DETERMINATION OF PROGNOSIS Prediction of duration, course, and termination of a disease and its response to treatment. Must be determined after the diagnosis is made and before treatment is planned.

PERIODONTAL PROGNOSIS Overall and Individual teeth

OVERALL PROGNOSIS Should treatment be undertaken? Is it likely to succeed? Are the remaining teeth able to support the added burden of needed prosthetics?

SLOWLY PROGRESSIVE PERIODONTITIS directly related to severity of inflammation and the height of remaining bone. Better prognosis for the patient with greater inflammation

RAPIDLY PROGRESSIVE PERIODONTITIS difficult to form prognosis leukocyte defects some cases respond to conventional therapy plus antibiotics No methods to predict

REFRACTORY PERIODONTITIS Usually resistant to treatment JUVENILE PERIODONTITIS Prognosis is usually poor

AGE Two patients with the same amount of destruction - prognosis is better for older patient.

SYSTEMIC BACKGROUND Prognosis improves with correction of systemic problem

MALOCCLUSION interferes with plaque control

SMOKING direct relationship exists between smoking and gingivitis and periodontitis Smoking cessation improves prognosis and predictability of treatment

PATIENT COOPERATION Patient must desire to retain natural teeth and have willingness and ability to maintain oral hygiene

PROGNOSIS FOR INDIVIDUAL TEETH Determined after overall prognosis Consider the following for prognosis of individual teeth:

MOBILITY Caused by bone loss trauma from occlusion and inflammation Prognosis is worse if mobility is from bone loss

PERIODONTAL POCKETS level of attachment degree of bone loss type of pocket

MUCOGINGIVAL PROBLEMS lack of attached gingiva prognosis is poor unless corrected

FURCATION INVOLVEMENT difficulty of access by operator and patient if these can be corrected then prognosis is similar to single rooted tooth

TOOTH MORPHOLOGY Prognosis is poor for teeth with short tapered roots and large crowns Root concavities Developmental grooves Enamel projections

TEETH ADJACENT TO EDENTULOUS AREAS abutments have more functional demands special oral hygiene

EXCELLENT PROGNOSIS - no bone loss, excellent gingival condition, adequate patient cooperation

GOOD PROGNOSIS - one or more of the following: adequate remaining bone support; adequate possibilities to control etiologic factors and establish a maintainable dentition; adequate patient cooperation

FAIR PROGNOSIS - one ore more of the following; less than adequate remaining bone support, some tooth mobility, grade I furcation involvement, adequate maintenance possible, acceptable patient cooperation

POOR PROGNOSIS - one or more of the following: moderate to advanced bone loss, tooth mobility, grade I and II furcation involvements, difficult-to-maintain areas and/or doubtful patient compliance

QUESTIONABLE PROGNOSIS - one or more of the following: advanced bone loss, grade II and III furcation involvements, tooth mobility, inaccessible areas.

HOPELESS PROGNOSIS - one or more of the following: advanced bone loss, nonmaintainable areas, extractions indicated