DOCSLIB.ORG

The Rationale for the Three Monthly Peridontal Recall Interval

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Rationale for the Three Monthly Peridontal Recall Interval See you in three months! IN BRIEF • Outlines the relevance of making recall plans individual to a patient’s needs GENERAL The rationale for the three and recognising the importance of compliance with these regimens. • Provides an understanding of the importance of risk assessment of monthly periodontal recall periodontal disease progression. • Enables an understanding of the concept of supportive periodontal therapy and the interval: a risk based approach integration of SPT with risk assessments. J. Darcey1 and M. Ashley2 VERIFIABLE CPD PAPER There is significant evidence to support the regular review of patients with chronic periodontitis. There is, however, com- paratively little evidence to demonstrate how often such reviews should take place. This paper looks at the periodontal healing period, the risks of periodontal progression and current thinking about maintenance programmes. It thus attempts to establish some guidelines that practitioners may use when calculating recall intervals. Clinical relevance The choice of individual, patient-focused recall intervals is essential to limit disease progression and maintain healthy periodontal tissues. These are so often the parting words as in turn give rise to further disease progres- Thus such combinations of active peri- a patient leaves the dental surgery after sion and ultimately failure of periodontal odontal therapy, oral hygiene advice and a course of periodontal treatment: ‘When treatment. The aim of this paper is to assess regular follow up have increasingly dem- would you like to see me again?’ It is the literature and discuss the rationale for onstrated improvements in periodontal then that the clinical auto-pilot engages such programmes. health.5-7 Thus we can begin to see a strong and a figure is reeled off: ‘Three months clinical argument for more regular peri- Mrs Jones.’ Years of education and clini- WHAT IS THE EVIDENCE FOR THE odontal maintenance therapy. IMPORTANCE OF MAINTENANCE? cal experience allow rapid processing of the information and we calculate a date. For obvious ethical reasons there are very WHAT IS THE CURRENT THINKING? Yet how? There is now a firm body of few studies that demonstrate the outcome Historically it is said that we should evidence supporting the prescription of of not treating or maintaining the peri- not undertake any form of periodontal recall intervals based upon caries risk odontal health of a population yet there treatment for three months after initial but when it comes to periodontal disease are some. In the seminal paper Loe et al.1 therapy so: and its follow up the literature becomes demonstrated significant progression of 1. There is sufficient time for more sparse. periodontal disease in a group of patients development and maturation of a long It is widely accepted that when a patient who had no periodontal therapy over 15 junctional epithelium with chronic periodontitis has come to years. This was also supported by Lindhe et 2. The sub-gingival flora can re-establish the end of a period of active periodontal al. in 1989 when a cohort of the Japanese and it is possible to assess whether treatment they should enter a maintenance population were observed for two years anaerobic periodontopathogens phase. The purpose of this is to allow the without any periodontal intervention: have re-colonised sites: In one study periodontal tissues to heal and for the although the extent of disease varied, there there was a marked reduction in clinical team to provide the appropri- was evident progression of periodontal spirochetes that continued up to ate support for the patient. Without such disease throughout the group.2 seven weeks after a course of root vigilance it is likely that the patient will Conversely for the last 50 years there planing and scaling.8 It has, however, not achieve an adequate standard of daily has been a growing body of evidence to also been noted that pathogens can dental hygiene and the tissues will become support the benefits of regular follow up. increase to pre-treatment levels in re-infected with dental plaque. This may In 1961 Lovdal et al. found that a com- 9-11 weeks9 bination of oral hygiene instruction and 3. Sufficient time has elapsed to assess 1*Specialist Registrar and Honorary Lecturer in Restora- cleaning performed 2-4×/annum for five the patient’s level of oral hygiene. tive Dentistry, 2Consultant in Restorative Dentistry, years dramatically reduced the incidence There is a tendency for this to plateau. University Dental Hospital of Manchester, Higher 3 Cambridge Street, Manchester, M15 6FH of tooth loss and inflammation. Axelsson Indeed it has been reported that *Correspondence to: Dr James Darcey and Lindhe in 1981 performed a similar without motivation patients’ oral Email: [email protected] study. The results indicated early follow- hygiene may deteriorate10 Refereed Paper up is linked to a reduction in disease and 4. Healing after non-surgical periodontal Accepted 21 July 2011 DOI: 10.1038/sj.bdj.2011.868 