Docstoc

PROGNOSIS

Document Sample
PROGNOSIS Powered By Docstoc
					PROGNOSIS
  PROGNOSIS is the prediction of the
  duration, course and termination of a
  disease and of its response to treatment.

Diagnosis          Prognosis    treatment plan

Prognosis of patient with Gingival disease

Depends on Role of Inflammation
Inflammation (Local Factors)   Good Prognosis
Associated with systematically
Caused tissue changes                 Less Favorable
(drug induced, nutritional, hormonal)

Prognosis of patient with periodontal disease

Two types of prognosis determination for periodontitis

1. Overall prognosis

2. Indivisual prognosis
            Overall prognosis
              (CONSIDERING DENTITION WHOLE)
Factors to be considered:
1. Type of periodontitis:
adult / slowly progressive                    Good
(with routine treatment plan)


Aggressive periodontitis                      Poor
(RPP, JP, Leukocyte defect,
PPP, Post. PP)
If treated in early stage    Fair Prognosis
With Tetracycline

  Any periodontitis associated with systemic
  diseases will have poor prognosis
2. Height of remaining bone:

Little bone loss           tooth is not affected




Bone loss is severe
                      mobility     poor
                                   prognosis
3. Age:
   Older age           better prognosis than
   younger age.
   Because the amount of bone loss is less in
   old age and more bone loss in younger
   age       short period of time.
4. Systemic background:
If patients is having systemic disease
Prognosis is affected in several ways.
5. Gingival inflammation:
  Prognosis is directly related to degree of
  severity of inflammation.
  Good prognosis          not associated with
                          systemic diseases
6. Malocclusion:
 Mal aligned teeth, abnormal occlusion
  relationship may be imp. Factor in etiology of
  periodontal disease.
  Plaque control is difficult.
7. Cooperation of the patient: depends: on
  attitude, willingness and ability of patient to
  maintain good oral hygiene.
 PROGNOSIS OF INDIVISUAL TEETH


Following factors are considered:
1. Mobility: caused by     a) loss of bone
                           b) T F O
Local factors & TFO             Good prognosis
     are correctable

Not correctable                poor prognosis
2.Periodontal Pockets:
  Pocket depth, level attachment, degree of
  bone loss and type of pocket are imp. in
  assessing the prognosis & treatment plan.
 (clinical radiographic examination are imp.)

Level attachment is close           poor
to apex and periapical lesions      prognosis

Supra bony pocket                   Fair
Infra bony pocket                   Good
3. Mucogingival problems:
decrease width of attached gingiva          poor
high frenal attachment                      prognosis
pocket extending beyond M.G.J.
4. Furcation involvement:
Depends on type furcation involvement
Pt. cooperation for attaining good oral hygiene.
Furcation shows less favorable prognosis
because of limited accessibility.
(upper molars, premolars)
5. Tooth morphology:
Short, tapered & large crowns               POOR
 Root concavities, developmental grooves,
 enamel grooves, and furcation area act as
  Plaque retentive areas.
6. Teeth adjacent to edentulous area:
   Subjected to ed functional demands.
7. Remaining bone in relation to the individual
  teeth: moderate bone loss           Favorable.
8. Caries, nonvital tooth and root resorption.
CLINICAL APPLICATION
EXCELLENT PROGNOSIS:
No bone loss, excellent gingival condition,
adequate patient cooperation.

GOOD PROGNOSIS: One or more of the
following:
adequate remaining bone support, possible
to eliminate etiology, good dentition and
adequate patient cooperation.
FAIR PROGNOSIS: Less than adequate
remaining bone support, grade 1 mobility, Furcation,
adequate maintaince possible and acceptable
patient cooperation.
POOR PROGNOSIS :Moderate to advanced
bone loss, grade 2 mobility ,furcation ,difficult
to maintain area and or doubtful patient
Cooperation.
QUESTIONABLE PROGNOSIS: Advanced bone
loss, grade 3 mobility, furcation, poor cooperation.
HOPELESS PROGNOSIS : Advanced bone
loss, nonmaintainable areas & indicated for Xn.

				
DOCUMENT INFO
Shared By:
Tags:
Stats:
views:41
posted:1/29/2012
language:
pages:16
hardipvegda hardipvegda
About