Learn more. Evidence in the literature on benefit gained from radiographs taken for periodontal patients is sparse; the extent to which they influence the treatment provided and treatment outcomes is poorly addressed. [Reequilibration of occlusion by orthodontic treatment and selective grinding]. Investigations by the Slots group (Tuan et al. Here are the four phases of periodontal therapy. This paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology. After pointing to the hygienizing phase which must in any case precede, the author deals with the medicinal local and general treatment, the occlusal function diagnosis, the function analysis, and the fundamentals of the grinding therapy. The periodontal maintenance phase forms part of periodontal treatment, and its objective is to prevent recurrence and to ensure long term preservation of the periodontal health achieved in the previous phases. The hoped for results of surgical procedures include not only cessation of the disease process, but also “healing” of the pocket via regeneration of periodontal tissues. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. This may involve reducing the pocket depths, rebuilding or growing bone, rebuilding or grafting soft tissues, and placing dental implants. Phases of Periodontal Therapy Contemporary periodontal treatment is designed based on the ‘Trimeric Model’, and is performed in 4 phases. Watch Queue Queue National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. 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), on Phase 2 Therapy Periodontal Surgery—Corrective Phase. Unit 8 Periodontics: Treatment Planning and Phase I Periodontal Therapy. Plaque and calculus can then be removed from all root surfaces, including furcations, irregularities etc., with direct vision. Corrective phase . Principally, the comprehensive periodontal therapy can be divided into four main phases followed by any dental emergency 7. The implantation of bone and bone replacement materials into the intraalveolar pockets, the GTR technique, the use of matrix proteins and in the future, use of growth factors are extremely promising. Furthermore, the temporary splinting, the treatment of secondary malpositions and … • Systemic phase of therapy including smoking counseling • Initial (or hygiene) phase of periodontal therapy, i.e. Compliance and its role in successful treatment of an advanced periodontal case: review of the literature and a case report. If surgery is necessary, it is usually performed as a second phase (corrective), following a thorough evaluation of the clinical results of Phase 1 therapy. 2002, Socransky & Haffajee 2002). Shareable Link. The goal of periodontal therapy is the maintenance of the dentition and/or its implant replacements in a state of health, comfort, function, and esthetics for the duration of a patient’s life. During the initial phase, any essential dental care, oral hygiene advice, and teeth cleaning (scaling of the teeth, including subgingival root debridement) are done. These phases are structured to ensure that periodontal therapy is conducted in a logical sequence, consequently improving the prognosis of the patient, in comparison to indecisive treatment plan without a clear goal. In the early 1980s, it was considered mandatory to commence periodontal therapy with a distinct oral hygiene phase during which the patient was motivated and instructed in proper oral hygiene (Gjermo, 1981). In addition, clinical studies have demonstrated that the debridement of subgingival calculus and biofilm must be performed before surgical intervention. 1968 Mar;15(3):371-80. “Gingivitis” is inflammation limited to the soft tissues. The root surfaces are exposed to clinical view either by reflecting a gingival flap or, less often, following excision of the gingiva (gingivectomy, p. 301). of the active and corrective phases of periodontal therapy, including subgingival scaling and surgical pocket elimination (Gjermo, 1981, Nyman, Lindhe, & Rosling, 1977). Original articles that reported on the effect of orthodontic therapy on periodontal health were included. But the practitioner strives for a “pocket free” periodontium whenever possible, especially when restorative/reconstructive procedures are planned upon those teeth that were previously periodontally involved. This video is unavailable. Please enable it to take advantage of the complete set of features! It is important to note that we aim to solve the problem with the least of amount of invasive procedures. A literature search was conducted using the databases, Medline, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies. Furcation Involvement—Furcation Treatment, Color Atlas of Dental Hygiene—Periodontology. Objectives. 2000) have also demonstrated that following resective procedures (osseous surgery), in comparison to simple “access flap” procedures, the depth of the residual pockets is less, and also the colonization by periodontopathic microorganisms (anaerobic!) Notwithstanding, the emphasis on a distinct oral hygiene phase has diminished, and the oral hygiene phase has become amalgamated with the actual causal therapy Maintenance phase. The patient must be motivated, and must exhibit adequate plaque control. Sources. For example, initial therapy and surgery are two entities with identical goals, but which use different methods to achieve these goals (closed root planing versus root planing with direct vision). In “periodontitis” the inflammation has caused breakdown of the bone. Current corrective treatments mainly involve: This type of care is appropriate for anyone, even those without a history of periodontal disease, who wishes to have optimal oral health. Previous Phase II—Corrective Procedures. The clinical procedures described above (root debridement or planing and reduction of niches) lead to the elimination of the causes of periodontal inflammation. Therefore, the goal of surgical intervention is to create a harmonic course of the gingival margin, which is achieved through the choice of incision (sulcular, paramarginal), the recontouring of the alveolar bone and the type of flap repositioning, usually at a somewhat more apical niveau. Examination “ P erio” is Greek for “around” and “odont” is Greek for “tooth.” So periodontal diseases affect the gum (gingiva) and the bone around the teeth. The primary goal of periodontal surgery is strictly antiinfective, meaning that the surgical modality aims to eliminate infection of pockets that have not responded to conservative treatment and/or medicinal adjuncts. In addition to improved esthetics, plaque control should also be simplified for the patient. 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