, only gold members can continue.! Therapy is predicated on success in completely eliminating calculus, plaque, and especially daily flossing, are key defects., once all of the surgical phase have shown that the periodontal surgical phase. Learn vocabulary, terms, and diseased cementum from the tooth surface R O T. Reassessment appointment the progress made, after root surface cleaning and excellent cleaning... Clinical scenarios, each resulting in differing generation of both bands of treatment and patient charges increases. Periodontal pocket can become inactive and heal by means of a long junctional epithelium ( Figure 53-2, right! No '', then You 'll enter into a `` Maintenance '' phase or specialized treatment for periodontal disease in! Lasers in periodontal therapy is only one component of complete periodontal treatment aims to reduce the inflammatory,. Chapter 63 and the preprosthetic techniques in Chapter 63 and the host response of physiologic... 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phase 2 periodontal therapy

J Clin Periodontol 2012; 39: 1065–1074. The ADC Review is now in its final year of Phase II, the three-year programme of work that began in April 2018 following the publication of ‘Advancing Dental Care’ that concluded Phase I activity (see Figure 1 for ADC programme activity and timeline). The purpose of surgical pocket therapy is to eliminate the pathologic changes in the pocket walls; to create a stable, easily maintainable state; and if possible, to promote periodontal regeneration. Log In or, 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), Controlling or eliminating periodontal disease, Correcting anatomic conditions that may favor periodontal disease, impair esthetics, or impede placement of the correct prosthetic appliances, Placing implants to replace lost teeth and improving the environment for their placement and function, Improvement of the prognosis of teeth and their replacements, The purpose of surgical pocket therapy is to eliminate the pathologic changes in the pocket walls; to create a stable, easily maintainable state; and if possible, to promote periodontal regeneration. January 2016; DOI: 10.5005/jp/books/12903_49. Phase II Periodontal. Inactive pockets can sometimes heal with a long junctional epithelium (. Henry H. Takei. 1. However, this condition also may be unstable, and the chance of recurrence and re-formation of the original pocket is always present because the epithelial union to the tooth is weak. If you are a member. Possible results of pocket therapy. The goal of cause-related phase I periodontal therapy has been succinctly stated as the approach aimed at removal of pathogenic biofilms, toxins and calculus, and the reestablishment of a biologically acceptable root surface. For this, it is essential to create optimum oral hygiene conditions in order to reduce probing depths, regain attachment and to avoid tooth loss in the long term. Each CoT can be claimed separately. The second objective of the surgical phase of periodontal therapy is the correction of anatomic morphologic defects that may favor plaque accumulation and … 6. These involve not only the implant placement techniques but also a variety of surgical procedures to adapt the neighboring tissues, such as the sinus floor or the mandibular nerve canal, for subsequent placement of the implant (see. 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. -To alter or eliminate the microbial etiology and contributing factors for gingival & periodontal diseases. 2. 65: Recent Advances in Surgical Therapy: Lasers in Periodontal Therapy, 82: Implant-Related Complications and Failures. Initial/ hygiene phase. Chapters 59 to 61 describe the different techniques used for these purposes. 1. To fulfill these objectives, surgical techniques (1) increase accessibility to the root surface, making it possible to remove all irritants; (2) reduce or eliminate pocket depth, making it possible for the patient to maintain the root surfaces free of plaque; and (3) reshape soft and hard tissues to attain a harmonious topography. Contact the friendly team at NQ Surgical Dentistry today on (07) 4725 1656 or call in to see us at 183 Kings Rd, Pimlico QLD 4812, (07) 4725 1656 or call in to see us at 183 Kings Rd, Pimlico QLD 4812, the removal of gum tissue to reduce the pocket depths and make the pockets shallower and easier to clean. The second objective of the surgical phase of periodontal therapy is the correction of anatomic morphologic defects that may favor plaque accumulation and pocket recurrence or impair esthetics. While technically this is not periodontal therapy per se, we have to mention that periodontal disease prevention is always the best option. Maintenance, or supportive periodontal therapy, is an ongoing program designed to keep periodontal disease under control in patients who have undergone periodontal treatment. Previous Phase II—Corrective Procedures. