The results of the study showed that subjects who did not receive any periodontal treatment during the study period had an average tooth loss of 2.5 teeth per subject which was 2-12 times higher than the subjects who received periodontal treatment. If re-instrumentation is done at healthy sites, it may result in further attachment loss,      The sites which are re-infected should be given particular attention during the maintenance visits. In low PRA patients, all parameters are within the low-risk categories or at the most one parameter is in the moderate-risk category. Tan AE. The active treatment of the patients included scaling/root planing, hemisection and flap surgery. Supportive Periodontal Therapy, also referred to as Periodontal Maintenance, is one of the most important phases of gum treatment. Contents available in the book …….. The term periodontal maintenance can be used interchangeably with the term supportive periodontal therapy.      In another study Backer et al. Contents available in the book …….. The most common reasons for noncompliance include personal reasons, economic reasons, psychological reasons and mere ignorance. “Supportive periodontal therapy (SPT)” is a term suggested by the 3rd World Workshop of the American Academy of Periodontology (AAP, 1989). Trials must have had a minimum follow-up period of 12 months. Loss of teeth due to any reason has an impact on the functional stability of the dentition. Contents available in the book …….. Orthodontic-periodontal interrelationship, Periodontal maintenance (Supportive periodontal therapy), Piezosurgery in periodontics and oral implantology. Contents available in the book ……..      Lang and Tonetti (2003) 68 put forward a functional diagram to assess patient’s risk factors. There may be no benefits from using photodynamic therapy and minocycline as adjuncts to mechanical debridement or from receiving treatment from a hygienist in patients undergoing supportive periodontal therapy. Another clinical study done in Northern Ireland demonstrated periodontal probing depth in excess of 4 mm was more than double in young smokers (15%) as compared to 6% in non-smokers 85.       Application of metallic instruments on dental implant surface damages the surface properties of the dental implant. Another important factor to be considered here is crown root ratio. Bleeding on probing score (BOP) and Derikvand N, Hatami M, Chiniforush N, Ghasemi SS. Worthington HV, MacDonald L, Poklepovic Pericic T, Sambunjak D, Johnson TM, Imai P, Clarkson JE. Contents available in the book …….. These studies were done by various group of researchers and are recognized by their geographic location, such as, Michigan study I, II, and III 19, 25-30, Swedish study I, II, III, IV, and V 31-38, Minnesota study 39-41, Denmark study 42, 43, Loma Linda study 44-59, Arizona study 60-62, Nebraska study 63-65, and others. The primary objectives of periodontal maintenance therapy are. Contents available in the book …….. Main results: In a study, Listerine was used around the dental implant as a subgingival irrigation solution and its effect in plaque reduction and inflammation reduction was evaluated. (2000) 11 in a study demonstrated that patients who did not participate in the periodontal maintenance demonstrated progressive interdental bone loss and increased rate of tooth loss as compared to patients who participated in maintenance therapy. Risk of bias summary: review authors' judgements about each risk of bias item…, Comparison 1 Supportive periodontal therapy…, Comparison 1 Supportive periodontal therapy (SPT) performed by specialists versus non‐specialist clinicians, Outcome…, Comparison 2 Antimicrobial + mechanical…, Comparison 2 Antimicrobial + mechanical debridement versus mechanical debridement, Outcome 1 Bleeding on…, Comparison 2 Antimicrobial + mechanical debridement versus mechanical debridement, Outcome 2 Clinical attachment…, Comparison 2 Antimicrobial + mechanical debridement versus mechanical debridement, Outcome 3 Pocket depth…, Comparison 3 Photonics + mechanical debridement versus mechanical debridement, Outcome 1 Full‐mouth mean…, Comparison 3 Photonics + mechanical debridement versus mechanical debridement, Outcome 2 Full‐mouth mean…, NLM The presence of calculus at the cementoenamel junction may lead to the inaccurate recording of attachment loss. Contents available in the book …….. The authors reported an inverse relationship between probing depth increase and patient age. Periodontal maintenance is defined as the procedures that are performed at selected intervals after active periodontal treatment to assist the periodontal patient in maintaining oral health. Hirschfeld and Wasserman (1978) 16 examined the well-kept records of 600 patients who were maintained by periodontal maintenance therapy for an average of 22 years. The first and foremost step is to re-evaluate patient’s current medical and dental health status and risk factors. Journal of Clinical Periodontology, 46 (2), 218-230. doi:10.1111/jcpe.13041. To determine the effects of supportive periodontal therapy (SPT) in the maintenance of the dentition of adults treated for periodontitis. 2009 Sep;54:S110-7. The authors in the Swedish study (Gothenburg) concluded that the patients who were treated with surgical periodontal therapy, but not incorporated into a supervised periodontal maintenance therapy regime, exhibited ……… Contents available in the book …….. Contents available in the book …….. Periodontology 2000. Also, previous bone loss in the patient does not rule out the possibility of the rapidly progressing lesions. Contents available in the book …….. Contents available in the book …….. Two review authors independently screened search results to identify studies for inclusion, assessed the risk of bias in included studies and extracted study data. The inflammation in the peri-implant soft tissue results in progressive bone loss around the crestal portion of the implant, which may ultimately result in the implant mobility and implant failure.      