The trimeric model of periodontal treatment planning

1. The Trimeric Model
A New Model of Periodontal Treatment Planning
By
Dr. Syed Jaffar Raza
Lecturer Periodontology
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3. Periodontal health
Is a prerequisite, of successful comprehensive dentistry.
To achieve the long-term therapeutic targets of
 comfort,
 function,
 predictable treatment,
 longevity,
 and ease of restorative and maintenance care.
Active periodontal infection must be treated and controlled before the
initiation of restorative, esthetic, and implant dentistry.
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4. The treatment plan
includes all procedures required for the establishment and maintenance of oral
health
involves the following decisions
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5. Need for emergency treatment (pain,
acute infections)
 Teeth that will require removal.
 Periodontal pocket therapy techniques (Nonsurgical followed by surgical)
 Endodontic therapy
 The need for occlusal correction, including orthodontic therapy.
 The use of implant therapy
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6. Need for emergency treatment (pain,
acute infections)
 The need for caries removal and the placement of temporary and final
restorations.
 Prosthetic replacements that may be needed and which teeth will be
abutments if a fixed prosthesis is used.
 Decisions regarding esthetic considerations in periodontal therapy.
 Sequence of therapy.
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7. Unforeseen developments during treatment may necessitate
modification of the initial treatment plan. However, except for
emergencies, no therapy should be initiated until a treatment plan
has been established
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8. Model of Periodontal Treatment Planning
(Carranza Textbook)
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9. Model of Periodontal Treatment Planning
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10. Model of Periodontal Treatment Planning
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11. Model of Periodontal Treatment Planning
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12. The trimeric model of periodontal
treatment planning
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13. Phase I (Initial therapy – disease control
Phase)
Reduction or elimination of gingival inflammation
Achieved by complete removal of all factors responsible for gingival inflammation
such as plaque, calculus, correction of defective restorations, restoration of carious
lesions, etc.
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14. Phase I (Initial therapy – disease control
Phase)
1. Treatment of emergencies
2. antimicrobial therapy
3. diet Control
4. Patient education and motivation
5. Correction of iatrogenic Factors
6. deep Caries
7. hopeless Teeth
8. Preliminary scaling
9. Temporary splinting, occlusal adjustment, and minor orthodontic tooth movement
10. scaling and root Planning
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15. re-evaluation Phase:
done after 3-6 weeks from initial therapy
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16. re-evaluation Phase:
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17. Phase II (Surgical therapy)
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18. Phase III (Restorative therapy)
Restoration of the defects with fixed or removable prosthodontics, Periodontal
Prosthesis, or other kinds of restorations are done.
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19. Phase IV
(Maintenance Phase - Supportive Periodontal therapy)
 Preservation of the periodontal health of the treated patient is as important as the
elimination of periodontal disease.
 scheduled a periodic recall visits for maintenance.
 The intervals between recall appointments are varied according to the patient
condition.
 The long-term success of periodontal treatment depends on the maintenance of the
results achieved in the other phases of the periodontal treatment plan.
 This mandates a lifelong relation between the patient and the treating dentist or
periodontist. 1914-Mar-19

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21. Any Questions are welcome
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