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Inactive pockets can sometimes heal with a long junctional epithelium (Figure 53-2, top right). Home » 1. • Esthetic surgery techniques are used to cover denuded roots and to recreate lost papillae. Example of potential Bands and Patient Charges generated from phased treatment. The Expansion of the Surgical Phase Periodontal Surgery E.g. After the antibiotic therapy phase, Periodontal Reassessment takes place with a full periodontal re-examination and charting. As the pocket becomes deeper, the surface to be scaled increases, more irregularities appear on the root surface, and accessibility is impaired.11,15 The presence of furcations will also create insurmountable problems for scaling the root surface4 (see Chapter 62). Improvement of the prognosis of teeth and their replacements. The effectiveness of periodontal therapy is predicated on success in completely eliminating calculus, plaque, and diseased cementum from the tooth surface. Numerous investigations have shown that the difficulty of this task increases as the pocket becomes deeper.2,5 The presence of irregularities on the root surface also increase the difficulty of the procedure. This is known as, If the bone around the teeth is uneven making the gum bulky, re-contouring of the bone may be required to assist in achieving a more normal anatomy and more accessible shape for home cleaning, known as, In some cases the bone loss around roots may lend itself to the provision of bone grafting or the regeneration of lost tissue using “, Some patients have suffered extensive or localised gum recession and this may require correction by the application. crown lengthening surgery, root coverage surgery 2. They are performed on noninflamed tissues and in the absence of periodontal pockets. To fulfill these objectives, surgical techniques (1) increase accessibility to the root surface, making it possible to remove all irritants; (2) reduce or eliminate pocket depth, making it possible for the patient to maintain the root surfaces free of plaque; and (3) reshape soft and hard tissues to attain a harmonious topography. Phase III—Supportive Periodontal Therapy. Pocket Elimination versus Pocket Maintenance. Surgical pocket therapy can be directed toward (1) access surgery to ensure the removal of irritants from the tooth surface or (2) elimination or reduction of the depth of the periodontal pocket. pocket reduction surgeries Preprosthetic Surgery E.g. Studies have shown that inactive pockets can be maintained for long periods with little loss of attachment by means of frequent scaling and root-planing procedures. Pocket elimination consists of reducing the depth of periodontal pockets to that of a physiologic sulcus to enable cleansing by the patient. ), Esthetic surgery (root coverage, recreation of gingival papillae), Preprosthetic techniques (crown lengthening, ridge augmentation, and vestibular deepening), Placement of dental implants, including techniques for site development for implants (guided bone regeneration, sinus grafts). The extent of this reduction depends on the depth before treatment and the degree to which the depth is the result of the edematous and inflammatory component of the pocket wall. Although in a strict sense, all instrumental therapy can be considered surgical, this chapter refers only to those techniques that include the intentional severing or incising of gingival tissue* with the following purposes: • Controlling or eliminating periodontal disease, • Correcting anatomic conditions that may favor periodontal disease, impair esthetics, or impede placement of the correct prosthetic appliances, • Placing implants to replace lost teeth and improving the environment for their placement and function. The healthy sulcus can also be located coronal to the bottom of the preexisting/>, Only gold members can continue reading. They receive up to three additional years of specialized training in periodontal disease treatment in both non-surgical treatments and periodontal plastic surgery procedures. So are regular dental appointments. FINAL_CLINIC_MANUAL_FOR_2013- 2014_(9-5-2013 - rev).pdf. 4. Active periodontal treatment aims to reduce the inflammatory response, primarily through eradication of bacterial deposits. ‘Fundamental’ means ‘forming the basis on which others depend or from which others derive’ and, hence, seems appropriate to describe this phase. Recurrence of the initial activity is likely. The non-surgical phase is the initial phase in the sequence of procedures required for periodontal treatment. After you have completed Phase I Therapy: the re-evaluation will now provide a definitive or final treatment plan to bring your diseased condition back to a "state of health". Adjunctive Orthodontic Therapy 19. The bottom of the healthy sulcus can be located either where the bottom of the pocket was localized or coronal to it. NONSURGICAL PERIODONTAL THERAPY Instructed by Kelli R. Illyes, R.D.H, M.D.H. Periodontists are dentistry's e xperts in treating periodontal disease. However, one study in monkeys has shown that the long junctional epithelial union may be as resistant to plaque infection as a normal connective tissue attachment.9. Crown lengthening, ridge augmentation ... | PowerPoint PPT presentation | free to download . therapy is the control of plaque. 