The Periodontal Reevaluation

Division of Periodontics
University of Colorado School of Dental Medicine

Periodontal Reevaluation

Objectives of the reevaluation

Assess the response to phase I therapy (non-surgical periodontal therapy)

Determine the next appropriate phase of periodontal therapy

Additional non-surgical therapy

Refine S&RP

Reinforce OHI

Periodontal surgery

Periodontal maintenance care

Phase 1 Therapy

Scaling and root planing

Manage contributing etiologies

Occlusal adjustment

Oral hygiene instructions

When do we reevaluate the periodOntium?

Studies state periods ranging from 3 weeks up to 12 months

HOWEVER

The greatest changes with respect to probing depth reduction and gain of clinical attachment
can be recorded after 4 to 6 weeks

Gradual repair and maturation of the periodontium may occur over 9 to 12 months

American Academy of Periodontology. Proceedings of the World Workshop in Clinical Periodontology, 1989

Periodontal Reevaluation Process

1.

Gingival assessment

2.

Record tooth mobility, fremitus, FGM, <2mm of keratinized tissue, furcations,

probing depths, bleeding on probing and suppuration

3.

Disclose/plaque index - to see pts compliance

4.

Compile and/or confirm a phase II periodontal treatment plan

Treatment planning

42 year old African American female

No dental treatment in the past 10 years

Medical history

Hypertension
Lisinopril
Amlodipine

Type 2 Diabetes Mellitus

Metformin

Atrial Fibrillation
Coumadin pt has clogged arteries blood thinner problem: hard to achieve hemostasis

Smoking history of 15 pack/years nicotine is a vasoconstrictor healing cells wont reach gum interferes
w healing & oral cavity constntly exposed to inflammatory molecues & carcinogens

SRP completed six weeks ago