiologic factors. Both overall and individual tooth prognosis are affected by clinical, systemic/environmental, local, and prosthetic/restorative factors. Reevaluation of prognosis after initial therapy can provide a better prediction of treatment success or failure.
This document provides information on risk assessment for periodontal disease. It defines risk assessment and identifies various elements of risk, including risk factors, determinants, indicators, and predictors. Major risk factors discussed include tobacco use, diabetes, and specific pathogenic bacteria. Other risk determinants addressed are genetic factors, age, gender, socioeconomic status, and stress. The document also discusses models for clinical risk assessment, including assessing risk at the patient, mouth, tooth, and site levels. Current methods for risk assessment mentioned are the Periodontal Risk Calculator, Health Information Suite, Periodontal Assessment Tool, and Hexagonal Risk Diagram for Periodontal Risk Assessment.
This document discusses risk factors, determinants, indicators, and predictors for periodontal disease. It identifies the major risk factors as smoking, diabetes, and pathogenic bacteria. It also discusses genetic factors, age, gender, socioeconomic status, and stress as risk determinants. HIV/AIDS, osteoporosis, and infrequent dental visits are provided as examples of risk indicators. Previous history of periodontal disease and bleeding on probing are given as examples of risk predictors. The document concludes by noting that clinical risk assessment involves collecting data on a patient's medical history, dental history, and clinical presentation and analyzing this using a computer-based tool to identify patients at risk of periodontal disease.
This document discusses risk assessment in periodontal disease. It defines risk factors, determinants, indicators, and markers. Major risk factors discussed include smoking, diabetes, pathogenic bacteria, genetic factors, age, gender, and socioeconomic status. It also covers risk indicators like HIV/AIDS, osteoporosis, and infrequent dental visits. Recent advances in risk assessment tools are introduced, including the Oral Health Information Suite, Periodontal Risk Calculator, and the Hexagonal Risk Diagram for Periodontal Risk Assessment. Risk is assessed at the patient, mouth, tooth, and site levels.
The document discusses a risk-based approach to periodontal treatment planning and management. It advocates assessing patient, tooth, and site-specific risk factors to determine the appropriate level of treatment. These include factors like smoking, diabetes, probing depths, bleeding, inflammation, root anatomy, tooth function and importance. The approach aims to more aggressively treat high risk patients and sites in order to better resolve inflammation and prevent further tissue destruction and systemic impacts. Multiple debridement methods and more frequent maintenance are suggested for higher risk cases to maximize the chances of controlling inflammation.
Risk factors for periodontal disease can be divided into modifiable risk factors like smoking and diabetes, and non-modifiable risk determinants like genetics. The development of periodontitis depends on both the specific bacteria involved and an individual's risk factor profile. Major risk factors include smoking, diabetes, stress, certain drugs, systemic diseases, and nutrition. Genetics, socioeconomic status, and gender can also influence risk. A thorough patient history is important to identify all relevant risk factors to guide treatment planning and prognosis.
This document provides information on epithelial tissue and cell junctions. It discusses the general features of epithelial tissue, including that epithelial cells are closely packed with many cell junctions. It also describes the different types of epithelial tissue (simple vs stratified), the cell shapes (squamous, cuboidal, columnar), and locations in the body. The document further explains the structure and functions of the basement membrane and cell junctions, including occluding junctions, anchoring junctions, and communicating junctions. Key cellular adhesion molecules and proteins involved in different junction types are also outlined.
This document provides information about lymph nodes and the lymphatic system. It discusses the anatomy, embryology, histology, and physiology of lymph nodes and lymphatic drainage. Key points include:
- Lymph nodes act as filters for the lymphatic system and help fight infection. They are located along lymphatic vessels.
- The primary lymphoid organs are the bone marrow and thymus, where lymphocytes develop. Secondary lymphoid organs include the spleen, lymph nodes, tonsils, and skin.
