Treatment Planning Flashcards

Which radiographic finding most strongly influences the decision to extract versus retain a periodontally compromised molar?

Answer: Root trunk length relative to total root length

A short root trunk exposes furcations at shallower bone loss levels, making furcation management more difficult and the prognosis worse, which strongly influences the retain-versus-extract decision.

When using the AAP Periodontal Risk Assessment (PRA) model, which combination places a patient in the highest risk category?

Answer: Heavy smoker, uncontrolled diabetes, >8 sites with BOP, multiple teeth lost

The PRA model considers smoking, systemic disease, bleeding on probing, tooth loss, and pocket depths; multiple severe risk indicators converge to place patients in the highest risk polygon.

In planning a mucogingival procedure for root coverage, which recession classification predicts the least favorable outcome for complete root coverage?

Answer: Cairo RT3 (interproximal attachment loss > buccal)

Cairo RT3 recession, where interproximal attachment loss exceeds buccal loss, predicts partial root coverage at best due to compromised blood supply and papilla height.

A patient with a history of infective endocarditis requires extensive periodontal surgery. Which antibiotic prophylaxis regimen is recommended by the AHA?

Answer: Amoxicillin 2g orally 30-60 minutes before the procedure

The AHA recommends amoxicillin 2g (or clindamycin 600mg if penicillin-allergic) taken 30-60 minutes before procedures that manipulate gingival tissue in high-risk cardiac patients.

Which clinical scenario most appropriately indicates orthodontic extrusion as part of the periodontal treatment plan?

Answer: A single tooth with a subgingival fracture or caries extending below the alveolar crest

Forced orthodontic eruption moves the fracture or carious margin supragingivally, allowing for restorable margins and simultaneous coronal migration of alveolar bone.

For a patient who smokes 20 cigarettes per day and requires periodontal surgery, which counseling approach is most appropriate?

Answer: Inform the patient that smoking is a risk factor that may compromise healing and outcomes, and provide cessation support

Smoking significantly impairs healing, reduces treatment response, and increases recurrence risk; clinicians should counsel patients, offer cessation resources, and document the discussion while proceeding with appropriate care.

What does the term 'critical probing depth' refer to in periodontal treatment planning?

Answer: The probing depth at which surgical therapy yields greater attachment gain than non-surgical therapy

The critical probing depth (approximately 4-6mm depending on the study) is the threshold below which surgical therapy produces greater clinical attachment level gains than SRP alone.