Treatment Planning Flashcards

A patient presents with localized aggressive periodontitis (Stage III Grade C, molar-incisor pattern). Which adjunctive therapy is most supported by evidence?

Answer: Systemic amoxicillin plus metronidazole combined with SRP

Combining systemic amoxicillin (500mg TID) and metronidazole (500mg TID) with SRP has the strongest evidence for Grade C molar-incisor pattern periodontitis due to Aggregatibacter actinomycetemcomitans.

Which classification system, adopted by the 2017 World Workshop, is currently used to classify periodontal diseases for treatment planning?

Answer: 2017 staging and grading system (Stage I-IV, Grade A-C)

The 2017 World Workshop classification replaced prior systems, using a staging (I-IV) and grading (A-C) framework that incorporates complexity factors and risk modifiers.

A patient with end-stage renal disease on dialysis requires periodontal treatment. Which planning consideration is most critical?

Answer: Coordinating treatment on non-dialysis days and checking drug dosing due to altered clearance

Renal patients have altered drug clearance and bleeding tendencies (post-dialysis heparin effect), so treatment is best scheduled the day after dialysis with appropriate drug dosing adjustments.

In treatment planning for a patient with gingival enlargement due to amlodipine (a calcium channel blocker), what is the first recommended step?

Answer: Consult with the prescribing physician about substituting the medication

Drug substitution (e.g., changing to another antihypertensive) combined with meticulous plaque control can lead to significant regression of drug-influenced gingival enlargement before considering surgery.

When evaluating a patient for periodontal implant therapy, which factor represents an absolute contraindication to implant placement?

Answer: Active head and neck radiation therapy field

Active irradiation of the jaw is an absolute contraindication due to severely compromised vascularity and high risk of osteoradionecrosis following implant placement.

The McGuire and Nunn prognosis classification assigns which prognosis to a tooth that is 'impossible to maintain'?

Answer: Hopeless

The McGuire and Nunn system uses 'Hopeless' for teeth that cannot be maintained due to severe bone loss, poor crown-to-root ratio, or unresolvable furcation involvement.

A patient with Stage IV Grade C periodontitis requires full-mouth rehabilitation. What is the recommended sequence for prosthodontic and periodontal therapy?

Answer: Complete periodontal therapy and confirm stability before final prosthetics

Final prosthetic restorations should only be placed after periodontal health is established and stable, as tissue dimensions change during healing and affect margins and emergence profiles.