the progression of caries and periodontal therapy is complete. Although ©British Dental Journal 2011; 211: 379-385 disease can be effectively halted.4 epithelialisation takes place after 2-7 BRITISH DENTAL JOURNAL VOLUME 211 NO. 8 OCT 22 2011 379 © 2011 Macmillan Publishers Limited. All rights reserved. GENERAL Presence of plaque days immature collagen fibres are current thinking is that not only is diabetes only laid down by 21 days. Complete We know that plaque is intimately related mellitus closely related to the aetiology of repair may take about seven weeks to periodontal disease.17,18 It is, however, periodontal disease but periodontal disease though collagen maturation may hard to correlate plaque levels to main- may be related to poor glycaemic control. take longer.11 tenance of periodontal health as host This, in turn has been demonstrated to lead inflammatory response to plaque is very to further bone destruction and progression Although these statements will be variable. Thus quantifying plaque levels, of periodontal disease.21 As such all patients known to most practitioners there is seem- though useful in terms of demonstrat- should be closely monitored. Conversely ingly little reference within the texts to the ing patient compliance, cannot so easily the dentist should be aware that progres- science behind them. Thus, although it is be used to quantify risk. It is the inflam- sive periodontitis in patients with otherwise useful to use these as a guide to selecting matory response to the plaque that is the controlled risk factors may be diabetic. It recall intervals, it would be more sensible crucial detail to correlate to plaques scores. is thought that approximately 30% of dia- to move away from generic statements and betic patients are undiagnosed. The dentist towards patient-focused decision making. Genetic influences certainly should screen and refer patients if To do this we can perform risk assessments In a study assessing 117 pairs of adult twins suspicions are aroused. for periodontal disease in the same way (monozygotic and dizygotic) Michalowicz we perform them for caries development et al. found statistically significant cor- Medication and progression. relations between these participants when There are several systemic medications compared to the general population for with the known side effect of gingival THE PERIODONTAL RISK adult periodontitis. Thus it has been sug- over growth. Though technically clas- ASSESSMENT gested genetic influences account for up to sified as a gingival disease modified by Risk is the likelihood of either developing 50% of the variance in disease across the medication, the ensuing overgrowth can a particular disease or of having a particu- population.19 This is thought to be related to present a risk for periodontal disease lar disease progress over a given period genetic differences in host response. Such through an interference to plaque con- of time. It depends on possession of and/ genetic polymorphisms include variants in trol. The most common enlargements or exposure to risk factors. Such risk fac- interleukin 1 (IL-1), tumour necrosis factor pertain to antihypertensive calcium chan- tors known to be involved in periodontal (TNF) and immunoglobulin G Fc (FcR). As nel blockers (nifedipine, amlodipine and disease include: such it is always wise to inquire as to fam- diltiazem), anti epileptics (phenytoin) ily history of gum disease or ‘pyorrhoea’ and immunosuppressants (cyclosporin). Current periodontal health and edentulousness in parents, grandpar- With such medications gingival enlarge- There is an ever increasing body of evi- ents and siblings. This may reveal a pre- ment is associated with plaque presence dence to suggest that the current disease disposition of which the patient needs to be and as such one can easily see a peri- status/severity is of paramount importance informed, so that preventive dental care can odontal condition deteriorating if plaque in calculating the future disease risk and be provided for younger family members. control is inhibited by gingival irregular- treatment planning for a patient.12 ity. Though the association has not been Systemic influences proven, as inadequate plaque control Bleeding on probing Diabetes mellitus is implicated in the aetiology of peri- The simplest measure of the absence of odontal disease, practitioners should be disease is the absence of bleeding on The strong relationship between diabe- vigilant nonetheless. probing. Bleeding is a marker of gingival tes mellitus and periodontal disease is inflammation and though not an indicator now recognised and being increasingly Local influences of attachment loss, it is a negative predic- understood. In such patients, chronically Mal-alignment, imbrications, drift- tor of future attachment loss.13 Bleeding elevated blood glucose levels speeds the ing and crowding have all been con- on probing can thus be regarded as a formation of advanced glycation end nected to loss of periodontal support.22 determinant of a higher risk of disease products (AGEs). These AGEs interact The risk of periodontal disease is greater progression.14,15 with endothelial cells and monocytes.
