Periodontal treatment often is divided into a presurgical or hygienic phase and a sur- gical or corrective phase (Ramfjord & Ash 1979). If surgery is necessary, it is usually performed as a second phase (corrective), following a thorough evaluation of the clinical results of Phase 1 therapy. HHS What is the level of expression of the disease with regard to symptoms of activity, bleeding (BOP)? Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Phase 2 Therapy Periodontal Surgery—Corrective Phase. Unfortunately, the predictability of success using these methods is, today, neither understood nor reliable (see also patient factors, p. 297). USA.gov. Toward these goals, a vast array of various surgical techniques is available; they will be described. supportive. The general medical history, local and systemic risk factors, “behaviors,” understanding of the individual oral situation and the interdependent consideration of the patient’s compliance are critical. The reference lists of potentially relevant review articles were also sought. Watch Queue Queue. The implantation of bone and bone replacement materials into the intraalveolar pockets, the GTR technique, the use of matrix proteins and in the future, use of growth factors are extremely promising. In patients with gingival recession, the depth and width of the gingival recession (Miller classification, p. 162) is of importance for predicting the therapeutic success. Enhancing Regeneration of Periodontal Tissues. The corrective phase The most important part of the corrective phase is periodontal surgery. The patient must be motivated, and must exhibit adequate plaque control. Download Citation | On Jan 1, 2012, Dorothy A. Perry and others published Phase I Periodontal Therapy | Find, read and cite all the research you need on ResearchGate These phases are structured to ensure that periodontal therapy is conducted in a logical sequence, consequently improving the prognosis of the patient, in comparison to indecisive treatment plan without a clear goal. In the maintenance phase, the aim is to maintain the successfully stabilized periodontal state in the long term. Sang-Yul Kim, Jae-Kwan Lee, Beom-Seok Chang, Heung-Sik Um, Effect of supportive periodontal therapy on the prevention of tooth loss in Korean adults, Journal of Periodontal & Implant Science, 10.5051/jpis.2014.44.2.65, 44, 2, (65), (2014). Phases of Periodontal Therapy Contemporary periodontal treatment is designed based on the ‘Trimeric Model’, and is performed in 4 phases. 1. NIH During the course of periodontitis within any given patient, gingival swelling or on the other hand gingival shrinkage may occur. [Reequilibration of occlusion by orthodontic treatment and selective grinding]. Periodontal surgical therapy is only one component of complete periodontal treatment.  |  Restorative Phase. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Phase III—Supportive Periodontal Therapy. If periodontal pockets greater than 3mm are still present, further treatment options may be suggested, including corrective surgical therapy. of the active and corrective phases of periodontal therapy, including subgingival scaling and surgical pocket elimination (Gjermo, 1981, Nyman, Lindhe, & Rosling, 1977). Sub-analysis showed that the outcome appeared to be dependent on tooth type, furcation involvement, severity of periodontal disease at i … If surgery is necessary, it is usually performed as a second phase (corrective), following a thorough evaluation of the clinical results of Phase 1 therapy. The first phase of The term SUPPORTIVE PERIODONTAL THERAPY expresses the essential need for therapeutic measures to support the patient’s own efforts to control periodontal infections and to avoid reinfection. Periodontal surgical therapy is only one component of complete periodontal treatment. adopted depend heavily on the patient’s success in controlling plaque on a daily basis and on the response to the preced-ing fundamental phase of therapy. Orthodontic treatment for the adult periodontal patient. Phase I therapy or Etiotropic Phase. The periodontal maintenance phase forms part of periodontal treatment, and its objective is to prevent recurrence and to ensure long term preservation of the periodontal health achieved in the previous phases. Greenwell H, Fiorellini J, Giannobile W, Offenbacher S, Salkin L, Townsend C, Sheridan P, Genco R; Research, Science and Therapy Committee. The secondary goal is the correction of defects in cases of unphysiologic gingival and osseous architecture, with special regard to creation of conditions that simplify or guarantee efficient plaque control, especially in the interdental areas. But the practitioner strives for a “pocket free” periodontium whenever possible, especially when restorative/reconstructive procedures are planned upon those teeth that were previously periodontally involved. additional measures