Periodontics. Fernando Suarez

Чтение книги онлайн.

СКАЧАТЬ manifestation of systemic diseases and developmental and acquired conditionsSystemic diseases or conditions affecting the periodontal supporting tissuesOther periodontal conditionsPeriodontal abscessesEndodontic-periodontic lesionsMucogingival deformities and conditions around teethGingival biotypeGingival/soft tissue recessionLack of gingivaDecreased vestibular depthAberrant frenum/muscle positionGingival excessAbnormal colorCondition of the exposed root surfaceTraumatic occlusal forcesPrimary occlusal traumaSecondary occlusal traumaOrthodontic forcesProsthesis- and tooth-related factors that modify or predispose to plaque-induced gingival diseases/periodontitisLocalized tooth-related factorsLocalized dental prosthesis–related factorsPeri-implant diseases and conditionsPeri-implant healthPeri-implant mucositisPeri-implantitisPeri-implant soft and hard tissue deficiencies

       The 2017 workshop characterized periodontal health and gingival inflammation in a reduced periodontium after completion of successful treatment of a patient with periodontitis.

       The workshop agreed that, consistent with current knowledge on pathophysiology, three forms of periodontitis can be identified:Necrotizing periodontitisPeriodontitis as a manifestation of systemic diseasePeriodontitis

       The forms of the disease previously recognized as “chronic” or “aggressive” are now grouped under a single category, “periodontitis.”

       A new classification framework for periodontitis was established and further characterized based on a multidimensional staging and grading system that can be adapted over time as new evidence emerges.Goals of staging a periodontitis patient40:Classify severity and extent of an individual based on currently measurable extent of destroyed and damaged tissue attributable to periodontitis.Assess specific factors that may determine complexity of controlling current disease and managing long-term function and esthetics of the patient’s dentition.Goals of grading a periodontitis patient40:Estimate future risk of periodontitis progression and responsiveness to standard therapeutic principles, to guide intensity of therapy and monitoring.Estimate potential health impact of periodontitis on systemic disease and the reverse, to guide systemic monitoring and cotherapy with medical colleagues.

       A new classification scheme for dental implants was developed by the workshop, including the following: peri-implant health, peri-implant mucositis, peri-implantitis, and peri-implant soft and hard tissue deficiencies.

      Conclusion

      The diagnosis represents the first stage and one of the most critical phases in the sequence of treatment for periodontal patients. An appropriate and accurate diagnosis is essential for continuing with the next phases of treatment (establishing an etiology, prognosis, treatment plan, etc). Without a proper diagnosis, the treatment plan may be incomplete or even harmful to the patient. Consequently, it is of paramount importance to understand and properly utilize the multitude of tools pertaining to the acquisition of data for the creation of a diagnosis. Last, while some of these parameters may be of greater diagnostic value than others, the diagnosis should be formed based on the information obtained from all these different tools and methods of examination, including both clinical and radiographic evidence. Relying on a single parameter can also result in incomplete or inadequate diagnosis.

      References

      1. American Academy of Periodontology. Glossary of Periodontal Terms. American Academy of Periodontology, 2001.

      2. Research, Science and Therapy Committee. Position Paper: Diagnosis of Periodontal Diseases. J Periodontol 2003;74:1237–1247.

3. The American Academy of Periodontology. Periodontal literature review: The Next Generation. A Review of Periodontal Literature from 1996 – 2010. Retrieved 24 October 2019 from https://www.perio.org/plr.

      4. Ramachandra SS, Mehta DS, Sandesh N, Baliga V, Amarnath J. Periodontal probing systems: A review of available equipment. Compend Contin Educ Dent 2011;32:71–77.

      5. Van der Velden U, de Vries JH. The influence of probing force on the reproducibility of pocket depth measurements. J Clin Periodontol 1980;7:414–420.

      6. Kalkwarf KI, Kaldahl WD, Patil KD. Comparison of manual and pressure-controlled periodontal probing. J Periodontol 1986;57:467–471.

7. Armitage GC. Periodontal diseases: Diagnosis. Ann Periodontol 1996;1:37–215.

      8. Persson GR. Effects of line-angle versus midproximal periodontal probing measurements on prevalence estimates of periodontal disease. J Periodontal Res 1991;26:527–529.

      9. Armitage GC, Svanberg GK, Löe H. Microscopic evaluation of clinical measurements of connective tissue attachment levels. J Clin Periodontol 1977;4:173–190.

      10. Schou S, Holmstrup P, Stoltze K, Hjørting-Hansen E, Fiehn NE, Skovgaard LT. Probing around implants and teeth with healthy or inflamed peri-implant mucosa/gingiva. A histologic comparison in cynomolgus monkeys (Macaca fascicularis). Clin Oral Implants Res 2002;13:113–126.

      11. Abrahamsson, I, Soldini C. Probe penetration in periodontal and peri-implant tissues. An experimental study in the beagle dog. Clin Oral Implants Res 2006;17:601–605.

      12. Magnusson I, Listgarten MA. Histological evaluation of probing depth following periodontal treatment. J Clin Periodontol 1980;7:26–31.

      13. Fowler C, Garrett S, Crigger M, Egelberg J. Histologic probe position in treated and untreated human periodontal tissues. J Clin Periodontol 1982;9:373–385.

      14. Lang NP, Wetzel AC, Stich H, Caffesse RG. Histologic probe penetration in healthy and inflamed peri-implant tissues. Clin Oral Implants Res 1994;5:191–201.

      15. Listgarten MA. Re: Periodontal terminology. J Periodontol 1993;64:918.

      16. Lang NP, Löe H. The relationship between the width of keratinized gingiva and gingival health. J Periodontol 1972;43:623–627.

      17. Kennedy JE, Bird WC, Palcanis KG, Dorfman HS. A longitudinal evaluation of varying widths of attached gingiva. J Clin Periodontol 1985;12:667–675.

      18. Lang NP, Joss A, Orsanic T, Gusberti FA, Siegrist BE. Bleeding on probing. A predictor for the progression of periodontal disease? J Clin Periodontol 1986;13:590–596.

      19. Lang NP, Joss A, Tonetti MS. Monitoring diseases during supportive periodontal treatment by bleeding on probing. Periodontol 2000 1996;12:44–48.

      20. Harpenau LA. Furcation involvement. In: Harpenau LA, Kao RT, Lundergan WP, Sanz M. Hall’s Critical Decisions in Periodontology and Dental Implantology, ed 5. Shelton, CT: People’s Medical Publishing House–USA, 2013:26–27.

      21. Glickman I. Clinical Periodontology: Prevention, Diagnosis, and Treatment of Periodontal Disease in the Practice of General Dentistry, ed 4. Philadelphia: Saunders, 1972:242–245.

      22. Hamp SE, Nyman S, Lindhe J. Periodontal treatment of multirooted teeth. Results after 5 years. J Clin Periodontol 1975;2:126–135.

      23. Tarnow D, Fletcher P. Classification of the vertical component of furcation involvement. J Periodontol 1985;55:283–284.

      24. Miller SC. Textbook of Periodontia. Philadelphia: Blakiston McGraw-Hill, 1938.

25. СКАЧАТЬ