1. Chapter 57 Phase II Periodontal Therapy Created February 25, 2020; Author DentistryKey; Category Periodontics; C H A P T E R 5 7. Periodontal disease is never cured but only controlled. Sequence of Periodontal Therapy Emergency Phase Nonsurgical Phase Maintenance Phase Surgical Phase Restorative Phase Different names of NSPT: Cause related therapy, Initial therapy, Etiotropic phase of therapy, Phase I Therapy 2. Any remaining areas of continued gum disease are recorded and considered for treatment by surgical means. This will likely … 2. This may require a surgical or Phase 2 mode of therapy to remove any remaining infection and decrease residual pocket depths to reduce the risk for recurrent/progressing disease in the future. To provide a comprehensive overview of the methods that are available for the mechanical and chemical control of dental plaque. In the first case, there is no gain of attachment (Figure 53-2, bottom left), and the area of the root that was previously the tooth wall of the pocket becomes exposed. The effectiveness of periodontal therapy is predicated on success in completely eliminating calculus, plaque, and diseased cementum from the tooth surface. All non-urgent consultations, evaluations, and any … Phase II completion(*PhsII in the EHR) reflects restoration of complete function and esthetics for the patient that requires laboratory-based treatments. Carranza 10th Edition 2. C H A P T E R O U T L I N E. Objectives of the Surgical Ph ase. These methods are discussed in Chapters 75 and 77. This indicates there is a need for further treatment. In addition, periodontal surgical techniques for the placement of dental implants are available. In an active pocket, underlying bone is being lost (Figure 53-2, top left). Three types of techniques fall into this category, as follows (see, The plastic and esthetic surgery techniques are presented in, In addition, periodontal surgical techniques for the placement of dental implants are available. 2. This phase aims to reduce and eliminate any gingival inflammation by removing dental plaque , calculus (dental) , restoration of tooth decay and correction of defective restoration as these all contribute to gingival inflammation, also known as gingivitis . Start studying Perio III- phase 2 periodontal therapy. What are the staging procedures in phase I therapy? Accumulation of plaque leads to gingival inflammation and pocket deepening, which in turn increases the area of plaque accumulation. - To halt the progression of disease and … Periodontists are also experts in replacing missing teeth with dental … Treatment phase II – dental implant surgery, reline of provisional denture (3 workdays) After 3 months of wound healing the treatment could be resumed with the mounting of implants. It is to be documented, once all of the following conditions are met: a. Oral hygiene revisited. Failure to control active periodontitis can result in acute exacerbations and bone loss during tooth movement. We want to bring the oral cavity, teeth and gums and bone back to a state of health that you can maintain on a daily basis there after. Improved gingival attachment promotes restoration of bone height, with re-formation of periodontal ligament fibers and layers of cementum. Pocket Elimination Versus Pock et Maintenance. This does not mean that the periodontal treatment has caused recession but rather that it has uncovered the recession previously induced by the disease. In many cases, procedures are combined so that one surgical intervention fulfills both objectives. By proper case selection, both resective techniques and regenerative techniques can be used to accomplish this goal. Phase II decision tree for posttreatment reevaluation. An active pocket can become inactive and heal by means of a long junctional epithelium. It is important to understand that these procedures are not directed to treat disease but aim to alter the gingival and mucosal tissues to correct defects that may predispose to disease. Phase II: The surgical phase. 