Periodontics Diagnosis

Diagnosis

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Prognosis Guidelines

Hopeless – Poor – Guarded – Fair – Good – Excellent
(From Clinical Guide to Periodontics, Schwarz et al)

Hopeless to Poor

  • Tooth has >40 % bone alveolar bone loss.
  • Class II-III furcation involvement of a molar.
  • Probing depths >8mm. Poor response to therapy.

Guarded to Fair

  • Tooth has 20-40% alveolar bone loss. Some mobility is present.
  • Class I-II furcation involvement on a molar.
  • Probing depths in the 5-7mm range.
  • Variable response to therapy

Good to Excellent

  • Tooth has < 20% alveolar bone loss.
  • Physiologic mobility only.
  • If a molar, maximum of class I furcation involvement.
  • Shallow probing depths

The patient’s health must also be considered in determining the prognosis. For example, the diabetic patient does not respond as well to periodontal therapy, and a patient with arthritis or limited dexterity is unable to perform normal oral hygiene. Other considerations are patient age, current severity of disease, presence of plaque, calculus and other local factors, patient compliance, and history or use of tobacco products.

AxiUm Baseline Form

Whenever you see a new patient in the clinic you must fill out a baseline form in axiUm. Here are some guidelines to fill out the form. You should include the following:

Periodontal Diagnosis (as applies to your patient)

  • 1. Periodontal diagnosis/ Inflammatory disease
  • 2. Mucogingival problems
  • 3. Occlusal trauma

* Remember that primary is excessive force on a normal periodontium and secondary is normal forces on a compromised periodontium.

Etiology (as applies to your patient)

  • 1.  Bacterial plaque
  • 2.  Calculus
  • 3.  Open margins
  • 4.  Over contoured margins
  • 5.  Tooth decay
  • 6.  Malaligned teeth
  • 7.  Enamel pearls/projections
  • 8.  Occlusal trauma
  • 9.  Smoking
  • 10. Diabetes
  • 11. Other

Periodontal Prognosis

Example: Maxilla — good, Mandible — fair, #31 — poor

New Diagnostic Terms (2017 World Workshop)

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