7.+Expected+Outcomes+of+Phase+I+Therapy



Expected Outcomes of Phase I Therapy

AH 28

Shah, M., & Kumar, S. (2011). Improvement of Oral Health Related Quality of Life in Periodontitis Patients after Non-Surgical Periodontal Therapy. //Journal Of International Oral Health//, //3//(6), 15-22.

According to Carranza Phase I Therapy is intended to eliminate factors contributing to periodontal disease in our patients and involves removal of plaque and calculus and patient OH education. It also includes referral to appropriate specialists so that other needs can be addressed. In this way the overall health of the patient is being cared for and my article mentions that as an adjunct to the positive clinical outcomes of periodontal treatment, the quality of life of our patients improves as well. Yelena Bobova #23

Leininger, M., Tenenbaum, H., & Davideau, J. (2010). Modified periodontal risk assessment score: long-term predictive value of treatment outcomes. A retrospective study. //Journal Of Clinical Periodontology//, //37//(5), 427-435. doi:10.1111/j.1600-051X.2010.01553.x

Carranza states that the objective of Phase I therapy is to alter or eliminate the microbial etiology and contributing factors for gingival and periodontal diseases. My article concentrated on what Carranza describes as the intended result of Phase I therapy; halting the progression of disease and returning the dentition to a state of health and comfort. My article concluded that patient compliance and consistent supportive periodontal treatment is essential in the preservation of teeth after Phase I therapy. The long-term study done in my article demonstrated that patients that did not have SPT and none-to-less compliance exhibited more tooth loss than those who were compliant and had SPT. Carranza states that long-term success of periodontal treatment depends on maintaining the results achieved with Phase I therapy, evaluating tissue response and the patient's attitude toward periodontal care are crucial to the overall success of the treatment. Arlene C. Sides #35

Adriaens, L.; Adriaens, P. (2004). Effects of nonsurgical periodontal therapy on hard and soft tissues. //Periodontology 2000, 36, pp. 121-145.// The big idea is that phase I therapy is used to remove the local contributing factors. Treatment should consist of removal of calculus, correction or replacement of poorly fitting restorations and prosthetic devices, restorations of carious lesions, orthodontic treatment, treatment of food impacted areas, treatment of occlusal trauma, and extraction of hopeless teeth. After root planing and scaling if a pocket depth of 5mm plus still is present at the 4 week re-eval the pocket should be considered for referral. Velinda Davis #24

Treatment of Plaque-induced Gingivitis, Chronic Periodontitis, and Other Clinical Conditions." // Journal of International Oral Health // 2.36 (2010): 90-99. Print. Carranza states that the objective of Phase 1 Therapy is to change/ reduce of eliminate the mictobial/ bacteria causing agents that contribute to gingival and periodontal dieseas.This s done by complete removal of calculus, restorations and treatment of carious lesions and daily plaque control. My artical also agreed with the statments above. It also mentioned that curetage can serve as an adjunct with scaling and root planning in the treatment of chronic perio with shallow suprabony pockets may be utilized. Ca20.

Tüter, G., Kurtiş, B., Serdar, M., Yücel, A., Ayhan, E., Karaduman, B., & Ozcan, G. (2005). Effects of phase I periodontal treatment on gingival crevicular fluid levels of matrix metalloproteinase-3 and tissue inhibitor of metalloproteinase-1. //Journal//  // Of Clinical Periodontology // ,  //32//  (9), 1011-1015 The purpose of phase I therapy is to alter or eliminate the microbial etiology and contributing factors. My article also discusses the importance of the microbial etiology and the study was done to check the levels of enzymes before and after treatment, the results were a significant decrease in the enzymes associated with the destruction of periodontal tissues. The expected outcome of phase I therapy is elimination or reduction of etiologic and contributing local factors, effective plaque control, reduction of inflammation and pocket depths. Lauren #38

Kaushik, R., Yeltiwar, R. K., & Pushpanshu, K. (2011). Salivary Interleukin-1β Levels in Patients With Chronic Periodontitis Before and After Periodontal Phase I Therapy and Healthy Controls: A Case-Control Study. //Journal Of Periodontology//, //82//(9), 1353-1359. doi:10.1902/jop.2011.100472. Retrieved April 1, 2011 from : [|http://ezproxy.mvc.edu:2074/ehost/detail?vid=8&hid=107&sid=6bd04def-c7ad-4f15-b903-65ca3ac23fef%40sessionmgr104&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=ddh&AN=66424839].