- Lymph nodes have an outer cortex and inner medulla. Lymph enters through afferent vessels and exits through efferent vessels. High endothelial venules are found
Dr. Sonam Rani presented on the topic of cementum to several professors and colleagues. Cementum is a calcified tissue that covers tooth roots and provides attachment for periodontal ligaments. It comes in several types classified based on cellularity, presence of fibers, and origin. Cementum is formed by cementoblasts and cementocytes and plays an important role in tooth adaptation and repair. Systemic conditions like Paget's disease and cleidocranial dysplasia can affect cementum formation and structure.
This document provides an overview of pain, including its definition, classification, theories, transmission and modulation pathways, assessment, and management approaches. It begins with definitions of pain from Dorland's Medical Dictionary and Monheim. It then classifies pain according to intensity, temporal relationship, qualities, onset, and localization. Theories of pain discussed include specificity, pattern, and gate control theories. It describes the dual nature of pain and the transduction, transmission, modulation, and perception of pain. It discusses referred pain and neuropathic pain. The document concludes by covering pain assessment tools and pharmacological and non-pharmacological management strategies.
COMMON SEMINAR STERILISATION, INFECTION CONTROL AND HOSPITAL MANAGEMENT.pptxmalti19
This document discusses sterilization, infection control, and hospital management in dentistry. It defines key terms like sterilization, disinfection, and asepsis. It then describes various methods of sterilization including physical methods like heat and radiation, and chemical methods like alcohols, phenols, aldehydes, halogens, and gases. The document provides details on specific sterilization techniques and protocols for sterilizing dental instruments used in different specialties. It emphasizes the importance of proper sterilization to prevent disease transmission between patients.
This document summarizes key concepts in immunology as they relate to periodontal disease. It discusses the epithelial barrier and pattern recognition receptors that detect pathogens. Inflammatory mediators recruit immune cells through chemotaxis. T lymphocytes develop and differentiate into subsets like Th1, Th2, Th17 that activate different immune responses. B cells produce antibodies through somatic hypermutation. Regulatory T cells control self-tolerance. The adaptive response becomes antigen-specific and develops memory. Dendritic cells present antigens to activate T cells. An imbalance in T cell subsets can lead to tissue destruction in periodontal disease.
Thrombosis, embolism, and infarction are related pathological processes involving blood clots. Thrombosis is the formation of a blood clot within a blood vessel, while embolism occurs when a piece of a clot breaks off and travels to another location. Infarction results from obstruction of blood flow by a clot, causing tissue death. The document discusses the mechanisms, types, features, and progression of thrombosis, embolism, and infarction. It also covers related topics like Virchow's triad, hypercoagulable states, fat embolism, and amniotic fluid embolism.
Thrombosis, embolism, and infarction are related pathological processes involving blood clots. Thrombosis is the formation of a blood clot within a blood vessel, while embolism occurs when a piece of a clot breaks off and travels to another location. Infarction results from obstruction of blood flow by a clot, causing tissue death. The document discusses the mechanisms, classifications, and morphological features of thrombosis, embolism, and infarction. It also covers related topics like Virchow's triad, hypercoagulable states, and the development and types of infarcts over time.
Immune responses in periodontal disease final.pptxmalti19
This document discusses the immune responses involved in periodontal disease. It begins by defining periodontitis as an infectious disease caused by anaerobic bacteria. Both bacteria and a susceptible host are required to cause disease. It then describes the pathogenesis which involves environmental and genetic risk factors interacting with the microbial challenge to activate the host immune response, resulting in inflammation and bone/tissue destruction. The document discusses the types of immunity, including innate and adaptive immunity. It covers topics such as dendritic cells, T-cell and B-cell roles, the roles of cytokines and RANKL in linking the immune response to bone loss, and hypotheses about the roles of the Th1 and Th2 responses in periodontitis.
This document provides an overview of antibiotics used in periodontics. It begins with an introduction to antibiotics and their historical background. It then covers classification of antimicrobial agents based on chemical structure, mechanism of action, organisms targeted, and spectrum of activity. Guidelines for antibiotic use in periodontal diseases are presented, along with the diseases where antibiotics can be used. Commonly used antibiotics like tetracycline, doxycycline, metronidazole, penicillin, and amoxicillin-clavulanate are described in detail. The document concludes with a reference to research on systemic antibiotic use in periodontics.