Load more

Recommended publications
  • Comparison of a Tridimensional Cephalometric Analysis Performed
    Maspero et al. Progress in Orthodontics (2019) 20:40 https://doi.org/10.1186/s40510-019-0293-x RESEARCH Open Access Comparison of a tridimensional cephalometric analysis performed on 3T- MRI compared with CBCT: a pilot study in adults Cinzia Maspero1,2*† , Andrea Abate1,2†, Francesca Bellincioni1,2†, Davide Cavagnetto1,2†, Valentina Lanteri1,2, Antonella Costa1 and Marco Farronato1,2 Abstract Objective: Since the introduction of cone-beam computed tomography (CBCT) in dentistry, this technology has enabled distortion-free three-dimensional cephalometric analysis for orthodontic and orthognathic surgery diagnosis. However, CBCT is associated with significantly higher radiation exposure than traditional routine bidimensional examinations for orthodontic diagnosis, although low-dose protocols have markedly reduced radiation exposure over time. The objective of this preliminary feasibility study is to compare the accuracy and diagnostic capabilities of an already-validated three-dimensional cephalometric analysis on CBCT to those of an analysis on 3-T magnetic resonance imaging (3T-MRI) to assess whether the latter can deliver a comparable quality of information while avoiding radiation exposure. Materials and methods: In order to test the feasibility of three-dimensional cephalometry on 3T-MRI, 18 subjects (4 male; 14 female) with mean age 37.8 ± SD 10.2, who had undergone both maxillofacial CBCT and maxillofacial 3T-MRI for various purposes within 1 month, were selected from the archive of the Department of Dentistry and Maxillofacial Surgery of Fondazione Ospedale Policlinico Maggiore, IRCCS, Milano, Italy. A three-dimensional cephalometric analysis composed of ten midsagittal and four bilateral landmarks and 24 measurements (11 angular, 13 linear) was performed on both scans using Mimics Research® v.
    [Show full text]
  • TITLE: Photo-Activated Disinfection Therapy for Dental Surgery: Review of the Clinical Effectiveness
    TITLE: Photo-Activated Disinfection Therapy for Dental Surgery: Review of the Clinical Effectiveness DATE: 11 September 2013 CONTEXT AND POLICY ISSUES The oral cavity harbors more than 700 prokaryote species;1 most of these species are normal flora of the healthy oral cavity.2 Some of these microorganisms are responsible for oral pathologies. Bacteria such as Actinobacillus actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia are responsible for common forms of periodontal diseases,3 and Bacteroides, Peptostreptococcus, and microaerophilic Streptococcus species may cause osteomyelitis of the jaw.4 During a surgical intervention, disinfection of the oral cavity is attempted by using different chemical solutions such as chlorhexidine and iodine. This is done to prevent, or at least reduce the risk of wound infections or bacteremia following the surgical intervention.5 In the case of periodontal and endodontic treatments, mechanical cleaning of the affected surfaces are believed to be the gold standard.6 Photodynamic antimicrobial chemotherapy or light-activated disinfection is a technology based on the production of free oxygen radicals capable of affecting the membranes of microorganisms.7 The technique is composed of a photosensitizer substance that can be activated with a suitable wave length and light source. The photosensitizer, usually toluidine blue, is activated with a light source. After its activation, it produces energy capable of transforming the surrounding oxygen into free radicals. The free radical then attacks the exposed microorganisms.7 Photodynamic chemotherapy may be used in dentistry to reduce the bacterial load in cases of periodontal lesions and during root canals. Another potential use of this technique is as a pre- surgical disinfection method for the oral cavity to prevent oral flora from penetrating the bone and submucosal tissues during surgery.
