Periodontics Determination Short And Long Essay Question And Answers

Determination Of Prognosis

Determination Of Prognosis Important Notes

1. Factors determining prognosis

1. Prognosis

• It is a prediction of the probable course, duration, and outcome of a disease based on general knowledge of the pathogenesis of the disease and the presence of risk factors for the disease.
• It is established after the diagnosis is made and before the treatment plan is established

2. For a younger patient with rapid bone destruction, the prognosis is considered poor because of the shorter period in which the bone loss has occurred in spite of greater bone reparative capacity

Determination Of Prognosis Long Essay

Question 1. Define Prognosis. Describe in detail the factors determining prognosis.
Answer:

Overall:

1. Patient age:

• Old age- Better prognosis
• Young age – Not good

2. Disease severity:

1. Pocket depth:
   • Deep pocket – Better prognosis
2. Level of attachment:
   • The extent of disease to the root surface
3. Pulpal involvement:
   • Endodontic involvement – Poor prognosis
4. Degree of bone loss:
   • Height of remaining bone determining prognosis
5. Type of bony defects:
   • Vertical bone defect – Good prognosis
   • Good regeneration

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3. Plaque control:

• Effective plaque removal – Good prognosis

4. Patient compliance and cooperation:

• Cooperative patients – Good prognosis
• Unwilling patients – Poor prognosis

5. Economic consideration:

• Patients having low income try to avoid expensive treatment
• Thus have a poor prognosis

6. Knowledge and ability of dentist: Dentists should know different modalities of treatment of a specific case.

Systemic Factors:

1. Type 1 and type 2 diabetes:

• The prognosis depends on the patient’s compliance

2. Uncontrolled diabetes:

• Questionable prognosis

3. Parkinson’s disease:

• Improved prognosis by use of automated oral hygiene devices

4. Genetic factors:

• Defects – Genetic polymorphism
• Increased production of IL1-ẞ

Stage:

• Early detection of patients at risk
• Identification of risk during the course of treatment
• Identification of young patients at risk
• Alterations in treatment improve prognosis

Respective Measures:

• Early implementation of therapy
• Adjunctive antibiotic therapy
• Early intervention

5. Environmental factors:

• Smokers – Fair to poor prognosis
• Patient having quit smoking – Fair to good progress

6. Local Factors:

• Plaque/calculus – Efficient removal-good prognosis
• Subgingival restoration – Poor prognosis
• Anatomic variations/factors

Types:

• Short tapered roots
• CEP
• Enamel pearls
• Poor concavities
• Developmental grooves
• Poor prognosis due to reduced periodontal support

Determination Of Prognosis Short Essays

Question 1. Types of Prognosis.
Answer:

Question 2. Anatomic Variations.
Answer:

1. Cervical enamel projections:

• Flat, ectopic extensions of enamel
• Extend: Beyond CEJ furcations
• Site: Buccal surfaces of maxillary 2nd molars

2. Enamel pearls:

• Large round deposits of enamel
• Extend – Furcation and root surfaces
• Effect – Interferes with attachment
• Prevent regeneration

3. Root concavities:

• Shallow flutings to deep depressions
• Resistant to torquing forces
• Inaccessible areas

4. Developmental grooves:

• Palato gingival grooves
• Extend – Enamel to the root surface

5. Other:

• Root proximity
• Furcation areas
• Difficult to access

Determination Of Prognosis Viva Voce

1. The prognosis is considered poor if the base of the pocket is close to the root apex
2. In the case of supra bony pocket, the prognosis depends on the height of the existing bone
3. In the case of infrabony pockets, the contour of existing bone and the number of remaining osseous walls influ- ences prognosis