This document discusses evidence-based periodontology and decision making. It defines evidence-based periodontology as applying evidence-based healthcare to periodontology by integrating the best available evidence with clinical practice. The document outlines the steps of evidence-based periodontology, including asking questions using the PICO format, searching for and appraising evidence from systematic reviews and clinical practice guidelines, and applying the evidence to clinical decisions. It also discusses tools for critically assessing evidence, such as considering different levels of evidence and ensuring temporality between causes and effects.
Calcium and Phosphorous metabolism 23-03-23.pptxmalti19
Calcium and phosphorus metabolism is tightly regulated by vitamin D, parathyroid hormone, and calcitonin. Calcium is crucial for bone development, nerve function, and other processes. The recommended daily intake is 800 mg for adults. Dietary sources include dairy products, leafy greens, and fish. Absorption occurs in the small intestine and is influenced by vitamin D, PTH, and other factors. Hormonal signals work to maintain calcium levels within a narrow range. Disorders like rickets and osteomalacia can result from vitamin D deficiency. Precise regulation is needed to prevent hypercalcemia or hypocalcemia.
The document summarizes the anatomy and function of the muscles of mastication. It describes the three main muscles - masseter, temporalis, and medial and lateral pterygoid. It discusses their embryological development, nerve supply, actions, and clinical evaluation. The masseter muscle is palpated to assess for hypertrophy. Orthodontic treatment can impact the thickness of the muscles. The medial pterygoid muscle is also described in more detail, including its nerve supply by the mandibular nerve, blood supply, actions, and clinical examination.
The facial nerve emerges from the brainstem between the pons and medulla. It has motor, sensory, and parasympathetic secretomotor components. During embryonic development, it arises from the second branchial arch. The nerve passes through the internal acoustic meatus and facial canal within the temporal bone. It gives off several branches within the facial canal before exiting at the stylomastoid foramen. Its main branches in the face include the temporal, zygomatic, buccal, marginal mandibular, and cervical branches which innervate the muscles of facial expression.
1) PRP and PRF are platelet concentrates that provide growth factors that may enhance tissue regeneration.
2) Studies have shown PRP and PRF can increase the release of growth factors like PDGF, TGF-β1, and VEGF compared to control groups.
3) However, the evidence on whether PRP and PRF improve bone regeneration outcomes is mixed. Some studies found benefits for parameters like new bone formation and defect fill, while other studies found no additional benefits compared to control treatments.
This document discusses chlorhexidine, a commonly used chemical plaque control agent. It provides details on the history, chemistry, forms, mechanisms of action, products, clinical uses, toxicity and side effects of chlorhexidine. Chlorhexidine is a bisbiguanide antiseptic that is highly effective at inhibiting plaque formation and controlling gingivitis when used as a mouthrinse. It has a wide range of clinical applications and is generally well-tolerated, though long-term use can cause staining and changes to taste sensation in some individuals.
Oral hygiene and overall health
Department of Periodontology and oral Implantology
The document discusses the importance of oral hygiene for preventing dental diseases and maintaining overall health. It notes that over 3.5 billion people suffer from oral diseases according to the WHO, but many can be prevented through proper oral hygiene. Maintaining oral hygiene includes brushing teeth twice daily, flossing, cleaning the tongue, and visiting the dentist regularly. Poor oral hygiene can lead to dental caries, gum disease, and systemic issues like diabetes and heart disease.
Reducing fracture risk with Calcium and Vitamin D
Osteoporotic fractures are a major health problem that most commonly affect the spine and hip. Low calcium intake and vitamin D deficiency increase fracture risk by reducing bone mineral density and strength. Clinical trials show that calcium and vitamin D supplementation can reduce fracture risk, especially when vitamin D doses reach 800 IU daily and calcium intake reaches 1000-1200 mg. For older individuals, supplementation is most effective for those at high risk of deficiency living in nursing homes or with low dairy intake.