    [Show full text]
  • Importance of Chlorhexidine in Maintaining Periodontal Health
    International Journal of Dentistry Research 2016; 1(1): 31-33 Review Article Importance of Chlorhexidine in Maintaining Periodontal IJDR 2016; 1(1): 31-33 December Health © 2016, All rights reserved www.dentistryscience.com Dr. Manpreet Kaur*1, Dr. Krishan Kumar1 1 Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak-124001, Haryana, India Abstract Plaque is responsible for periodontal diseases. In order to prevent occurrence and progression of periodontal disease, removal of plaque becomes important. Mechanical tooth cleaning aids such as toothbrushes, dental floss, interdental brushes are used for removal of plaque. However, in some cases, chemical agents are used as an adjunct to mechanical methods to facilitate plaque control and prevent gingivitis. Chlorhexidine (CHX) mouthwash is the most commonly used and is considered as gold standard chemical agent. In this review, mechanism of action and other properties of CHX are discussed. Keywords: Plaque, Chemical agents, Chlorhexidine (CHX). INTRODUCTION Dental plaque is primary etiologic factor responsible for gingivitis and periodontitis [1]. Mechanical plaque control using toothbrushes, interdental brushes, dental floss prevent occurrence of gingivitis. However, in majority of population, mechanical methods of plaque control are ineffective due to less time spent[2] for plaque removal and lack of consistency. These limitations necessitate use of chemical plaque control agents as an adjunct to mechanical plaque control. Among various chemical agents, chlorhexidine (CHX) is considered to be a gold standard chemical agent for plaque control. Its structural formula consists of two symmetric 4-chlorophenyl rings and two biguanide groups connected by a central hexamethylene chain. Mechanism of action for CHX CHX is bactericidal and is effective against gram-positive bacteria, gram-negative bacteria and yeast organisms.
    [Show full text]
  • DENTIN HYPERSENSITIVITY: Consensus-Based Recommendations for the Diagnosis & Management of Dentin Hypersensitivity
    October 2008 | Volume 4, Number 9 (Special Issue) DENTIN HYPERSENSITIVITY: Consensus-Based Recommendations for the Diagnosis & Management of Dentin Hypersensitivity A Supplement to InsideDentistry® Published by AEGISPublications,LLC © 2008 PUBLISHER Inside Dentistry® and De ntin Hypersensitivity: Consensus-Based Recommendations AEGIS Publications, LLC for the Diagnosis & Management of Dentin Hypersensitivity are published by AEGIS Publications, LLC. EDITORS Lisa Neuman Copyright © 2008 by AEGIS Publications, LLC. Justin Romano All rights reserved under United States, International and Pan-American Copyright Conventions. No part of this publication may be reproduced, stored in a PRODUCTION/DESIGN Claire Novo retrieval system or transmitted in any form or by any means without prior written permission from the publisher. The views and opinions expressed in the articles appearing in this publication are those of the author(s) and do not necessarily reflect the views or opinions of the editors, the editorial board, or the publisher. As a matter of policy, the editors, the editorial board, the publisher, and the university affiliate do not endorse any prod- ucts, medical techniques, or diagnoses, and publication of any material in this jour- nal should not be construed as such an endorsement. PHOTOCOPY PERMISSIONS POLICY: This publication is registered with Copyright Clearance Center (CCC), Inc., 222 Rosewood Drive, Danvers, MA 01923. Permission is granted for photocopying of specified articles provided the base fee is paid directly to CCC. WARNING: Reading this supplement, Dentin Hypersensitivity: Consensus-Based Recommendations for the Diagnosis & Management of Dentin Hypersensitivity PRESIDENT / CEO does not necessarily qualify you to integrate new techniques or procedures into your practice. AEGIS Publications expects its readers to rely on their judgment Daniel W.
    [Show full text]
  • Bleeding Disorders of Importance in Dental Care and Related Patient Management
    Clinical P RACTIC E Bleeding Disorders of Importance in Dental Care and Related Patient Management Contact Author Anurag Gupta, BDS; Joel B. Epstein, DMD, MSD, FRCD(C); Robert J. Cabay, MD, DDS Dr. Epstein Email: [email protected] ABSTRACT Oral care providers must be aware of the impact of bleeding disorders on the manage- ment of dental patients. Initial recognition of a bleeding disorder, which may indicate the presence of a systemic pathologic process, may occur in dental practice. Furthermore, prophylactic, restorative and surgical dental care of patients with bleeding disorders is best accomplished by practitioners who are knowledgeable about the pathology, com- plications and treatment options associated with these conditions. The purpose of this paper is to review common bleeding disorders and their effects on the delivery of oral health care. For citation purposes, the electronic version MeSH Key Words: blood coagulation/physiology blood coagulation disorders/complications dental care is the definitive version of this article: www.cda-adc.ca/jcda/vol-73/issue-1/77.html entists must be aware of the impact of The patient should be asked for any history bleeding disorders on the management of significant and prolonged bleeding after Dof their patients. Proper dental and med- dental extraction or bleeding from gingivae. ical evaluation of patients is therefore neces- A history of nasal or oral bleeding should sary before treatment, especially if an invasive be noted. Many bleeding disorders, such as dental procedure is planned. Patient evalua- hemophilia and von Willebrand’s disease, tion and history should begin with standard run in families; therefore, a family history medical questionnaires.
