牙周炎预后课件.ppt

periodontal disease Gingival Disease Periodontitis the probability of obtaining stability of the periodontal supporting apparatus ———— Kwok and Caton Overall Clinical Factors Systemic and Environmental Factors Local Factors Anatomic Factors Prosthetic and Restorative Factors Favorable prognosis Questionable prognosis Unfavorable prognosis Hopeless prognosis Overall Clinical Factors Patient Age younger patient vs older patients 同样的侵袭性牙周炎中，老年与青年？ 青年预后差，青年人比老年人更易发生侵袭性牙周炎 青年人修复能力强，但短时间骨的快速丧失意味骨修复能力小于破坏因素 Plaque Control 物理方法、化学方法 Patient Compliance and Cooperation 充分的沟通；复诊提醒； 告知牙周病的特点－了解患者期望－讨论患者自身努力的重要性； 对患者的态度积极肯定或建设性批评； 指出后果。 Systemic and Environmental Factors Smoking Systemic Disease or Condition …… Genetic Factors Stress Local Factors Plaque and Calculus the ability of the patient and the clinician to remove these etiologic factors Subgingival Restorations Anatomic Factors Tooth Mobility Anatomic Factors short, tapered roots with large crowns; cervical enamel projections enamel pearls; root concavities developmental grooves root proximity and the location and anatomy of furcations Tooth Mobility loss of alveolar bone inflammatory changes in the periodontal ligament, trauma from occlusion correctable：inflammation and trauma from occlusion not likely to be corrected： loss of alveolar bone Prosthetic and Restorative Factors Endodontics Prosthetics Oral and Maxillofacial Surgery Orthodontics Dental implant * 预后是在确立诊断之后，治疗计划制定之前，根据疾病的临床表现、诊治技术、和临床经验来评估治疗后的效果。 prognosis of periodontal disease 牙周病的预后 gingivitis 菌斑性牙龈炎（plaque-induced gingivitis） 菌斑控制 彻底菌斑去除 不及时治疗发展成牙周炎 受全身因素影响的牙龈病（gingival disease modified by systemic factors） 1 青春期龈炎（puberty-associated gingivitis) 2 妊娠期龈炎(pregnancy-associated gingivitis) 3 药物性牙龈增生/龈炎 全身因素控制后可痊愈 牙周病的预后 Overall Prognosis Individual Tooth Prognosis 稳定，少量修复 ４周后评估 恢复正常 维 护 牙周外科 消除牙周袋