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1、牙周病學(xué)Periodontology山東大學(xué)口腔醫(yī)學(xué)院葛少華Chapter11PeriodontalPrognosis&PeriodontalTreatmentPlanningThecontentsthatshouldbemastered:1factorstoconsiderwhenassigningprognosisofperiodontitis2ObjectivesofperiodontaltreatmentandtreatmentprocedurePeriodontalPrognosisPrognosisisapredictionoftheprobablecourseandoutcome
2、ofadisease.Itisdeterminedfollowinginitialexamination,andfollowingactivetherapyphase.PeriodontalPrognosisImportance:Clinician:Todeterminewhichtreatmentmodalitieswillbemosteffective.Todeveloprestorativerecommendationandtreatmentplans.PeriodontalPrognosisImportance:Patient:todeterminewhethertreatmentse
3、emsworthwhile.(EBM)FactorstoconsiderwhenassigningoverallPrognosis1Typeofperiodontitis:chronicoraggressive,withorwithoutsystemicfactors.2Degreeofperiodontiumdestruction(DiseaseSeverity)3Theeliminationoflocalfactors:calculus,plaque,occlusaltrauma4Toothmobilitydegree5Thenumberofteethremaininginoralcavi
4、ty6patientcooperation:self-performingplaquecontrol,reevaluationattime7environmentalandbehavioralfactors:smoking8systemicfactors:diabetes9age:Factorstoconsiderwhenassigningindividualtoothprognosis:1PDandAL2thealveolarboneresorptiondegreeandtypes:3toothmobilitydegree4Anatomicfactors:short,taperedroots
5、;cervicalenamelprojections,rootconcavities,developmentalgroovesAssigningprognosis:GoodPrognosis:Indicatesthatthereisadequateperiodontalsupportanditispossibletocontroletiologicfactorstoassurethattheteethwillberelativelyeasilymaintained.AssigningprognosisThefollowingcriteriaconstituteagoodprognosis:-P
6、robingdepth0-3mm.-Lessthan10%boneloss.-Nofurcation.-Nopathologicmobility.AssigningprognosisFairprognosis:Indicatesthereisagoodchancethattheteethcanberestoredtohealthandretained,assumingpropermaintenance.AssigningprognosisThefollowingfactorsaresuggestiveoffairprognosis:(oneormore)-Pocketdepthupto5mm.
7、-Upto30%boneloss.-MaintainableClassIfurcation.-MobilityI.AssigningprognosisPoorprognosis:Oneormoreofthefollowing:Moderateattachmentloss.ClassIand/orclassIIfuraction(s)Thelocationanddepthofthefuraction