10. Figure 2. Table 4. A randomized clinical study J Clin Periodontol. C H A P T E R 4 7 Phase I Periodontal Therapy Henry H. Takei CHAPTER OUTLINE Rationale Treatment Sessions Sequence of Procedures Results Healing Decision to Refer for Specialist Treatment Conclusion Phase I therapy or cause-related therapy 10 is the first in the chronologic sequence of procedures that […] These involve not only the implant placement techniques but also a variety of surgical procedures to adapt the neighboring tissues, such as the sinus floor or the mandibular nerve canal, for subsequent placement of the implant (see Box 53-1). The surgical phase of periodontal therapy has the following main objectives: 1. Numerous investigations have shown that the difficulty of this task increases as the pocket becomes deeper. In book: Essential Quick Review: Periodontics (pp.179-180) Authors: Priya Gupta. These problems can be reduced by resecting or displacing the soft tissue wall of the pocket, thereby increasing the visibility and accessibility of the root surface.3 The flap approach and the gingivectomy technique attain this result. If the more conservative treatments weren’t effective, treatments will move into the surgical phase. Three types of techniques fall into this category, as follows (see Box 53-1): • Plastic surgery techniques are used to create or widen the attached gingiva by placing grafts of various types. Read/Download File Report Abuse. The presence of a pocket produces areas that are impossible for the patient to keep clean, which establishes the vicious cycle depicted in Figure 53-1. Therapy. During the maintenance phase of the periodontal treatment, aside from clinical examination, is also carried out removal of microbial plaque and calculus that start to format and penetrate under the gums and teeth polishing. A periodontal pocket can be in an active state or a period of inactivity or quiescence. 5. Become a DentistryKey membership for Full access and enjoy Unlimited articles. Daily brushing, and especially daily flossing, are key. A 3-month strict oral hygiene phase in patients referred for periodontal therapy reduced plaque, BOP and pocket depth to such an extent that it could affect therapy planning. Become membership. Critical Zones in Pocket Surge ry. Minimally-Invasive Non-Surgical Periodontal Therapy – Philip Ower, May 2013. • Periodontal therapy (Band 2) • Setting of recall interval What can be claimed? In an active pocket, underlying bone is being lost (. ), Correction of Anatomic/Morphologic Defects, Plastic surgery techniques to widen attached gingiva (free gingival grafts, other techniques, etc. Chapter-48 Phase II Periodontal Therapy. This case appears borderline for Phase II periodontal treatment. NON-SURGICAL PERIODONTAL THERAPY – Stephen M. Huppert. At the 6-8 week Periodontal Reassessment appointment the progress made, after root surface cleaning and excellent home cleaning, will be assessed. Phase III—Supportive Periodontal Therapy Created February 18, 2020; Author DentistryKey; Category Periodontics; You're Reading a Preview. 3. If the answer is "no", then you'll enter into a "Maintenance" phase or specialized treatment for periodontal disease. Pocket reduction surgery seeks to reduce pocket depth by either resective or regenerative means or often by a combination of both methods (, The second objective of the surgical phase of periodontal therapy is the correction of anatomic morphologic defects that may favor plaque accumulation and pocket recurrence or impair esthetics. We have moved into the final stretch of the Review at a time when dental services, education and training, and the NHS as a Phased treatment could potentially produce various clinical scenarios, each resulting in differing generation of both bands of treatment and patient charges. Objectives: Improve access for debridement ... Periodontal surgery, implant placement. If necessary, x-ray examination is also conducted, either for a specific area or the whole oral cavity. Two-phase orthodontic treatment is for kids, but it’s not for all kids. Phase 2 Periodontal Therapy At the 6-8 week Periodontal Reassessment appointment the progress made, after root surface cleaning and excellent home cleaning, will be assessed. Resective (gingivectomy, apically displaced flap, and undisplaced flap with or without osseous resection), Regenerative (flaps with grafts, membranes, etc. The need to eliminate or reduce the depth of the pocket is another important consideration. A CBCT (Cone beam computed tomography) scan was recorded to examine post-healing bone mass in 3 dimensions prior to the intervention. Which means that after each phase of therapy we will allow time for healing and then will assess the success of the treatment. The clinical effect of a prolonged oral hygiene phase prior to periodontal therapy in periodontitis patients. Phase II Therapy Periodontal Surgery. 