牙周病学第四版8__培训课件.ppt

Local symptoms Several posterior teeth have lost spontaneously in the past 2-3 years Gum bleeding on brushing for 4-5 years Gingival swelling and painful occasionally Increasing mobility of most teeth Cannot bite and chew food Oral Hygiene habit and smoking status Brush teeth twice a day,2 minutes per time Never use interdental brush or floss Non-smoker Dental History Supragingival scaling several times in other clinic (cannot alleviate symptoms) Family history Father has lost some teeth because of mobility Medical history No significant findings Pre-treatment intra-oral view Chart (after supragingival scaling) X-ray Diagnosis 1.Aggressive periodontitis (generalized) 29 years old severe bone loss no systemic disease family history Diagnosis 2.Residual root of 48 3.Dentition defect 4.Malocclusion (deep over bite and deep over jet of anterior teeth) Risk assessment Patient level Systemically healthy Fair compliance Poor oral hygiene Missing of 16,15,22,34-37,44-47 Family history Risk assessment Tooth level Plaque accumulation and calculus Furcation involvement of 26 Potential abutment of 17,14,21,23,38,33,43 Tooth mobility of all teeth except 38 Severe alveolar bone loss Prognosis / 17 / / 14 13 12 11 21 / 23 24 25 26 27 / Good prognosis + + Questionable prognosis + + Poor prognosis + + + + + + + / / / / / 43 42 41 31 32 33 / / / / 38 Good prognosis Questionable prognosis + Poor prognosis + + + + + + Treatment plan(OM