THE PERIODONTAL TREATMENT PLAN.ppt

THE PERIODONTAL TREATMENT PLAN
DR RISHI EMMATTY

1. THE PERIODONTAL
TREATMENT PLAN

2. Diagnosis
Prognosis
Treatment Plan

3. “Blueprint”for case management

4. Decisions regarding the following are made;
•Extraction vs. restoration
•Treatment of pockets -surgical vs. nonsurgical
•Need for occlusal correction
•Temporary and final restorations
•Need for orthodontic treatment
•Endodontic therapy
•Esthetic considerations
•Sequencing of therapy

5. Exceptforemergencies,notreatment
shouldbestarteduntilthetreatment
planhasbeenestablished

6. Thepurposeofperiodontaltreatment
shouldbethemaintenanceofa
functionallyandestheticallyacceptable
dentitionthroughoutthelifeofthe
individual

7. Extraction of a hopeless tooth may be
postponed if,
•Itmaintainstheposteriorvertical
dimensionofocclusion
•Itislocatedinanestheticallycriticalarea
•Periodontalsurgeryoftheadjacentteeth
arerequired

8. Phases of Periodontal Therapy
•Preliminary Phase
•Etiotropic Phase(Phase I therapy)
•Evaluation of response toetiotropic phase
•Surgical Phase(Phase II therapy)
•Restorative Phase(Phase III therapy)
•Evaluation of response to Restorative
Phase
•Maintenance Phase(Phase IV therapy)

9. Preliminary Phase
Treatment of emergencies:
•Dental or periapical
•Periodontal
•Other
Extraction of hopeless teeth and
provisional replacement if needed

10. Etiotropic Phase (Phase I Therapy)
also known asCause-related or Hygienic
Phase
•Plaque control and patient education
•Diet control
•Scaling and root planing
•Correction of restorative and prosthetic
irritational factors
•Restoration of carious teeth
(temporary/permanent)

11. Phase Icontd.,
•Antimicrobial therapy (local or systemic)
•Occlusal therapy
•Minor orthodontic tooth movement
•Provisional splinting and prosthesis

12. Evaluation of response toetiotropic phase
Rechecking
•Pocket depth and gingival inflammation
•Plaque and calculus, caries
Depending on the response to Phase I therapy
the subsequent treatment plan may change

14. Surgical Phase(Phase II therapy,
Corrective phase)
•Periodontal therapy including placement of
implants
•Endodontic therapy

15. Restorative Phase(Phase III
therapy)
•Final restorations
•Fixed and/or removable prosthesis

16. Evaluation of response to
Restorative Phase
•Periodontal examination

17. Maintenance Phase(Phase IV therapy,
Supportive Periodontal Therapy (SPT))
Periodic rechecking for
•Plaque and calculus
•Gingival condition (pockets, inflammation)
•Occlusion, tooth mobility
•Other pathologic changes

18. Preferred Sequence of Periodontal
Therapy
Emergency Phase
Etiotropic Phase
Maintenance phase
Surgical Phase Restorative Phase