    [Show full text]
  • The Consumer's Guide to Safe, Anxiety-Free Dental Surgery
    The Consumer’s Guide to Safe, Anxiety-Free Dental Surgery Jeffrey V. Anzalone, DDS 1 2 About The Author 7 Meet The Anzalones 9 Acknowledgments 11 Overview of the BIG PICTURE 13 The 9 Most Important Dental Surgery Secrets 13 Chapter 2 Selecting the Right Dental Surgeon 17 What Are the Dental Specialties That Perform Surgery? 19 What Is a Periodontist? 20 Chapter 3 The Consultation 23 The Initial Consultation: Examining the Doctor 25 Am I a candidate for surgery? 26 14 Questions to Ask Your Prospective Periodontist 27 Chapter 4 Gum Disease (Periodontitis) 29 Gum Disease Symptoms 30 Pocket Recording 32 Is gum disease contagious? 32 Gum Disease and the Human Body 33 Gum Disease and Cardiovascular Disease 33 Gum Disease and Other Systemic Diseases 34 Gum Disease and Women 35 Gum Disease and Children 37 Signs of Periodontal Disease 38 Advice for Parents 39 Gum Disease Risk Factors 41 Non-Surgical Periodontal Treatment 42 Regenerative Procedures 43 Pocket Reduction Procedures 44 Follow-Up Care 45 Chapter 5 The Photo Gallery 47 Free Gingival Graft 47 Connective Tissue Graft 49 Dental Implants 51 Sinus Lift With Dental Implant Placement 53 Classification of Implant Sites 53 Implants placed after sinus has been elevated 54 3 4 Sinus Lift as a Separate Procedure 55 Sinus Perforation 55 Bone Grafting 57 Esthetic Crown Lengthening 59 Crown Lengthening for a Restoration 60 Tooth Extraction and Socket Grafting 61 More Photos of Procedures 62 Connective Tissue Graft 62 Connective Tissue Graft + Crowns 64 Free Gingival Graft 64 Esthetic Crown Lengthening
    [Show full text]
  • Retrospective Analysis of the Risk Factors of Peri-Implantitis Nathan Anderson1, Adam Lords2, Ronald Laux3, Wendy Woodall4, Neamat Hassan Abubakr5
    ORIGINAL RESEARCH Retrospective Analysis of the Risk Factors of Peri-implantitis Nathan Anderson1, Adam Lords2, Ronald Laux3, Wendy Woodall4, Neamat Hassan Abubakr5 ABSTRACT Aim and objective: Peri-implantitis is a key concern for dental implants and the main common reason for implant failure. This investigation evaluated the risk factors and their implications on peri-implantitis. Materials and methods: A retrospective search of the patients’ clinical notes was performed to identify the documented cases of peri-implantitis. The inclusion criteria encompassed patients who were 18 years and older and were seen at the School of Dental Medicine, University of Nevada, Las Vegas, from January 2014 through September 2018. The search revealed that the number of peri-implantitis cases was 28, with an overall 45 implants. Data were collected and analyzed using the Chi-square test. Results: Total 28 patients presented with peri-implantitis. The distribution of males to females with peri-implantitis was 60.7 and 39.3%, respectively. The highest number of patients (21.4%) presenting with peri-implantitis fell within the age range of 65–69 years; 53.3% of peri- implantitis cases were in the maxillary arch. The predilection area for peri-implantitis was the mandibular first molar (24.4%). Periodontitis was the most significant cause (60.7%); respiratory diseases (42.9%) followed by hypertension (28.6%) were the most prevalent medical conditions in the studied population. Peri-implantitis occurred most frequently among Caucasians (62.7%), followed by Hispanics (29%). Conclusion: Within the limitations of the current evaluation, findings support previous claims that periodontitis remains the strongest predictor of peri-implantitis.
