Prognosis Of Periodontal Disease

Prognosis Of Periodontal Disease

Define prognosis. Describe various factors which influence prognosis in patients with periodontal disease.
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.

Various Factors which Influence Prognosis in Patients with Periodontal Disease

Chronic Periodontitis

• In slight-to-moderate periodontitis, where the clinical attachment loss as well as bone loss is very limited, the prognosis is good.
• In cases with more severe disease characterized by furcation involvement, increased tooth mobility or non compliant patients, prognosis is downgraded from fair to poor.

Aggressive Periodontitis

• In this clinical, microbiological and immunologic features indicate a poor prognosis.
• In localized aggressive periodontitis, patient usually shows a strong serum antibody response to the infecting agents, which causes localization of lesions.
• If diagnosis is done early, conservative therapy with oral hygiene instructions and systemic antibiotic therapy gives excellent prognosis.

Periodontitis as Manifestation of Systemic Disease

• Systemic diseases alter the ability of the host to respond to the microbial challenge presented, and this may affect progression of disease and the prognosis.
• Unless the systemic diseases can be corrected, these patients exhibit fair to poor prognosis.
• In cases of genetic disorders which alter the host response, prognosis is fair to poor.

Necrotizing Periodontal Diseases

• Necrotizing ulcerative gingivitis: Prognosis is usually good, provided both bacterial plaque and secondary factors including acute psychological stress, tobacco smoking and poor nutrition are adequately controlled. In repeated episodes of necrotizing ulcerative gingivitis prognosis is downgraded to fair.
• Necrotizing ulcerative periodontitis: In this prognosis depends on control of local and secondary factors along with management of systemic problem. Many of patients of necrotizing ulcerative periodontitis having systemic conditions such as HIV where the prognosis depends on the dealing with systemic problems.