Treatment_in_Periodontics textbook oriented

treatment planning phases

1. Treatment in Periodontics According to Carranza’s Clinical Periodontology By: [Your Name]

2. Objectives - Review phases of periodontal therapy - Understand nonsurgical and surgical modalities - Highlight adjunctive therapies and maintenance

3. Phases of Periodontal Therapy 1. Phase I – Initial Therapy (Disease Control) 2. Re‑evaluation 3. Phase II – Surgical Therapy 4. Phase III – Restorative/Reconstructive Therapy 5. Phase IV – Maintenance (Supportive Periodontal Therapy)

4. Phase I – Initial Therapy • Emergency management (abscesses) • Patient education and motivation • Removal of local factors (scaling & root planing) • Occlusal adjustment / Splinting • Extraction of hopeless teeth • Adjunctive antimicrobial / Host modulation therapy

5. Re‑evaluation • Done 3–6 weeks after Phase I • Assess: plaque, inflammation, probing depth, attachment • Modify treatment plan accordingly

6. Phase II – Surgical Therapy • Indicated for residual deep pockets (≥5mm) • Flap surgery / osseous surgery • Regenerative procedures (bone grafts, membranes) • Periodontal plastic surgery (root coverage) • Furcation therapy • Laser-assisted therapy

7. Phase III – Restorative & Reconstructive • After periodontal stability • Includes prosthetic/orthodontic rehabilitation • Ensure restoration margins and occlusion support health

8. Phase IV – Maintenance • Lifelong phase; recall every 3–4 months • Re-assess: probing, bleeding, mobility • Professional cleaning and patient motivation • Early detection of recurrence

9. Adjunctive Therapies • Local drug delivery (chlorhexidine, doxycycline) • Systemic antibiotics (for aggressive cases) • Host modulation (low-dose doxycycline) • Lasers, guided tissue regeneration, growth factors

10. Decision Making & Prognosis • Site-specific therapy • Consider risk factors (smoking, diabetes) • Use re‑evaluation findings to decide next steps • Focus on microbial reduction and host modification

11. Key Takeaways • Periodontal therapy is phased and evidence-based • Non-surgical phase is the foundation • Surgical treatment only when needed • Maintenance is critical for long-term success

12. References • Newman & Carranza’s Clinical Periodontology (14th Ed.) • Lindhe et al., Clinical Periodontology and Implant Dentistry • Recent peer-reviewed studies and AAP guidelines