such as periodontal surgery, and/or endodontic therapy, implant surgery, restorative, orthodontic and/or prosthetic treatment • Maintenance phase (care), i.e. Corrective phase . National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Active non-surgical periodontal therapy in patients with adult periodontitis resulted in approximately one third of the cases in the success endpoint of PPD ≤ 5mm. Terms in this set (44) What is the principles of successful treatment planning? “Gingivitis” is inflammation limited to the soft tissues. Pocket depth reduction and/or pocket elimination maintain their importance in contemporary periodontal therapy (Slots 2002, Petersilka et al. 2002, Socransky & Haffajee 2002). Unit 8 Periodontics: Treatment Planning and Phase I Periodontal Therapy.  |  The first phase of initial therapy, professional supragingival tooth cleaning, must be complete. Periodontal surgery, its goals and purposes, can only be considered in conjunction with complete periodontal treatment. Become a DentistryKey membership for Full access and enjoy Unlimited articles. In addition to improved esthetics, plaque control should also be simplified for the patient. What is the extent and severity of the disease? In the corrective phase of periodontal therapy, the treatment approaches to be . The approach to periodontal treatment planning has changed over the years. Which means that after each phase of therapy we will allow time for healing and then will assess the success of the treatment. Previous Phase II—Corrective Procedures. Supportive periodontal therapy, Periodontal Maintenance, Ma intenance Phase, Patient’s Car e, Patient’s Health detection and treatment of new and recurring disease is 4 Phase II therapy or Surgical Phase. The root surfaces are exposed to clinical view either by reflecting a gingival flap or, less often, following excision of the gingiva (gingivectomy, p. 301). 5. Investigations by the Slots group (Tuan et al. Clinical symptoms of activity such as exudation, bleeding and suppuration are eliminated.  |  This paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology. What form of periodontitis is present? The following important aspects will be considered: Purposes and goals of periodontal surgery, Periodontal surgery: methods and indications, Furcation problems, defects and classifications. This goal has been approached with some successes during the past two decades. CORRECTIVE PHASE OF PERIODONTAL THERAPY (Surgical phase)( phase 2) Introduction Once the factors responsible for the periodontal disease have been controlled or eliminated, the goal of treatment becomes the correction of residual damage, thereby creating an environment that can more easily be maintained in a state of health. Chronic or aggressive? Another major goal is soft tissue coverage in areas of gingival recession and correction of alveolar ridge defects, which anticipate additional treatment in the areas of prosthetics and dental implantology. In most industrialized nations today, every patient has the “right” to medical/dental treatment. Any dental emergency is treated first to achieve patient comfort. [Article in German] Schmidt H. After pointing to the hygienizing phase which must in any case precede, the author deals with the medicinal local and general treatment, the occlusal function diagnosis, the function analysis, and the fundamentals of the grinding therapy. Examination “ P erio” is Greek for “around” and “odont” is Greek for “tooth.” So periodontal diseases affect the gum (gingiva) and the bone around the teeth. Watch Queue Queue This type of care is appropriate for anyone, even those without a history of periodontal disease, who wishes to have optimal oral health. Freedom from inflammation always leads to consolidation of the gingival tissues, shrinkage or gingival recession; this alone results in a more or less pronounced pocket depth reduction. Periodontal pockets can be eliminated by flap surgery or gingivectomy (resective therapy). [The corrective phase of periodontal therapy]. Corrective surgical therapy . The regeneration or restitution of lost supporting tissue has always been considered the ideal objective of periodontal therapy. Creation of Physiologic Morphology of the Marginal Periodontium. If you are a member. While on maintenance phase, with its periodic checkups & controls, patient enters into Surgical phase (Phase II) & Restorative (reparative) phase (Phase III) of T/t Include perio surgery to repair & improve condition of perio & surrounding tissues & their esthetics, rebuilding of lost structures, placement of implants & construction of necessary restorative work 46 All of these factors lead to the obvious conclusion that the therapeutic possibilities and the type of therapy may be quite different for each individual patient. corrective. Plaque and calculus can then be removed from all root surfaces, including