Download Periodontal Therapy Guideline. postcare problems in periodontal therapy. Additionally, these guidelines should not be deemed … of comprehensive periodontal therapy. Tooth extraction
american academy of pediatric dentistry
Guideline for Periodontal Therapy
american academy of periodontology
Endorsed/Reaffirmed by the American Academy of Pediatric Dentistry
1992, 1993, 2000, 2001, 2003
Research has provided evidence that chronic inflammatory periodontal diseases are treatable.1-8 Studies have also been directed at providing information to permit better understanding of mechanisms of disease progression and pathogenesis in order to make treatment of periodontal diseases more effective and predictable.9-11 As a result of advances in knowledge and therapy, the great majority of patients retain their dentition over their lifetime with proper treatment, reasonable plaque control, and continuing maintenance care.12-21 However, there are some situations when traditional therapy is not effective in arresting the disease. In these instances, the progression of the disease may be slowed, but eventually the teeth may be lost.14-21 Adherence to the following guidelines will not guarantee a successful outcome and will not obviate all complications or postcare problems in periodontal therapy. Additionally, these guidelines should not be deemed inclusive of all methods of care, or exclusive of treatment reasonably directed at obtaining the same results. It should also be noted that these guidelines describe summaries of patient evaluation and treatment procedures that have been presented in considerably more detail within textbooks of periodontology as well as in the medical and dental literature. Ultimately judgments regarding the appropriateness of any specific procedure must be made by the practitioner in light of all the circumstances presented by the individual patient.
The goals of periodontal therapy are to preserve the natural dentition, periodontium and peri-implant tissues; to maintain and improve periodontal and peri-implant health, comfort, esthetics, and function. Currently accepted clinical signs of a healthy periodontium include the absence of inflammatory signs of disease such as redness, swelling, suppuration, and bleeding on probing; maintenance of a functional periodontal attachment level; minimal or no recession in the absence of inter-proximal bone loss; and functional dental implants.
All patients should receive a comprehensive periodontal examination. Such an examination includes discussion with the patient regarding the chief complaint, medical and dental history review, clinical examination, and radiographic analysis. Microbiologic, genetic, biochemical, or other diagnostic tests may also be useful, on an individual basis, for assessing the periodontal status of selected patients or sites. Some or all of the following procedures may be included in a comprehensive periodontal examination: 1. Extra- and intraoral examination to detect nonperiodontal oral diseases or conditions. 2. General periodontal examination to evaluate the topography of the gingiva and related structures; to assess probing depth, recession, and attachment level; to evaluate the health of the subgingival area with measures such as bleeding on probing and suppuration; to assess clinical furcation status; and to detect endodontic-periodontal lesions. 3. Assessment of the presence, degree and/or distribution of plaque, calculus and gingival inflammation. 4. Dental examination, including caries assessment, proxi mal contact relationships, the status of dental restorations and prosthetic appliances, and other tooth- or implant-related problems. 5. Determination of the degree of mobility of teeth and dental implants. 6. Occlusal examination. 7. Interpretation of a satisfactory number of updated, diagnostic quality periapical and bite-wing radiographs or other diagnostic imaging needed for implant therapy.
Scope of periodontics
Periodontics is the specialty of dentistry that encompasses prevention, diagnosis, and treatment of diseases of the supporting and surrounding tissues of teeth and dental implants. The specialty includes maintenance of the health, function, and esthetics of all supporting structures and tissues (gingiva, periodontal ligament, cementum, alveolar bone, and sites for tooth replacements). Tissue regeneration, management of periodontal-endodontic lesions, and providing dental implants as tooth replacements are, when indicated, integral components of comprehensive periodontal therapy. Tooth extraction and implant site development may accompany either periodontal or implant therapy. Patient management during therapy may include the administration of intravenous conscious sedation.