Deck 18: Prognosis and Results After Periodontal Therapy

Question 1

A 58-year-old woman is postmenopausal and in good health.She takes one 5-mg aspirin tablet per day to control the pain from the osteoarthritis in her hands and has recently stopped taking 1 mg of estrogen per day.She has 4- to 5-mm probing depths,minimal recession,and moderate subgingival calculus throughout her mouth.Plaque control is poor,and generalized gingival and interproximal plaque are observed.The treatment plan includes oral hygiene instructions,including improved brushing,flossing with a tool,and quadrant scaling and root planing.Although the patient has not regularly visited the dentist during her life,she is cooperative and eager to improve her oral health.The overall prognosis for this patient is likely to be:

A) Excellent
B) Good
C) Poor to fair
D) Questionable
E) Hopeless

Answer 1

Good

Question 2

An individual tooth prognosis reflects the:

A) Global prognosis
B) Overall prognosis
C) Situation of one tooth
D) Situation of the teeth in the arch

Answer 2

Situation of one tooth

Question 3

Mr.CAA is 37 years old and has had repeated episodes of both nonsurgical and surgical periodontal therapy.He is conscientious about his oral hygiene and follows all treatment recommendations.He has also been on a 1-year course of low-dose doxycycline as an adjunct to periodontal therapy.Mr.CAA is in good health and takes no other medications but smokes two packs of cigarettes a day and has been unable to quit.The overall prognosis for Mr.CAA is most likely:

A) Excellent
B) Good
C) Poor to fair
D) Questionable
E) Hopeless

Answer 3

Poor to fair

Question 4

Ms.JTW is 40 years old and in excellent health.She has had periodontal therapy in the past,including surgery in the posterior sextants,and has been maintained for the past few years on 3-month recalls.Ms.JTW has recently moved to a new location to take a different job and is going through a divorce.When she arrives for her recall visit this time,the dental hygienist notes generalized gingivitis throughout her dentition.The dental hygienist provides Ms.JTW with oral hygiene instruction,scales and polishes her teeth (she is concerned about light staining),and asks her to return in 2 months for her next recall appointment.The global prognosis for this patient is likely to be:

A) Excellent
B) Good
C) Poor to Fair
D) Questionable
E) Hopeless

Question 5

If the periodontal condition is likely to worsen at some time in the future,then the prognosis would be:

A) Good to excellent
B) Fair to poor
C) Questionable
D) Hopeless

Question 6

After periodontal treatment is complete and the patient has been placed on maintenance,persistent bleeding:

A) Increases the chance of future attachment loss.
B) Decreases the chance of future attachment loss.
C) Is not significant in the overall prognosis of the patient.
D) Does not affect the chances of future attachment loss.

Question 7

The patient ultimately decides the treatment plan that will be followed.This judgment is made,in part,by the patient being fully informed of the prognosis,which is the expected outcome of the case.

A) Both statements are TRUE.
B) Both statements are FALSE.
C) The first statement is TRUE, and the second statement is FALSE.
D) The first statement is FALSE, and the second statement is TRUE.

Question 8

Persistent deep pockets would alter the overall prognosis of the patient by making it move from:

A) Poor to good
B) Good to poor
C) Good to excellent
D) Hopeless to questionable

Question 9

Sometimes,individual teeth that can be successfully treated for periodontal disease cannot be restored.The prognosis for the individual tooth would be:

A) Good to excellent
B) Fair to poor
C) Questionable
D) Cannot be determined

Question 10

In general,the prognosis for aggressive periodontitis:

A) Is better than the prognosis for chronic periodontitis.
B) Is worse than the prognosis for chronic periodontitis.
C) Is the same as the prognosis for chronic periodontitis.
D) Cannot be determined.

Question 11

Mobility that is caused by occlusal forces can often be corrected.This type of mobility does not adversely affect the prognosis.

A) Both statements are TRUE.
B) Both statements are FALSE.
C) The first statement is TRUE, and the second statement is FALSE.
D) The first statement is FALSE, and the second statement is TRUE.

Question 12

Extensive attachment loss suggests a worse prognosis for the patient.In periodontal therapy,all teeth with extensive attachment loss should be maintained as long as possible.

A) Both statements are TRUE.
B) Both statements are FALSE.
C) The first statement is TRUE, and the second statement is FALSE.
D) The first statement is FALSE, and the second statement is TRUE.

Question 13

Smoking affects the severity of periodontal disease.Tobacco use slows healing in those who smoke.

A) Both statements are TRUE.
B) Both statements are FALSE.
C) The first statement is TRUE, and the second statement is FALSE.
D) The first statement is FALSE, and the second statement is TRUE.