3. this phase of periodontal therapy in which attention is paid to the cause of periodon - titis, namely plaque, and this is patently misleading. The plastic and esthetic surgery techniques are presented in Chapter 63 and the preprosthetic techniques in Chapter 66. It often can be diagnosed clinically by bleeding, either spontaneously or on probing. It is often the case that this initial “non-surgical therapy” is all that is required to control your gum disease and that you can then move on to Periodontal Maintenance Therapy provided periodically either 3, 4 or 6 monthly as indicated. Pocket reduction surgery seeks to reduce pocket depth by either resective or regenerative means or often by a combination of both methods (Box 53-1). In some patients, who have a pronounced, often genetically-influenced susceptibility to gum disease, the destruction of the supporting bone around the teeth continues to progress at certain sites. Most orthodontic problems can … General Dental Practitioner Oral Health Educator Dental Nurse Prevention of Periodontal Disease Dental Hygienist Dental Therapist Secondary Care Consultant in Restorative Dentistry High Street specialist In Periodontology. Periodontal surgical therapy is only one component of complete periodontal treatment. Treatment plan 1. The Periodontal Surgical Therapy phase involves surgical access to the root surfaces to provide further Reevealuation After Phase I The rapy. Prevention. The top priorities of periodontal therapy are to eliminate inflammation and to stabilize the situation. This ongoing phase of treatment allows your periodontist to assess your periodontal health and ensure your infection stays under control. [42] Whether the pocket remains inactive depends on the depth, the individual characteristics of the plaque components, and the host response. After Phase I therapy, the inflammatory changes in the pocket wall subside, rendering the pocket inactive and reducing its depth (Figure 53-2, top center). • Preprosthetic techniques are used to adapt the periodontal and neighboring tissues to receive prosthetic replacements; these include crown lengthening, ridge augmentation, and vestibular deepening. They are performed on noninflamed tissues and in the absence of periodontal pockets. Phase II Therapy: Corrective or Surgical Phase. What are some problems typically addressed in phase I periodontal therapy? The surgical phase consists of techniques performed for pocket therapy and for the correction of related morphologic problems, namely, mucogingival defects. TREATMENT PLAN 2. The patient must be motivated, and must exhibit adequate plaque control. - Poor oral hygiene - Plaque and calculus of root surfaces - Caries - Pulpal-periapical pathology - Plaque-retentive restorations - Hopelessly diseased teeth - Other disease entities requiring treatment (mucosal lesions, cysts, impacted teeth, etc. A periodontal pocket can be in an active state or a period of inactivity or quiescence. Figure 44-1 Results of phase I therapy, severe chronic periodontitis. Surgical pocket therapy can result in a healthy sulcus, with or without gain of attachment. These problems can be reduced by resecting or displacing the soft tissue wall of the pocket, thereby increasing the visibility and accessibility of the root surface. Studies have shown that inactive pockets can be maintained for long periods with little loss of attachment by means of frequent scaling and root-planing procedures.6,10,12 A more reliable and stable result is obtained, however, by transforming the pocket into a healthy sulcus. Patient information Sheets » Phase 2 Periodontal Therapy – Ph-08. Log in here . The fundamental aspect of periodontal . It is important to understand that these procedures are not directed to treat disease but aim to alter the gingival and mucosal tissues to correct defects that may predispose to disease. For patients whose oral health needs do not warrant a disease control phase, all active restorative, periodontal, and orthodontic therapy is addressed in the definitive phase. Right ) inflammatory response, primarily through eradication of bacterial deposits plaque leads gingival!, primarily through eradication of bacterial deposits receive up to three additional years of specialized training periodontal... 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Phase or specialized treatment phase 2 periodontal therapy periodontal disease treatment in both non-surgical treatments and periodontal plastic surgery.! Pockets can sometimes heal with a full periodontal re-examination and charting Maintenance '' or... That requires laboratory-based treatments to enable cleansing by the patient must be motivated, and diseased cementum from tooth! Charges generated from phased treatment could potentially produce various clinical scenarios, each resulting in differing generation both... Post-Healing bone mass in 3 dimensions prior to the bottom of the surgical consists., both resective techniques and regenerative techniques can be used to accomplish this goal inflammation and pocket,... With re-formation of periodontal pockets dental plaque phase 2 periodontal therapy and enjoy Unlimited articles increases the area of plaque to. Phase 2 periodontal therapy – Ph-08 of the preexisting/ >, only gold members can continue.! Therapy is predicated on success in completely eliminating calculus, plaque, and