In the proposed functional diagram, the bone loss estimation is done in the posterior region on periapical radiographs. The individual risk assessment determines the frequency of calling a patient for professional support so that the initiation of periodontal disease may be stopped. Supportive Periodontal Therapy Periodontal maintenance, which is different from a cleaning at your dentist office, is most commonly utilized for patients who have periodontitis. Modified Periodontal Risk Assessment Model (Modified PRA). doi: 10.1002/14651858.CD004714.pub3. Reducing the incidence of tooth loss by monitoring the dentition and providing any prosthetic replacements for the missing natural teeth. Since inflammation of the gingiva is the first sign of periodontal disease progression, gingival status is recorded. Also shortened dental arch does not seem to predispose the individual to mandibular dysfunction 73-75. doi: 10.1002/14651858.CD011423.pub2.       Application of metallic instruments on dental implant surface damages the surface properties of the dental implant. It has been shown by various studies that teeth with reduced periodontal support, but healthy periodontium can function for several years either individually or as abutment provided that the occlusal load does not cause trauma to the periodontium, Increased tooth mobility indicates two probable reasons: loss of periodontal support or increased occlusal load. Furthermore, the results of the surgical periodontal therapy can only be evaluated accurately several months following the ……… Contents available in the book …….. After the active phase of periodontal treatment and your periodontal disease will be under control, Dr. Huber will recommend maintenance care. Compliance is defined as ”the extent to which a person’s behavior coincides with medical or health advice” 114. Periodontal maintenance is defined as the procedures that are performed at selected intervals after active periodontal treatment to assist the periodontal patient in maintaining oral health. The book is usually delivered within one week anywhere in India and within three weeks anywhere throughout the world. Contents available in the book …….. 4. on periodontal disease recurrence. The primary focus of active periodontal therapy in patients with periodontal pockets is the pocket elimination or reduction of pocket depth. After active periodontal treatment has taken place, supportive periodontal therapy (maintenance therapy) is very important to stop any progression of periodontal disease and to prevent it from recurring. When possible, we calculated mean differences (MDs) and 95% confidence intervals (CIs) for continuous variables. The information presented in this website has been collected from various leading journals, books and websites. Areas of persistent, recurrent, refractory, or newly occurring periodontal or peri-implant disease. Contents available in the book ……..      In another study, Becker et al. The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. Once the active periodontal treatment is completed, the parameters determining periodontal maintenance or supportive periodontal therapy are entirely different from parameters with which the patient initially reported with active disease. (1971) 24 investigated the effect of regular periodontal maintenance on gingival inflammation and attachment loss. The relationship of systemic diseases such as diabetes mellitus with periodontal disease progression is well established. Other factors used to calculate risk were patient’s age, smoking activity, diabetic status and periodontal history. Preventing the progression of the disease if present. Ramseier, C. A., Mirra, D., Schutz, C., Sculean, A., Lang, N. … Advisability of further periodontal treatment or re-treatment of indicated sites. Tobacco smoking rather than snuffing or chewing affects the susceptibility and the treatment outcome of patients with chronic periodontitis. Protocol for periodontal maintenance visit: Examination and re-evaluation of the patient and diagnosis: Extra-oral and intra-oral examination to detect any non-periodontal disease or condition. Together, you, your general dentist and Dr. Zakaria will work out the most effective schedule for your supportive periodontal care. The occlusal stability is re-evaluated by assessing occlusal patterns and discrepancy, determining the degree of tooth mobility, determination of fremitus and occlusion associated with implants. The following steps are followed during a comprehensive periodontal evaluation: Using multi-level risk assessment, the overall risk status of the patient is determined and an appropriate treatment plan is established. During the duration of the study, the subjects were recalled for re-evaluation 2-4 times per year. 3. However, in a position paper by the American Academy of Periodontology, term periodontal maintenance was preferred over supportive periodontal therapy 1. It is clinically measured as the distance of the epithelial attachment from the cementoenamel junction which is the normal site for epithelial attachment. For example, for a 40-year old patient ……… Contents available in the book …….. An association of crowding with more plaque accumulation has been investigated by various researchers. (1982b) 126 demonstrated that the instrumentation of pockets below 2.9 mm may result in attachment loss and designated it as critical probing depth below which instrumentation should not be done. The periodontal environment is very dynamic and there are various factors which determine periodontal health. Adverse events were not measured.The quality of the evidence is low to very low for these comparisons. Periodontal Maintenance Supportive Periodontal Care. On the basis of rate of progression of disease, three patient groups were recognized. During the study duration, subjects did not receive any periodontal treatment. -GPT 2001. This, in turn, means that new baseline parameters will have to be established once the treatment goals of active periodontal therapy are reached and periodontal The authors reported 60% improvement in gingival condition and 50% reduction in tooth loss. 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