Carranza states that phase I periodontal therapy is to eliminate the microbial eitology and contributing factors which is the complete removal of calculus and daily plaque control mechanisms. Complete phase I therapy is said to help reduce BOP and pocket depths if one is to comply with home plaque control. In this article they studied the outcome after phase I periodontal therapy of salivary interleukin 1B levels. it is said that the salivary interleukin-1b is found in patient's with periodontal disease and can contribute to the disease.The research showes that hteir was a reduction in BOP, probing depths and interleukin-1b levels after phase I periodontal therapy. Natalie Baeza #22

Rann, S., Holmlund, A., & Rahm, V. (2008). Clinical, Socioeconomic and Patient Outcomes of Intensive Versus Conventional Scaling and Root Planing in the Treatment of Periodontal Infection. //Oral Health & Preventive Dentistry//, //6//(4), 303-308.

My article discusses the difference between conventional SRP treatment, which is one quadrant per session over 4 weeks, and intensive treatment, which is considered treating all 4 quads in two sessions within 24 hours. The results showed no difference in outcomes with the two different methods. There was a significant reduction in BOP's, probing depths, and amount of plaque in both methods. The only difference between the two is that there was more post op pain, tenderness, and swelling with the patients that received the intensive method, but the article explains that this method could be very useful for patients who don’t have time to come back four different times to have each quadrant done separately. Carranza explains that phase I therapy is to alter or eliminate the microbial etiology and contributing factors for gingival and periodontal diseases. Carranza also explains that the treatment and number of appointments just depends on the patient and how involved they are. This could include the general health of the patient and their tolerance, the number of teeth present, amount of subgingival calculus, pocket depths, furcation involvement, teeth alignment, margins of restorations, and developmental anomalies. So in regards to my article the 4 quads being treated within 24 hours may not be ideal for some patients, which is why every treatment plan is individualized for each patient.

Amber Starnes 36

The hygienist is involved in phase one periodontal therapy. Phase I periodontal therapy involves scaling and root planning, nutritional counseling, patient education and smoking cessation. Phase I is a preventive measure to preserve the dentition and maintain a functioning and healthy loss. This involved preventing: tooth loss, attachment loss and gingival and periodontal infections.

My article documented a controlled study to compare the treatment out comes of 100 patients that were not compliant with there phase i therapy for ten years. The purpose of this study what to compare their oral health comes to those who were compliant with their oral health and phase I therapy. The study took into account those that had medical conditions that could aggravate periodontal disease and grouped them accordingly. The study concluded that phase I periodontal therapy is an essential part of dental health because when comparing the non- compliant individuals to those that were compliant there was a vast difference in the oral health of the different groups. The oral health of the compliant group had signs of health vs the un-compliant individuals who had a much higher prevalence of attachment loss, tooth loss and infection.

Newman, M.G., Takei, H.H.,Klokkevold,P.R.,&Carranza,F.A. (2006). Carranza's Clinical Periodontology (10th ed.).St. Louis Eickholz, P., Kaltschmitt, J., Berbig, J., Reitmeir, P., & Pretzl, B. (2008). Tooth loss after active periodontal therapy. 1: patient-related factors for risk, prognosis, and quality of outcome. //Journal Of Clinical Periodontology//, //35//(2), 165-174. doi:10.1111/j.1600-051X.2007.01184.x -Kimberley Robinson #32

Müller, H., & Heinecke, A. (2004). Clinical effects of scaling and root planing in adults infected with Actinobacillus //actinomycetemcomitans//.// Clinical Oral Investigations //, // 8 //(2), 63-69. doi:10.1007/s00784-003-0251-2

