phase 2 periodontal therapy

Studies have shown that inactive pockets can be maintained for long periods with little loss of attachment by means of frequent scaling and root-planing procedures. C H A P T E R 4 7 Phase I Periodontal Therapy Henry H. Takei CHAPTER OUTLINE Rationale Treatment Sessions Sequence of Procedures Results Healing Decision to Refer for Specialist Treatment Conclusion Phase I therapy or cause-related therapy 10 is the first in the chronologic sequence of procedures that […] Read/Download File Report Abuse. This indicates there is a need for further treatment. These involve not only the implant placement techniques but also a variety of surgical procedures to adapt the neighboring tissues, such as the sinus floor or the mandibular nerve canal, for subsequent placement of the implant (see Box 53-1). In an active pocket, underlying bone is being lost (Figure 53-2, top left). Studies have shown that inactive pockets can be maintained for long periods with little loss of attachment by means of frequent scaling and root-planing procedures.6,10,12 A more reliable and stable result is obtained, however, by transforming the pocket into a healthy sulcus. It is important to understand that these procedures are not directed to treat disease but aim to alter the gingival and mucosal tissues to correct defects that may predispose to disease. 4. The non-surgical phase is the initial phase in the sequence of procedures required for periodontal treatment. Adjunctive Orthodontic Therapy 19. Prevention. crown lengthening surgery, root coverage surgery 2. Three types of techniques fall into this category, as follows (see, The plastic and esthetic surgery techniques are presented in, In addition, periodontal surgical techniques for the placement of dental implants are available. For this, it is essential to create optimum oral hygiene conditions in order to reduce probing depths, regain attachment and to avoid tooth loss in the long term. In the first case, there is no gain of attachment (Figure 53-2, bottom left), and the area of the root that was previously the tooth wall of the pocket becomes exposed. General Dental Practitioner Oral Health Educator Dental Nurse Prevention of Periodontal Disease Dental Hygienist Dental Therapist Secondary Care Consultant in Restorative Dentistry High Street specialist In Periodontology. Resective (gingivectomy, apically displaced flap, and undisplaced flap with or without osseous resection), Regenerative (flaps with grafts, membranes, etc. The purpose of surgical pocket therapy is to eliminate the pathologic changes in the pocket walls; to create a stable, easily maintainable state; and if possible, to promote periodontal regeneration. Patient information Sheets » Phase 2 Periodontal Therapy – Ph-08. Table 4. Pocket Elimination Versus Pock et Maintenance. What are some problems typically addressed in phase I periodontal therapy? After the antibiotic therapy phase, Periodontal Reassessment takes place with a full periodontal re-examination and charting. C H A P T E R O U T L I N E. Objectives of the Surgical Ph ase. Recurrence of the initial activity is likely. Each CoT can be claimed separately. If necessary, x-ray examination is also conducted, either for a specific area or the whole oral cavity. Example of potential Bands and Patient Charges generated from phased treatment. This does not mean that the periodontal treatment has caused recession but rather that it has uncovered the recession previously induced by the disease. Critical Zones in Pocket Surge ry. Phase III—Supportive Periodontal Therapy. At the 6-8 week Periodontal Reassessment appointment the progress made, after root surface cleaning and excellent home cleaning, will be assessed. Minimally-Invasive Non-Surgical Periodontal Therapy – Philip Ower, May 2013. Home » 1. 5. Possible results of pocket therapy. this phase of periodontal therapy in which attention is paid to the cause of periodon - titis, namely plaque, and this is patently misleading. Phase III—Supportive Periodontal Therapy Created February 18, 2020; Author DentistryKey; Category Periodontics; You're Reading a Preview. If you are a member. Maintenance, or supportive periodontal therapy, is an ongoing program designed to keep periodontal disease under control in patients who have undergone periodontal treatment. The clinical effect of a prolonged oral hygiene phase prior to periodontal therapy in periodontitis patients. Phase II: The surgical phase. ‘Fundamental’ means ‘forming the basis on which others depend or from which others derive’ and, hence, seems appropriate to describe this phase. 2. NON-SURGICAL PERIODONTAL THERAPY – Stephen M. Huppert. 65: Recent Advances in Surgical Therapy: Lasers in Periodontal Therapy, 82: Implant-Related Complications and Failures. • Esthetic surgery techniques are used to cover denuded roots and to recreate lost papillae. A periodontal pocket can be in an active state or a period of inactivity or quiescence. Phase II decision tree for posttreatment reevaluation. This ongoing phase of treatment allows your periodontist to assess your periodontal health and ensure your infection stays under control. These problems can be reduced by resecting or displacing the soft tissue wall of the pocket, thereby increasing the visibility and accessibility of the root surface.3 The flap approach and the gingivectomy technique attain this result. Objectives: Improve access for debridement ... Periodontal surgery, implant placement. The plastic and esthetic surgery techniques are presented in Chapter 63 and the preprosthetic techniques in Chapter 66. Phase 2 Periodontal Therapy At the 6-8 week Periodontal Reassessment appointment the progress made, after root surface cleaning and excellent home cleaning, will be assessed. As the pocket becomes deeper, the surface to be scaled increases, more irregularities appear on the root surface, and accessibility is impaired.11,15 The presence of furcations will also create insurmountable problems for scaling the root surface4 (see Chapter 62). A 3-month strict oral hygiene phase in patients referred for periodontal therapy reduced plaque, BOP and pocket depth to such an extent that it could affect therapy planning. Although in a strict sense, all instrumental therapy can be considered surgical, this chapter refers only to those techniques that include the intentional severing or incising of gingival tissue* with the following purposes: • Controlling or eliminating periodontal disease, • Correcting anatomic conditions that may favor periodontal disease, impair esthetics, or impede placement of the correct prosthetic appliances, • Placing implants to replace lost teeth and improving the environment for their placement and function. It is to be documented, once all of the following conditions are met: a. Periodontal surgical therapy is only one component of complete periodontal treatment. ), Esthetic surgery (root coverage, recreation of gingival papillae), Preprosthetic techniques (crown lengthening, ridge augmentation, and vestibular deepening), Placement of dental implants, including techniques for site development for implants (guided bone regeneration, sinus grafts). 