【医学精品课件】牙周病的预后和计划(132p).ppt

the pattern of bone loss: horizontal, vertical or infrabony defects.the age of the patient and the etiologic factors involved in the patients disease. poorer prognosis: tilted, drifted, or rotated, hygiene difficult, elimination of pockets impaired periodontal disease is complicated by active systemic factors and traumatism morphologic in nature and include the number and distribution of teeth, tooth morphology, furcation involvement. Extent of involvement. Is the furcation partially or totally involved?Status of bone support. If the bone levels are relatively sound, the effort to save may be justifiable. Root length and crown-root ratio must be considered Angulation of root spread. Health of neighboring teeth. The number and distribution of teeth presentcrown-root ratio,shape and number of the root the height of the alveolar crestpersonal psychologic and sociologic, financial considerations. OTHER CONSIDERATIONS IN ESTABLISHING PROGNOSIS The performance of home care is acceptable and the caries incidence is low,the prognosis is better The prime consideration is the preservation of the dentition as a functioning unit. In some instancesthe extraction of a single tooth will make the whole situation untenable.In other situations isolated extractions will simplify the problem. what is considered to be a hopeless tooth. This will make treatment planning simpler. the characteristics of hopeless periodontally involved teeth: Associated with intractable pain relieved, massive infection reduced by extractionMobility beyond 3 degrees Furcation involvement with little or no interradicularboneBone loss beyond the apexBone loss to the apex on one side of the tooth Generalized circumferential bone loss to within 3 mm of the apexPocket depth to the apex without pulpal involvementVertical cracks or fractures Inaccessible perforations or accessory canalsNumber and position of remaining teeth precluding prostheticExtreme caries susceptibility Objectives