⭐ PROGNOSIS IN PERIODONTOLOGY
📌 POINTS TO PONDER
🔹Prognosis needs to be described at two levels: overall and individual teeth.
🔹Prognosis is a predilection of the probable course, duration and outcome of a disease based on a general knowledge of the pathogenesis of the disease and the presence of risk factors for the disease.
🔹Short-term prognosis usually refers to a period less than 5 years.
🔹Long-term prognosis usually refers to a period of 5 years or more.
🔹Prognosis of three-walled intrabony defects is usually favorable.
📣 Prognosis Of Patients With Gingival And Periodontal Diseases
🔺Prognosis of Patients with Gingival Diseases :
💡 Gingivitis associated with dental plaque only
🔹Plaque-induced gingival diseases modified by systemic factors
🔹Plaque-induced gingival diseases modified by medications
🔹Gingival diseases modified by malnutrition
💡Non-Plaque-induced gingival lesions
🔺Prognosis of Patients with Periodontitis :
🔹 Chronic Periodontitis
🔹Aggressive Periodontitis
🔹 Periodontitis as a Manifestation of Systemic
🔹 Necrotizing Periodontal Diseases
📣 Factors common for both prognosis and diagnosis of the disease
🔸Patient’s age
🔸Severity of disease
🔸Genetic susceptibility and
🔸Presence of systemic disease.
📣 Types/range Of Diagnostic Prognosis
🔸Excellent prognosis
🔸Good prognosis
🔸Fair prognosis
🔸Poor prognosis
🔸Questionable prognosis
🔸Hopeless prognosis
📌 VIVA VOCE
Q1. How does the patient’s age affect the overall prognosis?
Ans. The prognosis is not good for younger patients because of the shorter time frame in which the periodontal destruction has occurred.
Q2. Write the factors that are common for both prognosis and diagnosis of the disease.
Ans. Factors common for both prognosis and diagnosis of the disease are:
🔸Patient’s age
🔸Severity of disease
🔸Genetic susceptibility
🔸Presence of systemic disease.
Q3. If there is a question as to which prognosis a tooth should be given?
Ans. The operator should assign better of the two prognosis, e.g. if there is confusion between fair and poor prognosis tooth should be given fair one.
Q 4. What is the prognosis of first maxillary premolar with furcation involvement?
Ans. Poor prognosis.
Q5. What is the prognosis of three walled defect?
Ans. Three-walled osseous defect has good prognosis.
Q6. What is prognosis?
Ans. Prognosis is a prediction of the probable course, duration and outcome of a disease based on a general knowledge of the pathogenesis of the disease and the presence of risk factors for the disease.
Q7. What are the range of gradations given by McGuire and Nunn?
Ans. Good, fair, poor, questionable and hopeless prognosis.
Q8. What are the types of prognosis given by Hirschfeld and Wasserman?
Ans. Questionable and favorable prognosis.
Q9. What are cinguloradicular groove?
Ans. The grooves begin at the cingulum and extend a variable distance apically on the root surface between the midpalatal line and the line angle that is why they are called as “cinguloradicular groove”.
Q10. Where cinguloradicular grooves are usually found?
Ans. Maxillary lateral incisors and maxillary central incisors.
📌 MCQs
💡 Which of the following statement regarding periodontal prognosis is true?
A. Maxillary molar’s distal furcation involvement has poor prognosis because access for cleaning is poor
B. If the cause of periodontal diseases is directly related to plaque, then prognosis is much more favorable, than it is in cases where etiological agent is not obvious.
C. Prognosis depends heavily upon proper diagnosis and therapist’s clinical experience.
D. All of the above.
Answer : D
💡Which of the following does not affect periodontal prognosis:
A. Enamel pearl
B. Enamel projection
C. Bifurcation ridge
D. Talon’s cusp
Answer : D
💡Provided inflammation is controlled, the prognosis for moderate periodontitis is generally:
A. Good
B. Fair
C. Poor
D. Questionable
Answer : A
💡Prognosis is favorable for
A. Two walled intrabony defects
B. Three walled intrabony defects
C. One walled intrabony defects
D. Aggressive periodontitis
Answer : B
