Perio module 8

• Treatment Planning


  • Blueprint
  • Masterplan of all dental procedures needed
  • Detailed sequence of procedures to regain total oral health and maintenance

  
• 4 Phases of Periodontal Therapy

  • Non-surgical Phase
  • Surgical Phase
  • Restorative Phase
  • Maintenance

  
• Preliminary Phase


  1. Emergency Treatment (pain & acute infections)

  2. Tooth requiring extractions (focus of infection, obstructs function)

  
• Non-surgical Phase


  1. Plaque control and patient education

  2. Reconstruction of defective restoration and prosthesis

  3. Scaling

  4. Root Planing

  5. Minor orthodontic movement

  6. Occlusal therapy (premature contact)

  7. Provisional splinting (TMD)

  8. Provisional Prosthesis
• Scaling


  Remove plaque, calculus, stains, and other deposits on the enamel surface
• Root Planing


  Removal of deposits on the root surface includes portions of the cementum to create a smooth, hard, and clean surface
• Surgical Phase


  1. Implant placement

  2. Endodontic treatment

  3. Periodontal therapy with gingival flap
• Restorative Phase


  1. Final restorations

  2. Fixed & Removable prosthesis

  3. Evaluation of restorative procedure

  4. Periodontal examination
• Maintenance


  1. Periodic re-checking

  2. Monitoring

  3. Evaluation
• Scaling and Root Planning


  1. Disclosing

  2. SRP

  3. Polishing
• Polishing


  • Brush and Prophy Paste
  • Rubber cap
  • Flossing
• Treatment Planning Evaluation is done 8 weeks after first SRP
• Maintenance involves SRP and re-evaluation every 3 months
• Criteria for Successful Non-Surgical Treatment

  • Eliminate Pain
  • Eliminate Exudates
  • Eliminate Inflammation
  • Eliminate Bleeding
  • Reduce perio. pockets
  • Eliminate infection
  • Arrest destruction of bone, PDL, and gingiva
  • Reduce tooth mobility

  
• When to refer to a Periodontist

  - Patient has systemic problems

  - Difficult periodontal disease

  - Dental implant patients

  - Complex prosthetic construction that requires result

  - Needs complex surgical intervention

  - Requires osseous surgery

  - Requires complex regenerative procedures
• Procedures for General Practitioner


  • Localized gingivectomy
  • Flap curettage
• Commonly Extracted Teeth


  • Lower incisors
  • Upper incisors
  • Upper molars

  
• Common Reasons for Extraction


  • Tooth mobility
  • Furcation Involvement