Treatment Planning Flashcards

A 45-year-old patient with Stage II periodontitis and a chief complaint of sensitivity is interested in implants after losing a first molar. What must be established before implant placement can be planned?

Answer: Periodontal disease must be controlled and the patient in stable maintenance

Untreated periodontitis is a risk factor for peri-implantitis; periodontal stability across the entire dentition must be confirmed before implant therapy is initiated.

In the 2017 periodontal classification, which factor upgrades a patient from Grade B to Grade C?

Answer: Smoking ≥10 cigarettes per day or HbA1c ≥7%

Grade C modifiers include smoking ≥10 cigarettes/day or HbA1c ≥7%, or a case exhibiting rapid progression or specific risk factors like molar-incisor pattern.

Which mucogingival condition is most likely to require treatment planning for gingival augmentation before orthodontic tooth movement?

Answer: Thin gingival biotype with minimal attached gingiva at teeth being moved facially

Thin biotype and inadequate attached gingiva at teeth being moved labially predisposes to recession during and after orthodontic treatment, warranting prophylactic augmentation.

A patient with necrotizing periodontal disease presents with an acute episode. Which is the correct initial treatment sequence?

Answer: Gentle debridement, oral hygiene instruction, 0.12% chlorhexidine rinse, and systemic metronidazole if systemic signs are present

Acute management of necrotizing periodontal disease includes gentle mechanical debridement, improved oral hygiene, antimicrobial rinses, and systemic metronidazole when fever or lymphadenopathy is present.

When determining crown-to-root ratio for strategic tooth retention, what ratio is generally considered the minimum acceptable for a tooth under occlusal load?

Answer: 1:2

A crown-to-root ratio of 1:2 (one-third crown to two-thirds root) is the minimum considered acceptable for teeth bearing occlusal load, though even this may be compromised by bone loss pattern or root morphology.

Which of the following best describes the role of occlusal adjustment in periodontal treatment planning?

Answer: It is adjunctive and indicated to reduce trauma from occlusion in teeth with mobility, but does not replace plaque control

Trauma from occlusion is a co-destructive factor that can worsen attachment loss in the presence of periodontal infection; adjustment reduces forces but is not a substitute for controlling the microbial etiology.

Which outcome measure is most appropriate for evaluating the success of active periodontal therapy at the re-evaluation appointment?

Answer: Reduction in bleeding on probing, pocket depth reduction, and gain in clinical attachment level

Re-evaluation success is measured primarily by reduced BOP (indicating inflammation control), pocket depth reduction, and clinical attachment level gain as objective clinical endpoints.