Treatment plan

• Treatment plan is the blue print for case

management
• After diagnosis & prognosis, treatment is
planned
• Includes all procedures required for the
establishment &maintenance of oral health
• Unforeseen developments may necessitate
modification of treatment plan
• Except for emergencies, no treatment to be
started unless treatment plan has been
established
 Master plan for treatment
• Total treatment
• Primary goal is elimination of gingival
inflammation and correction of conditions
that cause and/or perpetuate it
Extracting or preserving a tooth
• Periodontal treatment value measured in
years of healthy functioning of the entire
dentition , not by the number of teeth
retained at the time of treatment

• Periodontal condition of teeth to be retained

is more important than the number of such
teeth
• Removal, retention or temporary retention of
one or more teeth is a very important part of
overall treatment plan
– Tooth will be extracted
– Tooth will be retained if prognosis good to
excellent
– Tooth will be retained temporarily
Therapeutic procedures
• Periodontal therapy is an inseparable part of
dental therapy
• In phases of periodontal therapy, other
procedures not performed by periodontist is
listed to emphasize the close relationship of
periodontal therapy with other phases of
therapy
Phases of periodontal therapy

• Preliminary phase
• Etiotropic phase – phase I
• Surgical phase – phase II
• Restorative phase – phase III
• Maintenance phase – phase IV
Preferred sequence
Emergency phase

Etiotropic phase

Maintenance phase

` Surgical phase Restorative phase

Preliminary phase
Treatment of emergencies
• Dental or periapical
• Periodontal
• Other
• Extraction of hopeless teeth and provisional
replacement if needed
Etiotropic phase (plaque control &patient education)
• Diet control
• Removal of calculus & root planing
• Correction of restorative & prosthetic irritational
factors
• Excavation of caries & restoration- temp or final
• Antimicrobial therapy- local or systemic
• Occlusal therapy
• Minor orthodontic movement
• Provisional splinting & prosthesis
Evaluation of response to etiotropic phase

Rechecking
• Pocket depth & gingival inflammation
• Plaque & calculus, caries
Surgical phase

• Periodontal therapy including placement of implants

• Endodontic therapy
Restorative phase

• Final restorations
• Fixed and/ or removable prosthodontics
Evaluation of response to restorative procedures

• Periodontal examination
Maintenance phase

periodic rechecking
• Plaque & calculus
• Gingival condition- pockets, inflammation
• Occlusion, tooth mobility
• Other pathologic changes