How+is+prognosis+determined?

=How the Prognosis of a Case Is Determined =

The prognosis is your prediction in the outcome after treatment of the patient's periodontal disease. There are six prognoses available for a clinician to decide which is best suited for the patient. It is the only prognosis that can be established with a reasonable degree of accuracy.

A provisional prognosis will allow the clinician to start treatment of teeth that have a doubtful outlook in hope that a favorable response will occur so the teeth may be retained.

An individual tooth prognosis will be determined after the overall prognosis. Overall clinical factors

Factors to consider when determining a prognosis:

1. Patient age, disease severity, plaque control, patient compliance. Systemic and environmental factors

2. Smoking, systemic disease or condition, stress, genetic factors Local factors

3. Plaque and Calculus Subgingival restorations Anatomic factors:
 * short, tapered roots
 * cervical enamel projections
 * enamel pearls
 * bifurcation ridges
 * root concavities
 * developmental grooves
 * root proximity
 * furcation involvement
 * tooth mobility

4. Prosthetic and restorative factors caries, non-vital teeth, root resorption


 * 6 Available Prognoses**:

1. **__Excellent prognosis__**: the patient has no bone loss and excellent gingiva with good patient oral hygiene cooperation and has no systemic diseases or environmental factors.

2. **__Good prognosis__**: The patient has adequate remaining bone support, adequate possibilities to control etiologic factors and establish a maintainable dentition with adequate patient cooperation for oral hygiene, well controlled systemic or environmental factors if one's present.

3. **__Fair prognosis__**: The patient has less than adequate bone support, some tooth mobility, grade I furcation, adequate maintenance is possible and patient does cooperate with oral hygiene instruction. There is a presence of limited systemic or environmental factors.

4. **__Poor prognosis__**: The patient has moderate to advanced bone loss, tooth mobility, grade I and II furcation involvement. It’s difficult to maintain areas of the dentition and poor patient oral hygiene care. The patient does have presence of a systemic or environmental factors.

5. **__Questionable prognosis__**: The patient has advanced bone loss, grade II and III furcations involvement, tooth mobility, inaccessible area(s) present, and has presence of systemic or environmental factors.

6. **__Hopeless prognosis__**: The patient has advanced bone loss, nonmaintainable areas, extraction(s) needed and patient has the presence of uncontrolled systemic or environmental factors.