Question 14

A 68-year-old man has never been a regular visitor to the dentist.He is generally uncooperative but came to the appointment because his "gums bleed" and he has "bad breath." He is in good health and takes no medications.He has 4- to 6-mm pocket depths,little recession,heavy deposits of subgingival calculus,and heavy supragingival plaque biofilm throughout.The treatment plan consists of oral hygiene instructions,quadrant scaling and root planing,and re-evaluation for referral to a periodontist.The global prognosis for this patient is most likely:

A) Excellent
B) Good
C) Poor to fair
D) Questionable
E) Hopeless

Question 15

If periodontal therapy is going to be attempted but may not be successful,then the prognosis would be:

A) Good to excellent
B) Fair to poor
C) Questionable
D) Hopeless

Question 16

A 23-year-old woman came to see the periodontist because she was concerned that her teeth have become extremely sensitive after using a home bleaching kit.The periodontist assured her that the sensitivity would be transient and would resolve itself without intervention in a few weeks and referred her for dental hygiene care.The patient is in excellent health,not pregnant,and takes no medications.Slight gingivitis in the posterior interproximal areas,light supragingival calculus on the lingual surfaces of the lower anterior teeth,and generalized interproximal plaque biofilm are observed on examination.The dental hygienist's treatment plan is to provide oral hygiene instructions,scale the teeth,polish selectively,and encourage a 6-month recall.The overall prognosis for the patient's response is likely to be:

A) Excellent
B) Good
C) Poor to fair
D) Questionable
E) Hopeless

Question 17

Enamel projections are common on molar teeth.They are only significant when periodontal tissues become detached from them through the disease process.

A) Both statements are TRUE.
B) Both statements are FALSE.
C) The first statement is TRUE, and the second statement is FALSE.
D) The first statement is FALSE, and the second statement is TRUE.

Question 18

Mr.SJB is 56 years of age.He has had a full upper denture for 4 years and has not been back to the dentist since it was completed.He has 5- to 6-mm probing depths,several millimeters of recession around all of his remaining teeth,and the gingiva readily bleeds when probed.Observation reveals that he has heavy subgingival calculus,staining,root caries,and heavy deposits of plaque biofilm.The dental hygienist will provide preventive care and scale his remaining teeth.The likely overall prognosis for this patient is:

A) Excellent
B) Good
C) Poor to fair
D) Questionable
E) Hopeless

Question 19

Teeth that have lost so much attachment and support that they require extraction are considered to have what prognosis?

A) Good to excellent
B) Fair to poor
C) Questionable
D) Hopeless

Question 20

If the teeth are predicted to remain healthy and functioning for a long time,then the prognosis would be:

A) Good to excellent
B) Fair to poor
C) Questionable
D) Hopeless

Question 21

List five of the nine factors that can affect the prognosis of individual teeth.
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________

Question 22

The clinical condition that is considered a risk predictor for patients on periodontal maintenance is ________________________________.

Question 23

Advanced bone loss,inadequate attachment,uncontrolled environmental and systemic factors,and tooth extraction all describe which one of the following categories of individual tooth prognoses?

A) Excellent
B) Good
C) Fair
D) Poor
E) Questionable
F) Hopeless

Question 24

Once patients are placed on a maintenance schedule after periodontal treatment,bleeding is indicative of ____________________________________.

Question 25

The prediction or forecast of the extent and duration of disease and its response to treatment is called ______________________.

Question 26

The prognosis is not a major consideration when treatment planning.

Question 27

The overall prognosis for treatment outcome is determined by:

A) Specific risk factors
B) Type of active disease present
C) Systemic diseases and conditions
D) All of the above
E) None of the above

Question 28

A global prognosis is made using subjective and objective assessments for each patient.

Question 29

Prognosis is an exact science.

Question 30

Attachment loss and furcation involvement (Class I),likely patient cooperation,and controlled systemic factors all describe which one of the following categories of individual tooth prognoses?

A) Excellent
B) Good
C) Fair
D) Poor
E) Questionable f. Hopeless

Question 31

Younger patients exhibit greater periodontal destruction than older patients.

Question 32

Adequate remaining periodontal support and ease of maintenance and adequate patient cooperation all describe which one of the following categories of individual tooth prognoses?

A) Excellent
B) Good
C) Fair
D) Poor
E) Questionable f. Hopeless

Question 33

The patient's host ability to respond to periodontal diseases is influenced by systemic diseases and conditions.

Question 34

The overall prognosis for a patient's treatment relies on several important factors.What are three of the six factors that require consideration for developing an overall prognosis?
____________________________________
____________________________________
____________________________________

Question 35

No bone loss,excellent gingival condition,no systemic considerations,and good patient cooperation all describe which one of the following categories of individual tooth prognoses?

A) Excellent
B) Good
C) Fair
D) Poor
E) Questionable f. Hopeless

Question 36

Attachment loss and furcation involvement that can only be maintained with difficulty (Class II or III),tooth mobility,and the presence of systemic factors all describe which one of the following categories of individual tooth prognoses?

A) Excellent
B) Good
C) Fair
D) Poor
E) Questionable f. Hopeless