Clinical Cases in Periodontics. Группа авторов

is the significance of obtaining medical and dental history in treating a patient with periodontal conditions?

      2 Aside from conventional parameters such as probing depth, recession, mobility and bleeding on probing, what are the additional parameters that should be obtained during a comprehensive periodontal evaluation?

      3 How did we derive periodontal diagnosis for this case of interest?

      4 What is the importance of conducting a comprehensive periodontal evaluation for a patient who needs a dental implant?

      5 Aside from periodontal charting, are there any other clinical findings that clinicians should record during their routine comprehensive examinations?

      Answers located at the end of the chapter.

References

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      2 2. Kwon T, Levin L. Cause‐related therapy: a review and suggested guidelines. Quintessence Int 2014; 45(7):585–591.

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      5 5. Grossi SG, Genco RJ, Machtei EE, et al. Assessment of risk for periodontal disease. II. Risk indicators for alveolar bone loss. J Periodontol 1995; 66(1):23–29.

      6 6. Loe H, Theilade E, Jensen SB. Experimental gingivitis in man. J Periodontol 1965; 36:177–187.

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      9 9. McGuire MK, Nunn ME. Prognosis versus actual outcome. III. The effectiveness of clinical parameters in accurately predicting tooth survival. J Periodontol 1996; 67(7):666–674.

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      11 11. Thakur AM, Baburaj MD. Analysis of spontaneous repositioning of pathologically migrated teeth: a clinical and radiographic study. Quintessence Int 2014; 45(9):733–741.

      12 12. Berglundh T, Armitage G, Araujo MG, et al. Peri‐implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. J Periodontol 2018; 89(Suppl 1):S313–S318.

      13 13. Schwarz F, Derks J, Monje A, Wang H‐L. Peri‐implantitis. J Clin Periodontol 2018; 45(Suppl 20):S246–S266.

      14 14. Ferreira SD, Martins CC, Amaral SA, et al. Periodontitis as a risk factor for peri‐implantitis: systematic review and meta‐analysis of observational studies. J Dent 2018; 79:1–10.

      15 15. Swierkot K, Lottholz P, Flores‐de‐Jacoby L, Mengel R. Mucositis, peri‐implantitis, implant success, and survival of implants in patients with treated generalized aggressive periodontitis: 3‐ to 16‐year results of a prospective long‐term cohort study. J Periodontol 2012; 83(10):1213–1225.

      16 16. Clark D, Levin L. Dental implant management and maintenance: how to improve long‐term implant success? Quintessence Int 2016; 47(5):417–423.

      17 17. Jepsen S, Caton JG, Albandar JM, et al. Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. J Periodontol 2018; 89(Suppl 1):S237–S248.

      18 18. Fan J, Caton JG. Occlusal trauma and excessive occlusal forces: narrative review, case definitions, and diagnostic considerations. J Periodontol 2018; 89(Suppl 1):S214–S222.

      19 19. Cortellini P, Tonetti MS, Lang NP, et al. The simplified papilla preservation flap in the regenerative treatment of deep intrabony defects: clinical outcomes and postoperative morbidity. J Periodontol 2001; 72(12):1702–1712.

      20 20. Seibert JS. Reconstruction of deformed, partially edentulous ridges, using full thickness onlay grafts. Part II. Prosthetic/periodontal interrelationships. Compend Contin Educ Dent 1983; 4(6):549–562.

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      TAKE‐HOME POINTS

A. The pathogenesis of periodontal diseases is multifactorial in nature, involving dental plaque, susceptible host, and environmental factors (Figure 1.1.4) [2]. Thus, during medical and dental history‐taking, clinicians should obtain information related to these factors.

       Susceptible Host

      Patients with diabetes may be at greater risk for developing periodontal diseases compared to healthy counterparts, especially when the diabetic condition is not under control (HbA_1c >7.0%) [1,3]. If necessary, medical consultation with the patient’s physician should be considered. Furthermore, some patients may be susceptible to periodontal diseases genetically. Thus, under family history‐taking, the patient should be asked about the periodontal conditions of his or her family members.

       Environmental Factor

Cigarette smoking is a risk factor for developing periodontal diseases [1,4,5]. Under social history‐taking, the patient should be asked about their smoking habit (i.e. never smoked, past smoker, or active smoker). Smoking habit should be recorded as number of cigarettes consumed per day as well as number of years of active smoking.

Figure 1.1.4 Pathogenesis of periodontal diseases.

      Source: modified from Kwon and Levin [2].

       Dental Plaque

      Dental plaque is the etiologic factor for periodontal diseases [6]. Under dental history‐taking, patients should be asked about their routine home oral care or dental plaque control. Their daily frequency of toothbrushing as well as interproximal cleaning (i.e. floss, interdental brush, interdental toothpick) should be recorded. During clinical evaluation, a plaque disclosing tablet may be used to objectively record the patient’s plaque control as well. Furthermore, patients should be asked about their previous periodontal treatment as well as its outcome, all of which should be recorded. If necessary, a consultation with the patient’s previous dental or periodontal provider may be considered.

       B.

       Furcation Involvement

According to previous studies, furcated molars have a significantly greater chance to be lost than nonfurcated molars [7–9]. Thus clinicians should proactively evaluate molars (or any other multirooted teeth) for furcation involvement, which would ensure their treatment in a timely manner, improving their periodontal prognosis. For easier detection of furcation involvement,