Phase II therapy
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on Jul 23, 2012 Says :
good ppt on periodontal therapies.
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Slide 1 :
DEPARMENT OF PERIODONTICS (VYDEHI INSTITUTE OF DENTAL SCIENCES AND RESEARCH CENTER) SEMINAR ON PHASE II THERAPY PRESENTED BY:- DR. MAITREY.G.BHALODIA
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Phases of treatment of periodontal disease Introduction Purpose of Phase II therapy Objectives Conclusion References Contents
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Phases of treatment of periodontal disease The treatment of periodontal diseases typically involves following phases: Phase I: Etiotropic Phase Phase II: Surgical Phase Phase III: Restorative Phase Phase IV: Maintenance Phase
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. Introduction Once the factors responsible for the periodontal disease have been controlled or eliminated, the goal of treatment becomes the correction of residual damage, thereby creating an environment that can more easily be maintained in a state of health. These corrections are accomplished by various surgical techniques
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PURPOSE OF PHASE II THERAPY Controlling or eliminating periodontal disease. Correcting anatomic conditions that may favor periodontal disease, impair esthetics, or impede placement of the correct prosthetic appliances. Placing implants to replace lost teeth and improving the environment of their placement and function.
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OBJECTIVES OF PHASE II THERAPY The surgical phase of periodontal therapy has the following main objectives: 1. Improvement of the prognosis of teeth and their replacements 2. Pocket therapy 3. Improvement of esthetics -Morphological defect 1.Mucogingival Surgery 2.Esthetic Surgery 3.Preprosthetic Surgery
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Improvement of the prognosis of teeth REEVALUATION AFTER PHASE I THERAPY All patients should be treated initially with scaling and root planing. Final decision on the need for periodontal surgery should he made only after a thorough evaluation of the effects of Phase I therapy. The assessment is generally made 9 months after the completion of Phase I therapy. Reevaluation of the periodontal condition should include reprobing the entire mouth, with rechecking for the presence of calculus, root caries, defective restorations, and all signs of persistent inflammation Reprobing pockets Presence of calculus Defective restoration
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IMPLANTS TYPES OF IMPLANTS Endosseous implant Subperiosteal implant Transmandibular implants
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SURGICAL POCKET THERAPY PURPOSE:-Its purpose is to eliminate the pathologic changes in the pocket walls; to create a stable, easily maintainable state; and, if possible, to promote periodontal regeneration. Pocket reduction surgery seeks to reduce pocket depth by either resective or regenerative means or often by a combination of both methods. Resective :-gingivectomy, apically displaced flap and undisplaced flap with or without osseous resection. Regenerative:-flaps with grafts, membranes, etc.
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METHODS OF POCKET THERAPY Treatment of pocket on the type of pocket Pseudo/Gingival pocket True/Periodonatal pocket Treatment option: Scaling and root planing Scaling and root planing Re-evaluation and maintenance Re-evaluation and maintenance persistent pockets Removal of pocket wall Gingivectomy and gingivoplasty Removal of pocket side of the pocket
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REMOVAL OF THE POCKET WALL Removal of the pocket wall is the most common method. The wall of the pocket consists of soft tissue and may also include bone in the case of infrabony pockets. It can be removed by the following: Retraction or shrinkage, in which scaling and rootplaning procedures resolve the inflammatory process, and the gingiva therefore shrinks, reducing the pocket depth. Surgical removal performed by the gingivectomy technique or by means of an undisplaced flap. Apical displacement with an apically displaced flap.
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Treatment of suprabony and infrabony pockets suprabony pocket Infrabony pocket anterior teeth posterior teeth New attachment procedures Scaling+root planing Scaling+root planing and maintenance and maintenance persistent persistent pockets+ pockets inadequate access Curettage Flap surgery Flap surgery
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MUCOGINGIVAL SURGERIES The 1996 World Workshop in Clinical Periodontics renamed mucogingival surgery as “periodontal plastic surgery” This includes:- Technique to increase the width of the attached gingiva Free soft tissue autograft Apically displaced flap Technique for widening the zone of attached gingiva Fenestration operation/Periosteal seperation Vestibular extenstion operation Free gingival autograft Procedure for root coverage Laterally displaced flap Double papilla flap Guided tissue regenration Frenectomy
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ESTHETIC PERIODONTAL SURGERIES Crown lengthening Esthetic surgical correction Esthetic surgical correction around implants Surgical exposure of unerupted teeth for orthodontics Pre treatment Post treatment
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PREPROSTHETIC SURGERY This includes:- Ridge augmentation Crown lengthening
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Endodontic surgeries Surgical drainage Periradicular surgery -Curettage -Biopsy -Apicoectomy -Root resection - Hemi section Implant sugery
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Apicoectomy Hemi section Root resection
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Conclusion An objective of the overall treatment plan is the creation and maintenance of oral health, function, and esthetics. The outcome is thus long term and in most cases requires the coordination of several disciplines of dentistry. A large part of phase II therapy is eliminating inflammation. This is important not only to preserve periodontal tissues, but also to eliminate an oral source of inflammation contributing to overall systemic health. Treatment planning should focus on the list of diagnoses for the patient. Treatment should be planned in phases. At the completion of each phase, the patient should be reevaluated to assess response to treatment, and the treatment plan may be modified based on this.
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References Carranza’s: Clinical Periodontolgy(10th edition) Internet(google search engine, wikipidia)
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Thank you BY:Dr Maitrey g Bhalodia
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its about phase 2 therapy of periodontal treatment
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