    [Show full text]
  • Does Your Plan Cover Orthodontics in Progress?
    ® Cigna Dental Care (DHMO) DOES YOUR PLAN COVER ORTHODONTICS IN PROGRESS? Even though you or a family member is in the middle of “active orthodontic treatment,” when you join the Cigna DHMO*, your plan may help pay some of your orthodontic costs. Q: What is “Orthodontics in Progress”? Orthodontics in Progress Example** (Based on Patient Charge Schedule K1-08) A: Are you getting “active orthodontic treatment” that will not be finished until after your Cigna plan takes effect? “Active treatment” means the orthodontist has started . 24 months of active treatment to make your teeth move by putting bands between your teeth, or by putting an began on 08/09/12. orthodontic appliance (such as braces) in your mouth. If so, this is called “Orthodontics in Progress.” . On 1/1/13, the patient’s Cigna DHMO plan takes effect. Q: Do I have coverage for Orthodontics in Progress under my new . 20 months of active treatment Cigna plan? remaining. A: Your Cigna DHMO Patient Charge Schedule (“PCS”) tells you if you have orthodontic coverage under your plan. Your coverage with Cigna may be different . Cigna DHMO contribution for from the coverage you had under your old plan. Keep in mind, enrolling in the Cigna active treatment per month is plan does not change the terms of the contract you signed with your orthodontist $26.25. when your treatment began. You are still responsible for the orthodontist’s total case . The Cigna DHMO plan pays $525 fee. ($26.25 per month x 20 months of remaining active treatment). Q: What happens if I enroll again after my plan year ends and get a In this example, the patient’s Cigna new PCS at the beginning of a new coverage period? DHMO plan would contribute $26.25 A: Even though you would continue to be covered by a Cigna DHMO plan when a per month of the monthly orthodontic new coverage period begins, sometimes your PCS will change.
    [Show full text]
  • The Frontal Cephalometric Analysis – the Forgotten Perspective
    CONTINUING EDUCATION The frontal cephalometric analysis – the forgotten perspective Dr. Bradford Edgren delves into the benefits of the frontal analysis hen greeting a person for the first Wtime, we are supposed to make Educational aims and objectives This article aims to discuss the frontal cephalometric analysis and its direct eye contact and smile. But how often advantages in diagnosis. when you meet a person for the first time do you greet them towards the side of the Expected outcomes Correctly answering the questions on page xx, worth 2 hours of CE, will face? Nonetheless, this is generally the only demonstrate the reader can: perspective by which orthodontists routinely • Understand the value of the frontal analysis in orthodontic diagnosis. evaluate their patients radiographically • Recognize how the certain skeletal facial relationships can be detrimental to skeletal patterns that can affect orthodontic and cephalometrically. Rarely is a frontal treatment. radiograph and cephalometric analysis • Realize how frontal analysis is helpful for evaluation of skeletal facial made, even though our first impression of asymmetries. • Identify the importance of properly diagnosing transverse that new patient is from the front, when we discrepancies in all patients; especially the growing patient. greet him/her for the first time. • Realize the necessity to take appropriate, updated records on all A patient’s own smile assessment transfer patients. is made in the mirror, from the facial perspective. It is also the same perspective by which he/she will ultimately decide cephalometric analysis. outcomes. Furthermore, skeletal lingual if orthodontic treatment is a success Since all orthodontic patients are three- crossbite patterns are not just limited to or a failure.
