Prognosis

= Periodontal Prognosis =

 Discuss the concept of prognosis including how its determine and its relevance.

 **Prognosis is a prediction of probable course, duration and outcome of disease based on general knowledge and pathogenesis of disease and the presence of risk factors for the disease. It is established after diagnosis and after treatment plan. Clinical and radiographic findings should be used. An overall prognosis of dentition can be determined as well as for individual teeth.** 

Factors in determining prognosis:
1. Overall clinical factors: patient age, disease activity, plaque control, patient compliance 2. Systemic and Environmental Factors: smoking, systemic disease or condition, genetic factors, stress. 3. Local Factors: plaque and calculus, subgingival restorations, anatomical factors, tooth mobility. 4. Prosthetic and restorative factors: caries, non-vital teeth, root resorption.

Prognosis


1. Excellent:
 
 * No bone loss
 * Excellent gingival condition
 * Good patient cooperation
 * No systemic or environmental factors.

2. Good:
 One or more of the following: <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Adequate remaining bone support
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Adequate possibilities to control plaque
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Adequate patient cooperation
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-No systemic or environmental factors
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-If systemic factors are present, they are well controlled

<span style="color: #000000; font-family: 'Comic Sans MS',cursive;">3. Fair:
<span style="color: #000000; font-family: 'Comic Sans MS',cursive;"> One or more of the following: <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Less than adequate remaining bone support
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Some tooth mobility
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Class I furcation involvement
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Adequate maintenance possible
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Acceptable patient cooperation
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Presence of limited systemic or environmental factors

<span style="color: #000000; font-family: 'Comic Sans MS',cursive;">4. Poor:
<span style="color: #000000; font-family: 'Comic Sans MS',cursive;"> One or more of the following: <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Moderate to advanced bone loss
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Tooth mobility
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Class I or II furcations
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Difficult to maintain areas
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Doubtful patient cooperation
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Presence of systemic or environmental factors

<span style="color: #000000; font-family: 'Comic Sans MS',cursive;">5. Questionable:
<span style="color: #000000; font-family: 'Comic Sans MS',cursive;"> One or more of the following: <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Advanced bone loss
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Class II or III furcations
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Tooth mobility
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Inaccessible areas
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Presence of systemic or environmental factors

<span style="color: #000000; font-family: 'Comic Sans MS',cursive;">6. Hopeless:
<span style="color: #000000; font-family: 'Comic Sans MS',cursive;"> One or more of the following:
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Advanced bone loss
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Non maintainable areas
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Extractions indicated
 * <span style="color: #000000; font-family: 'Comic Sans MS',cursive;">-Presence of uncontrolled systemic or environmental factors.