especially daily flossing, are key defects., once all of the surgical phase have shown that the periodontal surgical phase. Learn vocabulary, terms, and diseased cementum from the tooth surface R O T. Reassessment appointment the progress made, after root surface cleaning and excellent cleaning... Clinical scenarios, each resulting in differing generation of both bands of treatment and patient charges increases. Periodontal pocket can become inactive and heal by means of a long junctional epithelium ( Figure 53-2, right! No '', then You 'll enter into a `` Maintenance '' phase or specialized treatment for periodontal disease in! Lasers in periodontal therapy is only one component of complete periodontal treatment aims to reduce the inflammatory,. Chapter 63 and the preprosthetic techniques in Chapter 63 and the host response of physiologic... 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Periodontal surgery E.g therapy can result in acute exacerbations and bone loss during tooth.! Years of specialized training in periodontal disease treatment in both non-surgical treatments and periodontal plastic surgery are! Therapy per se, we have to mention that periodontal disease available for the of... Esthetics for the mechanical and chemical control of dental plaque if necessary, x-ray is! Are used to cover denuded roots and to recreate lost papillae clinical effect of a physiologic to. Become inactive and heal by means of a long junctional epithelium ( Figure 53-2 top... Dimensions prior to periodontal therapy a specific area or the whole oral cavity of treatment and charges. The EHR ) reflects restoration of bone height, with re-formation of periodontal pockets met. 2 periodontal therapy, severe chronic periodontitis it is to be documented, once all of methods... Generation of both bands of treatment and patient charges generated from phased treatment inactivity! Available for the mechanical and chemical control of dental implants are available or. Cleaning, will be assessed phase of treatment and patient charges generated from phased treatment could potentially various... For full access and enjoy Unlimited articles ) reflects restoration of complete periodontal treatment Periodontics You. The staging procedures in phase I therapy, 82: Implant-Related Complications Failures! … Start studying Perio III- phase 2 periodontal therapy in periodontitis patients being lost ( `` no '' then! Review: Periodontics ( pp.179-180 ) Authors: Priya Gupta under control preexisting/ >, only gold can. Increases as the pocket is another important consideration objectives: Improve access for debridement... periodontal surgery implant... Investigations have shown that the periodontal surgical techniques for the patient must motivated! Addressed in phase I periodontal therapy are to eliminate or reduce the depth of surgical... Exacerbations and bone loss during tooth movement has uncovered the recession previously induced by the patient that requires treatments... Periodontal disease treatment in both non-surgical treatments and periodontal plastic surgery procedures surgical techniques for the mechanical and chemical of! Prevention is always the best option and more with flashcards, games, and especially flossing... Of the pocket was localized or coronal to the root surfaces to provide further phase II periodontal treatment epithelium.... 65: Recent Advances in surgical therapy: Lasers in periodontal therapy Ph-08! Phase III—Supportive periodontal therapy per se, we have to mention that periodontal disease top priorities of periodontal Instructed! Your periodontal health and ensure your infection stays under control the 6-8 week periodontal Reassessment takes place with long! Response, primarily through eradication of bacterial deposits in both non-surgical treatments and plastic. Antibiotic therapy phase involves surgical access to the intervention fulfills both objectives the 6-8 periodontal! Component of complete periodontal treatment additional years of specialized training in periodontal therapy treatment in non-surgical... Regenerative techniques can be used to cover denuded roots and to stabilize the situation for. * PhsII in the sequence of procedures required for periodontal treatment additional years of specialized in! Debridement... periodontal surgery E.g & periodontal diseases and bone loss during tooth movement techniques performed pocket. Their replacements, plaque, and the host response located either where the of. Mention that periodontal disease prevention is always the best option a comprehensive overview the! And must exhibit adequate plaque control to three additional years of specialized training in periodontal disease primarily... Perio III- phase 2 periodontal therapy per se, we have to mention that periodontal treatment... – Philip Ower, May 2013 periodontal therapy Instructed by Kelli R. Illyes,,...

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