    [Show full text]
  • Controlling the Intraoral Environment Before and After Implant Therapy a Peer-Reviewed Publication Written by Richard Nejat, DDS; Daniel Nejat, DDS; and Fiona M
    Earn 4 CE credits This course was written for dentists, dental hygienists, and assistants. Controlling the Intraoral Environment Before and After Implant Therapy A Peer-Reviewed Publication Written by Richard Nejat, DDS; Daniel Nejat, DDS; and Fiona M. Collins, BDS, MBA, MA PennWell is an ADA CERP Recognized Provider Go Green, Go Online to take your course This course has been made possible through an unrestricted educational grant. The cost of this CE course is $59.00 for 4 CE credits. Cancellation/Refund Policy: Any participant who is not 100% satisfied with this course can request a full refund by contacting PennWell in writing. Educational Objectives smoking and drinking. The association between systemic Upon completion of this course, the clinician will be able to disease and periodontal health is well established, and the do the following: relationship between periodontal health and peri-implant 1. Understand the process of patient selection and the health is well established. For short- and long-term success systemic considerations that affect candidacy for of implants, patients must be willing and able to perform implant treatment effective oral hygiene measures to control the intraoral 2. List the adverse implant outcomes due to biological/ microbial environment. microbiological factors and mechanical factors 3. Control the intraoral environment during all three Patient Selection phases of implant treatment—presurgical, postsurgical, Patient selection during implant treatment planning involves and maintenance many considerations. In addition to the intraoral environ- 4. Understand the precautions to be taken when using ment, the patient’s general health status and smoking habits instruments around implants and the potential damage are highly relevant.
    [Show full text]
  • American Academy of Periodontology Task Force Report on the Update to the 1999 Classification of Periodontal Diseases and Conditions*
    J Periodontol • July 2015 American Academy of Periodontology Task Force Report on the Update to the 1999 Classification of Periodontal Diseases and Conditions* The American Academy of Periodontology (AAP) peri- 4 mm CAL, and Severe =‡5 mm CAL.’’ Numerous odically publishes reports, statements, and guidelines important studies since 1999 have used similar pa- on a variety of topics relevant to periodontics. These rameters to define periodontitis. For example, the papers are developed by an appointed committee of recent epidemiologic studies outlining the prevalence experts, and the documents are reviewed and ap- of periodontitis in the United States used attachment proved by the AAP Board of Trustees. loss parameters to define various severities of peri- odontitis.2,3 It is recognized that CAL is of importance for the scientific advancement of the knowledge of n 2014, the American Academy of Periodontology periodontitis. However, in clinical practice, measure- Board of Trustees charged a Task Force to develop ment of CAL has proven to be challenging, and is time Ia clinical interpretation of the 1999 Classification consuming. Measuring the location of the cemento- of Periodontal Diseases and Conditions to address enamel junction (CEJ) when the gingival margin is concerns expressed by the education community, the located coronal to the CEJ is difficult and may involve American Board of Periodontology, and the practic- some guesswork when the CEJ is not readily evident ing community that the current Classification pres- via tactile sensation. These issues can result in ex- ents challenges for the education of dental students aminations being performed in which, rather than and implementation in clinical practice.
    [Show full text]
  • Painful Realities: General Anesthesia Access in Sacramento Gmc Dental Managed Care
    PAINFUL REALITIES: GENERAL ANESTHESIA ACCESS IN SACRAMENTO GMC DENTAL MANAGED CARE June 2020 SACRAMENTO COUNTY ORAL HEALTH PROGRAM BARBARA AVED ASSOCIATES PREPARED FOR THE MEDI-CAL DENTAL ADVISORY COMMITTEE Sacramento County Oral Health Program Prepared by Barbara Aved Associates Funding for this study was made possible by California Department of Public Health Office of Oral Health To obtain additional copies of this report please contact: Sacramento County Department of Health Services Public Health Division 7001-A East Parkway, Suite 600 Sacramento, CA 95823 Phone: (916) 875-6259 TTY: (877) 835-2929 Website: www.scph.com 2 | Page TABLE OF CONTENTS “These families don’t return [to the dentist] as they feel embarrassed and judged and usually just wait until their special needs child is complaining of pain or some type of issue with the child’s teeth is visible.” — Alta CA Regional Center staff “Failure to accommodate patients with special health care needs could be considered discrimination and a violation of federal and/or state law.” — American Academy of Pediatric Dentistry EXECUTIVE SUMMARY .................................................................................................................... 4 INTRODUCTION ............................................................................................................................... 8 PROCESS AND DATA SOURCES ...................................................................................................... 10 Study design ............................................................................................................................
    [Show full text]