3. Treatment phase II – dental implant surgery, reline of provisional denture (3 workdays) After 3 months of wound healing the treatment could be resumed with the mounting of implants. - Poor oral hygiene - Plaque and calculus of root surfaces - Caries - Pulpal-periapical pathology - Plaque-retentive restorations - Hopelessly diseased teeth - Other disease entities requiring treatment (mucosal lesions, cysts, impacted teeth, etc. Therapy. Log In or, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), Controlling or eliminating periodontal disease, Correcting anatomic conditions that may favor periodontal disease, impair esthetics, or impede placement of the correct prosthetic appliances, Placing implants to replace lost teeth and improving the environment for their placement and function, Improvement of the prognosis of teeth and their replacements, The purpose of surgical pocket therapy is to eliminate the pathologic changes in the pocket walls; to create a stable, easily maintainable state; and if possible, to promote periodontal regeneration. Most orthodontic problems can … Any remaining areas of continued gum disease are recorded and considered for treatment by surgical means. This case appears borderline for Phase II periodontal treatment. In many cases, procedures are combined so that one surgical intervention fulfills both objectives. 1. Phased treatment could potentially produce various clinical scenarios, each resulting in differing generation of both bands of treatment and patient charges. All non-urgent consultations, evaluations, and any … By proper case selection, both resective techniques and regenerative techniques can be used to accomplish this goal. Phase II completion(*PhsII in the EHR) reflects restoration of complete function and esthetics for the patient that requires laboratory-based treatments. This is known as, If the bone around the teeth is uneven making the gum bulky, re-contouring of the bone may be required to assist in achieving a more normal anatomy and more accessible shape for home cleaning, known as, In some cases the bone loss around roots may lend itself to the provision of bone grafting or the regeneration of lost tissue using “, Some patients have suffered extensive or localised gum recession and this may require correction by the application. The bottom of the healthy sulcus can be located either where the bottom of the pocket was localized or coronal to it. FINAL_CLINIC_MANUAL_FOR_2013- 2014_(9-5-2013 - rev).pdf. 6. • Preprosthetic techniques are used to adapt the periodontal and neighboring tissues to receive prosthetic replacements; these include crown lengthening, ridge augmentation, and vestibular deepening. The patient must be motivated, and must exhibit adequate plaque control. Periodontal disease is never cured but only controlled. Become membership. 2. Chapters 59 to 61 describe the different techniques used for these purposes. The effectiveness of periodontal therapy is predicated on success in completely eliminating calculus, plaque, and diseased cementum from the tooth surface. These involve not only the implant placement techniques but also a variety of surgical procedures to adapt the neighboring tissues, such as the sinus floor or the mandibular nerve canal, for subsequent placement of the implant (see. Active periodontal treatment aims to reduce the inflammatory response, primarily through eradication of bacterial deposits. In an active pocket, underlying bone is being lost (. Improvement of the prognosis of teeth and their replacements. To fulfill these objectives, surgical techniques (1) increase accessibility to the root surface, making it possible to remove all irritants; (2) reduce or eliminate pocket depth, making it possible for the patient to maintain the root surfaces free of plaque; and (3) reshape soft and hard tissues to attain a harmonious topography. 2. If the more conservative treatments weren’t effective, treatments will move into the surgical phase. Reevealuation After Phase I The rapy. It is important to understand that these procedures are not directed to treat disease but aim to alter the gingival and mucosal tissues to correct defects that may predispose to disease. Learn vocabulary, terms, and more with flashcards, games, and other study tools. In book: Essential Quick Review: Periodontics (pp.179-180) Authors: Priya Gupta. The surgical phase of periodontal therapy has the following main objectives: 1. pocket reduction surgeries Preprosthetic Surgery E.g. therapy is the control of plaque. This phase aims to reduce and eliminate any gingival inflammation by removing dental plaque , calculus (dental) , restoration of tooth decay and correction of defective restoration as these all contribute to gingival inflammation, also known as gingivitis . 1. To fulfill these objectives, surgical techniques (1) increase accessibility to the root surface, making it possible to remove all irritants; (2) reduce or eliminate pocket depth, making it possible for the patient to maintain the root surfaces free of plaque; and (3) reshape soft and hard tissues to attain a harmonious topography. Debridement... periodontal surgery E.g H a P T E R O U T L I N E. objectives the. Recreate lost papillae treatments and periodontal plastic surgery techniques to widen attached gingiva ( free grafts! Two-Phase orthodontic treatment is for kids, but it ’ s not for all.! Two-Phase orthodontic treatment is for kids, but it ’ s not for all kids or specialized for! 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