The goal of phase I therapy is effective plaque control because plaque is the etiology of gingival inflammation, which can lead to periodontal problems if not treated. In order to achieve this it is important to remove the etiology and irritants that are contributing to the accumulation/formation of plaque such as the removal of calculus, realignment of teeth, and correction of poorly fitted restorations. Phase one therapy includes all of these factors as is a critical part of restoring the patient's gingival health. The article that I read was a study that wanted to see if there was a correlation between the microorganism A.a before and after scaling and root planing. The study concluded that there was no significant correlation, but the results of scaling a root planing did bring about improvements in probing depths, bleeding, and attachment. ES #34

Brochut, P., Marin, I., Baehini, P., & Mombeli, A. (2005). Predictive value of clinical and microbiological paremeters for the treatment outcome of scaling and root planning. Journal of Clinical Periodontology, 32(7), 695-701.

In my reading from Caranza, phase 1 therapy involves individualized detailed analysis of the patient’s periodontal needs. The purpose is to eliminate any etiological factors that contribute to gingival and periodontal diseases. This slows down the disease and provides a healthy environment for the oral health. Phase 1 therapy allows the clinician to evaluate how the patient responds to periodontal care as well as tissue response, but overall the success of their treatment. Many patients respond well to phase 1 therapy; although there are certain cases where a patient may present with 5mm pockets or higher in which a referral to a specialist would be necessary. M y article discuses the evaluation and the outcomes of phase 1 therapy six weeks after and non-surgical periodontal treatment six months after. It also emphasized the importance of good oral hygiene prior to phase 1 therapy to sustain positive outcomes. ES 33

__Tüter, G., Kurtiş, B., Serdar, M., Yücel, A., Ayhan, E., Karaduman, B., & Ozcan, G. (2005). Effects of phase I periodontal treatment on gingival crevicular fluid levels of matrix metalloproteinase-3 and tissue inhibitor of metalloproteinase-1. //Journal Of Clinical Periodontology //, //32 //(9), 1011-1015. __

__Carranza states that Phase I Therapy is important in periodontal treatment. It talks about Phase I therapy as eliminating contributing factors for gingivitis or periodontal disease and the end result stopping the progression of either disease. The rationale in Carranza states that we want to take away all contributing factors so that we can evaluate the patients mouth at later time to be able to see if there is actual improvement of the tissues and then decide on the next part of the treatment plan. The big idea of my article was to basically show how important Phase I therapy is and how much it does improve patients tissues who have chronic periodontitis. Carranza as well as my article both correlate with each other in that Phase I therapy is a vital and critical part of improving the patients tissues. __ __SF 25 __

==== Cugini, M. A., Haffajee, A. D., Smith, C., Kent, R. L., & Socransky, S. S. (2000). The effect of scaling and root planing on the clinical and microbiological parameters of periodontal diseases: 12-month results. //Journal of Clinical Periodontology//, //5//(1), 246-271 ====

==== According to Carranza phase I therapy is done to eliminate the microbial etiology and factors that contribute to periodontal disease. This includes complete removal of plaque and calculus and daily plaque control mechanisms. The goal is to halt the progression of the disease and to restore the dentition to a state of health. My article discusses the specific outcomes that are achieved during phase I therapy. The results of the experiment indicated that there was a reduction in BOPs, probing depth and periodontal pathogens. The patients were on a 3 month recare and were given specific homecare instructions. ====

-Charlene Malit #29
___ Ekuni, D., Yamamoto, T., & Takeuchi, N. (2009). Retrospective study of teeth with a poor prognosis following non-surgical periodontal treatment. //Journal Of Clinical Periodontology//, //36//(4), 343-348. doi:10.1111/j.1600-051X.2009.01373.x

After reading Carranza and the article the objective of phase I therapy is to alter or eliminate the microbial etiology and local contributing factors of gingival and periodontal diseases. This is achieved by the removal of calculus, correction of defective restorations, treatment of carious lesions and an effective oral hygiene regime. Success depends on the patient’s ability to maintain the outcomes once phase I has been provided. The tissue should be evaluated 4-6 weeks post scaling to check the healing process and to determine if there is a need to refer to a specialist. A Yanez 37