Antibiotics in the management of chronic periodontitis.pptmalti19
This document summarizes evidence on the use of adjunctive antibiotics for chronic periodontitis. A systematic review of 25 studies found some additional benefits of antibiotics in deep pockets, including 0.2-0.6 mm more attachment gain and 0.2-0.8 mm more probing depth reduction. However, the clinical relevance is uncertain given limitations in defining chronic periodontitis and its microbiota. Overall, current studies have not conclusively established benefits of adjunctive antibiotics, so they cannot be routinely indicated as adjuncts for chronic periodontitis.
The document discusses immediate dentures, which are complete or partial dentures fabricated immediately after tooth extraction. It describes the differences between conventional (classic) immediate dentures and interim (transitional) immediate dentures. Conventional immediate dentures are intended as the long-term prosthesis and are made when only anterior teeth remain. Interim immediate dentures are short-term and are made when posterior teeth remain, requiring only one surgical visit. The document outlines the procedures, indications, contraindications, advantages and disadvantages of both types of immediate dentures.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
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How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
2. Overview
Introduction and definition.
Types of prognosis
Overall versus individual tooth prognosis
Factors in determination of prognosis
Overall Clinical Factors
Systemic and Environmental Factors
Local Factors
Prosthetic and Restorative Factors
Relationship between diagnosis and prognosis
Prognosis for Patients with Gingival Disease
Prognosis for Patients with Periodontitis
Reevaluation of prognosis after phase-I therapy.
Conclusion
3. Definitions: Prognosis
1. The expected course of a disease.
2. The patient's chance of recovery.
The prognosis predicts the outcome of a disease
and therefore the future for the patient.
4. Diagnosis
The art or act of identifying a disease
from its signs and symptoms.
5. Prognosis vs. risk
Prognosis is often confused with
the term risk.
Risk generally deals with the
likelihood that an individual will
develop a disease in a specified
period.
6. Risk factors are those characteristics of
an individual that put the person at
increased risk for developing a disease.
In contrast, prognosis is the prediction
of the course or outcome of a disease.
7. Essential elements of prognosis
1. Intended outcome
2. Timing of the projection
3. Consideration of individual teeth versus
the overall dentition.
9. Good prognosis: One or more of the
following remaining:
Adequate Bone support
Adequate possibilities to control
etiologic factors & establish a
maintainable dentition
Adequate patient cooperation, no
systemic or environmental factors
10. Fair prognosis: One or more of the
following:
Adequate remaining bone support
Some tooth mobility
Grade I furcation involvement
Adequate maintenance possible
acceptable patient cooperation
11. 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 or
doubtful patient cooperation
.Presence of systemic
or environmental factors.
12. Questionable prognosis: One or more of the
following:
Advanced bone loss.
Grade II & III furcation involvements
Tooth mobility
Inaccessible areas
Presence of systemic or environmental factors
13. Hopeless prognosis: One or more of the
following:
Advanced bone loss
Non maintainable areas
Extraction needed
14. Excellent, good, and hopeless prognoses are
the only prognoses that can be established with
a reasonable degree of accuracy.
Fair, poor, and questionable prognoses depend
on a large number of factors that can interact in
an unpredictable number of ways.
20. Overall Clinical Factors
Patient Age.
The prognosis is generally better for
the older patients.
For the younger patient, the
prognosis is not as good because of
the shorter time frame in which the
periodontal destruction has
occurred.
21. Although the younger patient would
ordinarily be expected to have a greater
reparative capacity, the occurrence of so
much destruction in a relatively short
period would exceed any naturally
occurring periodontal repair.
22. Disease Severity
Following variables should be recorded
because they are important for determining
the patient's past history of periodontal
disease.
Pocket depth,
Level of attachment,
Degree of bone loss, and
Type of bony defect.
23. Plaque Control.
Bacterial plaque is the
primary etiologic factor
associated with periodontal
disease.
