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Periodontal TreatmentPlan andRationale forTreatment
Objectives
Rationale for periodontaltreatment
Understand differencesbetween regeneration,repair, reattachment, newattachment and epithelialadaptation.
Objectives
Reasons for extractionConsiderations for
retention on hopeless teeth
Phases of periodontaltherapy
Maintenance therapy-principles and timing
Treatment of thePeriodontal Diseases
Examination
Diagnosis
Prognosis
Treatment Plan
Etiology
PrimaryBacterial plaque in a
susceptible host
Secondary (Co-factors)Calculus, malposed teeth,
smoking, diabetes,overhanging margins, foodimpaction.
Factors in Diagnosis
Presence of clinicallydetectable inflammation
Extent and pattern of boneloss
Rate of progressionPresence of miscellaneous
signs and symptoms
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Factors in Diagnosis
MicrobiologicalGeneticClinicalAltered host response
Treatment Plan
Begin with the endin mind.
Frank Covey
Habit 2
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Scaling and RootPlaning
Remove calculusRemove endotoxinProvide a smooth
detoxified root surface
Scaling and RootPlaning
ScalingThe removal of crown and root
surface deposits and stains
Root PlaningThe smoothing of roughened
cementum, and dentinimpregnated with calculus orcontaminated with toxins or
microorganisms
Scaling and RootPlaning
BenefitsDecreased bleedingGingival shrinkage (2Wks), Connective Tissuereattachment (4wks)
Pocket reductionReduced mobility
Initial Therapy
Scaling and RootPlaning
Local DeliveryTherapy
Antibiotics
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ANATOMY FurcationLocation Maxillary Premolar
Furcation location varies,average 7.9mm due tothe very long root trunk
Furcation invasionsignificantly downgradesthe prognosis
Mesial concavity 100% Very difficult to treat in a
predictable manner; root
resection is ineffective
ETIOLOGYPREDISPOSING / CONTRIBUTING FACTORS
PUPAL PATHOLOGY
Day of Root Canal Therapy 12 month follow up
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Dr. Deborah Johnson, Periodontology I, Summer Semester, 2012, School of Dentistry University of Minnesota
