Protocol of Prosthodontics
A sequence of interrelated steps is inherent to effective periodontal treatment: early and accurate diagnosis, comprehensive treatment, and continued periodontal maintenance and monitoring. A primary goal of periodontal therapy is to reduce the burden of pathogenic bacteria and thereby reduce the potential for progressive inflammation and recurrence of disease. Emerging evidence of possible perio-systemic links further reinforces the need for good periodontal health. The treatment of patients with periodontal disease is best accomplished within the structure of a uniform and consistent Periodontal Treatment Protocol (PTP).Such a protocol would reinforce accurate and timely diagnosis, treatment needs based on a specific diagnosis, and continual assessment and monitoring of outcomes.
Communication skills and patient education are vital components of effective therapy since slight and even moderate stages of the disease often have few noticeable symptoms to the patient. Accurate documentation and reporting of procedures for dental insurance reimbursement, coupled with scheduling considerations, assist general practice settings in effectively managing the increasing volume of patients that can benefit from early diagnosis and treatment of periodontal diseases.
PERIODONTAL EXAMINATION
Assessment of medical history
Assessment of dental history
Assessment of periodontal risk factors
Age
Gender
Medications
Presence of plaque and calculus (quantity and distribution)
Smoking
Race/Ethnicity
Systemic disease (eg, diabetes)
Oral hygiene
Socioeconomic status and level of education
Assessment of extraoral and intraoral structures and tissues
Assessment of teeth
Mobility
Caries
Furcation involvement
Position in dental arch and within alveolus
Occlusal relationships
Evidence of trauma from occlusion
Assessment of periodontal soft tissues including peri-implant tissues
Color
Contour
Consistency (fibrotic or edematous)
Presence of purulence (suppuration)
Amount of keratinized and attached tissue gingiva
Probing depths
Bleeding on probing
Clinical attachment levels
Presence and severity of gingival recession
Radiographic evaluation of alveolar bone loss, bone density, furcations,
NON SURGICALPERIODONTAL THERAPY
Comprehensive periodontal evaluation.
Adult prophylaxis.
Full mouth debridement to enable comprehensiveevaluation and diagnosis.
Scaling and root planing generalized per quandrant.
Localized delivery of antimicrobial agents via a controlled releasevehicle into diseased crevicular tissue.
Periodontal maintenance.