Therefore, effective removal
of plaque on a daily basis by
the patient is critical to the
success of periodontal therapy
and to the prognosis.
24. Patient Compliance and
Cooperation.
Prognosis for patients with
gingival and periodontal disease
is critically dependent on the
patient's attitude, desire to retain
the natural teeth, and willingness
and ability to maintain good oral
hygiene. Without these,
treatment cannot succeed.
25. Systemic and Environmental Factors
Smoking
Smoking may be the most
important environmental
risk factor impacting the
development and progression
of periodontal disease.
Smoking affects not only the
severity of periodontal
destruction, but also the
healing potential of the
periodontal tissues.
26. Prognosis in patients
who smoke and have
slight to moderate
periodontitis is
generally fair to poor.
Patients with severe
periodontitis, the
prognosis may be poor
to hopeless.
27. Smoking cessation can
affect the treatment
outcome and prognosis.
Patients with slight to
moderate periodontitis
who stop smoking can often
be upgraded to a good
prognosis, whereas those
with severe periodontitis
who stop smoking may be
upgraded to a fair
prognosis.
28. Systemic Disease or
Condition.
Patients diagnosed with
diabetes must be informed
of the impact of diabetic
control on the development
and progression of
periodontitis.
Prognosis in these cases
depends on patient
compliance relative to both
medical and dental status.
29. Similarly, in patients with
other systemic disorders
that could affect disease
progression, prognosis
improves with correction
of the systemic problem.
30. Genetic Factors
Genetic polymorphisms in the
interleukin-1 (IL-1) resulting in
increased production of IL- 1β
associated with a increase in
risk for severe, generalized,
chronic periodontitis.
31. The knowledge of the
patient's IL-1 genotype and
smoking status can aid the
clinician in assigning a
prognosis.
Genetic factors also appear to
influence serum
immunoglobulin G2 (IgG2)
antibody titers and expression
of FcyRII receptors on the
neutrophil, both of which may
be significant in aggressive
periodontitis.
32. Other genetic disorders, such as leukocyte
adhesion deficiency type 1, can influence
neutrophil function creating an additional risk
factor for aggressive periodontitis.
Finally, the familial aggregation that is
characteristic of aggressive periodontitis
indicates that additional, as yet unidentified,
genetic factors may be important in
susceptibility to this form of disease.
33. Detection of genetic variations linked
to periodontal disease can potentially
influence the prognosis in several ways.
First, early detection of patients at risk
because of genetic factors can lead to
early implementation of preventive and
treatment measures for these patients.
34. Second, identification of genetic risk
factors later in the disease or during the
course of treatment can influence
treatment recommendations, such as
use of adjunctive antibiotic therapy or
increased frequency of maintenance
visits.
35. Third, identification of young individuals
who have not been evaluated for
periodontitis, but who are recognized as
being at risk because of the familial
aggregation seen in aggressive
periodontitis, can lead to the development
of early intervention strategies.
In each of these cases, early diagnosis,
intervention, and alterations in the
treatment regimen may lead to an
improved prognosis for the patient.
36. Stress
Physical and emotional stress, as
well as substance abuse, may
alter the patient's ability to
respond to the periodontal
treatment performed.
These factors must be
realistically faced in attempting
to establish a prognosis.
37. Local Factors
Plaque and Calculus
The microbial challenge
presented by bacterial plaque
and calculus is the most
important local factor in
periodontal diseases.
Therefore, in most cases, having
a good prognosis depends on
the ability of the patient and the
clinician to remove these
etiologic factors.
38. Sub gingival Restorations.
Sub gingival margins
contribute to increased
plaque accumulation,
increased inflammation, and
increased bone loss when
compared with
supragingival margins.
Overhanging can negatively
impact the periodontium.
39. Anatomic Factors
Anatomic factors that may predispose the
periodontium to disease and therefore
affect the prognosis include
Short , tapered roots with large crowns,
Cervical enamel projections and enamel
pearls,
Intermediate bifurcation ridges,
Root concavities
Developmental grooves.