furcations, irregularities etc., with direct vision. The corrective phase of periodontal therapy (PMID:6998060) Abstract Citations; Related Articles; Data; BioEntities; External Links ' ' Schmidt H Stomatologie der DDR [01 Mar 1980, 30(3):199-218] Type: English Abstract, Review, Journal Article (lang: ger) Abstract. This phase of the periodontal treatment plan is aimed at restoring anatomical and functional conditions in patients who have had periodontitis, and who because of their specific traits are at high risk for developing recurrence and its consequent periodontal destruction. This video is unavailable. The term “selection” therefore does not imply ruling out any type of therapy; treatment recommendations and the definitive treatment plan may vary considerably for each individual patient. Phases of Periodontal Therapy. In addition, clinical studies have demonstrated that the debridement of subgingival calculus and biofilm must be performed before surgical intervention. Data. Corrective or surgical procedures will allow us to rebuild the foundation for you and maintain your natural teeth and dental implants. [The current status of periodontal therapy]. of periodontal therapy. Oral reconstructive and corrective considerations in periodontal therapy. Summaries. Numerous research studies have proven the importance of the periodontal maintenance phase, and it has become an essential part of comprehensive periodontal disease therapy. Notwithstanding, the emphasis on a distinct oral hygiene phase has diminished, and the oral hygiene phase has become amalgamated with the actual causal therapy Please enable it to take advantage of the complete set of features! This review aims to evaluate the effect of orthodontic therapy on periodontal health. Most importantly: Intra-alveolar defects are classified as 1-, 2- or 3-wall bony pockets, with consideration of the depth and the width of the “opening angle” of the defect, acknowledging that most of these defects represent “combined” bony pockets: In the apical region, three walls are in evidence, in the “middle,” two walls, and coronally only one wall! Shareable Link. This phase of treatment is initiated at the completion of Phase I therapy continues through the corrective phase (Phase II) and for the rest of the patient’ s life. Included here are the width and thickness of the gingiva (phenotype), course of the horizontal bone loss and the depth of supra-alveolar pockets. These corrections are accomplished by various surgical techniques . 1976 Jul;47(7):405-11. doi: 10.1902/jop.1976.47.7.405. Both patient factors and local defect factors—as well as the “aptitude” of the clinician, are of determining significance for the planning, type of surgical procedure and the ultimate results (see next page). The above-mentioned root irregularities, fusions and grooves can be reduced by means of careful odontoplasty, usually after flap reflection. The most important niche for subgingival microbial flora are periodontal pockets themselves. The goals often cannot be achieved using a single specific surgical procedure; rather, often combinations of various surgical methods are required, either simultaneously or one following upon the other: Root cleaning/debridement with direct vision, Reduction or elimination of plaque-retentive areas that promote infection, especially periodontal pockets, Enhancing the regeneration of periodontal tissues, Elimination of diseased tissues—resective therapy, Creation of physiologic morphology/architecture of the marginal periodontium, Correction of mucogingival defects, restoration of esthetics in the aveolodental tissues, Root Cleaning with Direct Vision (Access Flap). 299, 301). Nevertheless, such division helps to organise the treatment, to plan what … For example, initial therapy and surgery are two entities with identical goals, but which use different methods to achieve these goals (closed root planing versus root planing with direct vision). Become membership. What is the magnitude of plaque accumulation (PI score), and what is the level of patient compliance? supportive periodontal therapy (SPT Trimeric … Principally, the comprehensive periodontal therapy can be divided into four main phases followed by any dental emergency 7. 2000) have also demonstrated that following resective procedures (osseous surgery), in comparison to simple “access flap” procedures, the depth of the residual pockets is less, and also the colonization by periodontopathic microorganisms (anaerobic!) Current corrective treatments mainly involve: Phase III therapy or Restorative Phase. Furthermore, the temporary splinting, the treatment of secondary malpositions and problems as well as methods of periodontal surgery are mentioned. Phase 3 Therapy Periodontal Maintenance Therapy—Recall Dental Hygienists Rule! Rev Fr Odontostomatol. 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