DETERMINATION OF PROGNOSIS

Prediction of duration, course, and termination of a disease and its response to

treatment.

Must be determined after the diagnosis is made and before

treatment is planned.

PERIODONTAL PROGNOSIS

Overall

and

Individual teeth

OVERALL PROGNOSIS

Should treatment be undertaken?

Is it likely to succeed?

Are the remaining teeth able to support the added burden

of needed prosthetics?

SLOWLY PROGRESSIVE PERIODONTITIS

directly related to severity of inflammation and the height

of remaining bone.

Better prognosis for the patient with greater

inflammation

RAPIDLY PROGRESSIVE PERIODONTITIS

difficult to form prognosis

leukocyte defects

some cases respond to conventional therapy plus

antibiotics

No methods to predict

REFRACTORY PERIODONTITIS

Usually resistant to treatment

JUVENILE PERIODONTITIS

Prognosis is usually poor

AGE

Two patients with the same amount of destruction -

prognosis is better for older patient.

SYSTEMIC BACKGROUND

Prognosis improves with correction of systemic

problem

MALOCCLUSION

interferes with plaque control

SMOKING

direct relationship exists between smoking and

gingivitis and periodontitis

Smoking cessation improves prognosis and

predictability of treatment

PATIENT COOPERATION

Patient must desire to retain natural teeth and have

willingness and ability to maintain oral hygiene

PROGNOSIS FOR INDIVIDUAL TEETH

Determined after overall prognosis

Consider the following for prognosis of individual

teeth:

MOBILITY

Caused by bone loss

trauma from occlusion and inflammation

Prognosis is worse if mobility is from bone loss

PERIODONTAL POCKETS

level of attachment

degree of bone loss

type of pocket

MUCOGINGIVAL PROBLEMS

lack of attached gingiva

prognosis is poor unless corrected

FURCATION INVOLVEMENT

difficulty of access by operator and patient

if these can be corrected then prognosis is similar to

single rooted tooth

TOOTH MORPHOLOGY

Prognosis is poor for teeth with short tapered roots and

large crowns

Root concavities

Developmental grooves

Enamel projections

TEETH ADJACENT TO EDENTULOUS AREAS

abutments have more functional demands

special oral hygiene

EXCELLENT PROGNOSIS - no bone loss, excellent gingival condition, adequate patient

cooperation

GOOD PROGNOSIS - one or more of the following:

adequate remaining bone support; adequate

possibilities to control etiologic factors and

establish a maintainable dentition; adequate patient cooperation

FAIR PROGNOSIS - one ore more of the following; less than adequate remaining bone support, some tooth mobility, grade I furcation

involvement, adequate maintenance possible,

acceptable patient cooperation

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 and/or

doubtful patient compliance

QUESTIONABLE PROGNOSIS - one or more of the following: advanced bone loss, grade II

and III furcation involvements, tooth mobility,

inaccessible areas.

HOPELESS PROGNOSIS - one or more of the following:

advanced bone loss, nonmaintainable areas, extractions indicated