Root proximity and
Location and anatomy of furcations.
40. Tooth Mobility.
The principal causes of tooth
mobility are loss of alveolar
bone, inflammatory changes in
periodontal ligament, and
trauma from occlusion.
41. The stabilization of tooth
mobility through the use
of splinting may have a
beneficial impact on the
overall and individual
tooth prognosis.
42. Prosthetic and Restorative
Factors
The overall prognosis requires a
general consideration of bone
levels and attachment levels to
establish whether enough teeth
can be saved either to provide a
functional and aesthetic
dentition or to serve as
abutments for a useful
prosthetic replacement of the
missing teeth.
43. When few teeth remain, the
prosthodontic needs become more
important, and sometimes
periodontally treatable teeth may
have to be extracted if they are not
compatible with the design of the
prosthesis.
44. More rigid standards are required
when evaluating the prognosis of
teeth adjacent to edentulous
areas.
A tooth with a post that has
undergone endodontic treatment
is more likely to fracture when
serving as a distal abutment
supporting a distal removable
partial denture.
46. Caries, Nonvital Teeth, and
Root Resorption
For teeth mutilated by
extensive caries, the
feasibility of adequate
restoration and
endodontic therapy
should be considered
before undertaking
periodontal treatment.
47. The periodontal
prognosis of treated
nonvital teeth does
not differ from that
of vital teeth.
New attachment can
occur to the
cementum of both
nonvital and vital
teeth.
48. Relationship between diagnosis and prognosis
Factors such as patient age, severity of
disease genetic susceptibility, and
presence of systemic disease are
important criteria in the diagnosis of the
condition. These are also important in
developing a prognosis.
These common factors suggest that for
any given diagnosis there should be an
expected prognosis under ideal
conditions.
49. Prognosis for Patients with Gingival Disease
Dental Plaque-Induced Gingival
Diseases
Gingivitis Associated with
Dental Plaque only
Plaque-induced gingivitis is a
reversible disease that occurs when
bacterial plaque accumulates at the
gingival margin. This disease can
occur on a periodontium that has
experienced no attachment loss or on
a periodontium with nonprogressing
attachment loss.
50. In either case, the prognosis for
patients with gingivitis associated with
dental plaque only is good, provided all
local irritants are eliminated.
51. Plaque-Induced Gingival Diseases Modified by
Systemic Factors
The inflammatory response to
bacterial plaque at the gingival
margin can be influenced by
systemic factors, such as
endocrine-related changes
associated with puberty,
menstruation, pregnancy and
diabetes, and the presence of
blood dyscrasias.
52. In many cases the frank signs of gingival
inflammation that occur in these patients
are seen in the presence of relatively small
amounts of bacterial plaque.
Therefore the long term prognosis for
these patients depends not only on control
of bacterial plaque, but also on control or
correction of the systemic factors.
53. Plaque-Induced Gingival Diseases Modified by
Medications
Gingival diseases associated
with medications include
drug-influenced gingival
enlargement seen with
phenytoin, cyclosporine, and
Nifedipine and in oral
contraceptive-associated
gingivitis.
In drug-influenced gingival
enlargement, reductions in
dental plaque can limit the
severity of the lesions.
54. However, plaque control alone
does not prevent development
of the lesions. And surgical
intervention is usually
necessary to correct alterations
in gingival contour. Continued
use of the drug usually results in
recurrence of the enlargement
even after surgical intervention
.
Therefore long-term prognosis
depends on whether the
patient’s systemic problem can
be treated with an alternative
medication that does not have
gingival enlargements side
effect.
55. Gingival Diseases Modified by
Malnutrition
Although malnutrition has been
suspected to play a role in the
development of gingival diseases, most
clinical studies have not shown a
relationship between the two.
56. One possible exception is
severe vitamin C deficiency.
The prognosis in these
patients may depend on the
severity and duration of the
deficiency and on the
likelihood of reversing the
deficiency through dietary
supplementation.
