Determination Of Prognosis & Treatment Plan
Define prognosis and describe the prognosis.
Answer. “Prognosis is the prediction of probable course, duration and outcome of a disease-based on general knowledge of pathogenesis of disease and presence of risk factors for the disease and the likelihood of its response to treatment”.
Prognosis must be determined after the diagnosis is made and before treatment is planned. In most cases, careful analysis of these factors allows the clinician to establish one of the following prognosis.
Description of Prognosis
- Prognosis is established after the diagnosis and before the treatment plan.
- Prognosis may be excellent, good, fair, poor, questionable and hopeless.
- It is divided in overall prognosis and individual tooth prognosis.
Various factors to be considered by determining prognosis are:
Factors Determining the Overall Prognosis
Factors determining the overall prognosis are clinical factors and systemic/environmental factors. These are as follows:
- Overall clinical factors:
- Patient’s age
- Disease severity
- Plaque control
- Patient compliance and co-operation
- Systemic/environmental factors
- Patient habits: Smoking
- Systemic disease/condition
- Genetic factors
- Stress
Factors Considered in Determining Individual Prognosis of Tooth
Factors considered or affecting the individual tooth prognosis are:
- Local factors
- Prosthetic and restorative factors
Local factors
The local factors which are considered in determining individual prognosis of tooth are:
- Plaque and calculus
- Subgingival restorations
- Anatomic factors
Following are the anatomic factors
- Short, tapered roots
- Cervical enamel projections
- Enamel pearls
- Bifurcation ridges
- Root concavities
- Developmental grooves
- Tooth mobility
- Furcation involvement.
Prosthetic and Restorative Factors
Following are the prosthetic and restorative factors:
- Abutment selection
- Caries
- Non-vital teeth
- Root resorption.
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