Download - Treatment plan
Treatment plan
• Treatment plan is the blue print for case management
• After diagnosis & prognosis, treatment is planned
• Includes all procedures required for the establishment &maintenance of oral health
• Unforeseen developments may necessitate modification of treatment plan
• Except for emergencies, no treatment to be started unless treatment plan has been established
Master plan for treatment
• Total treatment• Primary goal is elimination of gingival
inflammation and correction of conditions that cause and/or perpetuate it
Extracting or preserving a tooth
• Periodontal treatment value measured in years of healthy functioning of the entire dentition , not by the number of teeth retained at the time of treatment
• Periodontal condition of teeth to be retained is more important than the number of such teeth
• Removal, retention or temporary retention of one or more teeth is a very important part of overall treatment plan– Tooth will be extracted– Tooth will be retained if prognosis good to
excellent– Tooth will be retained temporarily
Therapeutic procedures• Periodontal therapy is an inseparable part of
dental therapy• In phases of periodontal therapy, other
procedures not performed by periodontist is listed to emphasize the close relationship of periodontal therapy with other phases of therapy
Phases of periodontal therapy
• Preliminary phase• Etiotropic phase – phase I• Surgical phase – phase II• Restorative phase – phase III• Maintenance phase – phase IV
Preferred sequence
Emergency phase
Etiotropic phase
Maintenance phase
` Surgical phase Restorative phase
Preliminary phaseTreatment of emergencies• Dental or periapical• Periodontal• Other• Extraction of hopeless teeth and provisional
replacement if needed
Etiotropic phase (plaque control &patient education)• Diet control• Removal of calculus & root planing• Correction of restorative & prosthetic irritational
factors• Excavation of caries & restoration- temp or final• Antimicrobial therapy- local or systemic• Occlusal therapy• Minor orthodontic movement• Provisional splinting & prosthesis
Evaluation of response to etiotropic phase
Rechecking• Pocket depth & gingival inflammation• Plaque & calculus, caries
Surgical phase
• Periodontal therapy including placement of implants• Endodontic therapy
Restorative phase
• Final restorations• Fixed and/ or removable prosthodontics
Evaluation of response to restorative procedures
• Periodontal examination
Maintenance phase
periodic rechecking• Plaque & calculus• Gingival condition- pockets, inflammation• Occlusion, tooth mobility• Other pathologic changes