57. Non-Plaque-lnduced Gingival Lesions
Non-plaque induced gingivitis can be
seen in patients with a variety of
bacterial, fungal, and viral infections.
Since gingivitis in these patients is not
usually attributed to plaque
accumulation, prognosis depends on
elimination of the source of the
infectious agent.
58. Prognosis for Patients with Periodontitis
Chronic Periodontitis.
Chronic periodontitis can
present in a localized or
generalized form.
In cases where clinical
attachment loss and bone loss
are not very advanced (slight to
moderate periodontitis), the
prognosis is generally good,
provided the inflammation can
be controlled through good oral
hygiene and the removal of
local plaque-retentive factors.
59. In patients with more severe
disease, as evidenced by
furcation involvement and
increasing clinical mobility,
or in patients who are
noncompliant with oral
hygiene practices, the
prognosis may be
downgraded to fair to poor.
60. Aggressive Periodontitis
Aggressive periodontitis can present in a
localized or a generalized form.
Two common features of both forms are
(1) Rapid attachment loss and bone
destruction in an otherwise clinically
healthy patient and
(2) Familial aggregation.
61. These patients also may present with
phagocyte abnormalities and a hyper
responsive monocyte/macrophage
phenotype.
These clinical, microbiologic, and
immunologic features would suggest that
patients diagnosed with aggressive
periodontitis would have a poor
prognosis.
62. However, when diagnosed
early, these cases can be
treated conservatively with
oral hygiene instruction and
systemic antibiotic therapy,
resulting in an excellent
prognosis.
When more advanced disease
occurs, the prognosis can still
be good if the lesions are
treated with debridement,
local and systemic antibiotics,
and regenerative therapy.
63. PAPILLON
LEFERVE
SYNDROM
E
Periodontitis as a Manifestation of Systemic
Diseases
PERIODONTITIS AS A MANIFESTATION OF SYSTEMIC DISEASES
PERIODONTITIS ASSOCIATED
WITH HEMATOLIGIC DISORDERS
PERIODONTITIS ASSOCIATED
WITH GENETIC DISORDERS
LEUKEMIA NEUTROPENIA
ACQUIRED
DOWN S
SYNDROME
64. Although the primary
etiologic factor in
periodontal diseases is
bacterial plaque, systemic
diseases that alter the
ability of the host to
respond to the microbial
challenge presented may
affect the progression of
disease and therefore the
prognosis for the case.
65. Decreased numbers of
circulating neutrophils
(as in acquired
neutropenias) may
contribute to widespread
destruction of the
periodontium. Unless
the neutropenia can be
corrected, these patients
present with a fair to
poor prognosis.
66. Necrotizing Periodontal Diseases
Necrotizing periodontal disease
can be divided into necrotizing
ulcerative gingivitis NUG, and
necrotizing ulcerative
periodontitis NUP.
In NUG the primary predisposing
factor is bacterial plaque.
However, this disease is usually
complicated by the presence of
secondary factors such as acute
psychologic stress, tobacco
smoking, and poor nutrition, all
of which can contribute to
immunosuppression.
67. With control of both the bacterial
plaque and the secondary factors,
the prognosis for a patient with NUG
is good.
68. The clinical presentation of NUP is
similar to that of NUG, except the
necrosis extends from the gingiva into
the periodontal ligament and alveolar
bone.
However, many patients presenting with
NUP are immunocompromised through
systemic conditions, such as human
immunodeficiency virus (HIV)
infection. In these patients the
prognosis depends on not only reducing
local and secondary factors, but also on
dealing with systemic problem.
69. Reevaluation of prognosis after phase I therapy
A frank reduction in pocket depth and
inflammation and after Phase I therapy
indicates a favorable response to
treatment and may suggest a better
prognosis than previously assumed.
If the inflammatory changes present
cannot be controlled or reduced by Phase
I therapy overall prognosis may be
unfavorable.
70. Conclusion
Prognosis puts lights on future of
disease progression or demission
depending on factors affecting it