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Treatment plan

for periodontal
diseases
Ayesha Awan
Roll No : 556

What is a treatment
plan?
Treatment

plan is a blueprint for any case


management
It includes the following decisions
1.
2.
3.
4.
5.
6.

Need for any emergency treatment


Teeth which require Extraction
Periodontal therapy techniques
Endodontic therapy
Need for correct occlusion including orthodontics
Implant therapy

(Cond)
7.Need of removing caries and placement
of temporary and final restorations
8.Prosthetic replacements if required and
which teeth will become abutment teeth if
fixed prosthesis is used
9.Decisions regarding esthetics
consideration in periodontal therapy

What are the goals?


SHORT TERM
Eliminate

pain and
acute infections
Remove factors
involved in plaque
formation

LONG TERM
Reconstruction

of
a healthy dentition
that fulfills all
functional and
esthetic
requirements

Master plan for total treatment


Aim

of the plan is to coordinate the


short and long term goals for the
purpose of creating a well functioning
dentition in a healthy periodontal
environment.
Extracting or preserving a tooth?
Periodontal treatment is directed to
establishing and maintaining a
healthy periodontium rather than
attempting spectacular efforts to
Tighten Loose Teeth

Removal,

retention or temporary retention


of a tooth is an important part of the
overall plan.
A tooth should be extracted under the
following conditions
1. It is mobile that function becomes painful
2. Can cause acute abscess during
treatment
3. No use of it in the overall treatment plan

When
1.

2.

to retain a tooth temporarily?


It maintains posterior stops, the tooth
can be removed after treatment if it
can be replaced by prosthesis.
It maintains posterior stop, and maybe
functional after implant placement and
can be extracted once the implant is
restored

3.

In anterior region the tooth can be


retained during treatment then
extracted on completion of treatment
and restored

Phases of the Plan


Emergency phase
PHASE 1: Non-Surgical
PHASE 2 : Surgical
PHASE 3 : Restoration
PHASE 4 : Maintenance

Sequence?
EMERGENCY PHASE
Non Surgical Phase
Maintenance Phase

Surgical Phase
Restorative Phase

Emergency Phase
Treat

any type of pain e.g Acute


gingivitis
Extraction of hopeless Teeth
Draining of Abscess

Dental Abscess

Phase 1 : Non Surgical Phase


Plaque

control and patient education:


Diet control
Removal of calculus and root planing
Correction of restorative and prosthetic
irrational factors
Excavation of caries
Antimicrobial therapy
Occlusal therapy
Minor Orthodontic movement
Provisional splinting and prosthesis

Evaluation of response to non


surgical phase
Pocket

depth and gingival inflammation


Plaque and calculus
Caries

Surgical phase (Phase


2)
Periodontal

therapy including placement of

implants
Endodontic Therapy

Restorative phase
Final

restorations
Fixed and removable prosthodontic
appliance
Evaluation of response to periodontal
examination
Periodontal examination

Maintenance phase
Periodic

checking:
Plaque and calculus
Gingival condition (pocket and
inflammation)
Occlusion and tooth mobility
Pathological changes

Explaining the treatment


plan to the patient
Points

to remember while explaining the


plan to the patient
Be specific
Avoid vague arguments
Begin your discussion on a positive note
Explain the plan as a whole unit

Reference
Carranzas

Clinical Periodontology
(11th Edition)