Classification and prognosis evaluation of individual teeth—A comprehensive approach Annotations

Classification and prognosis evaluation of individual teeth—A comprehensive approach

Unmapped Annotations

• p. 377: Currently there is no accepted standardized tool for assessing the overall status of teeth.
• p. 377: An accurate diagnosis and prognosis evaluation are the basis of solid treatment planning and are essential when treatment options are considered
• p. 377: Prognosis is defined as “a prediction of the probable course and outcome of a disease, and the likelihood of recovery from a disease.”
• p. 378: In the periodontal literature, the search for clinical and radiographic markers that can accurately predict tooth loss has proven to be quite limited
• p. 378: but rather to attach a relative prognostic value, which aims to enable clinicians to distinguish between favorable teeth and those that are compromised to a certain degree.
• p. 378: Most of the attempts to attach a classification for the prognosis of individual teeth come from the periodontal literature
• p. 378: Annotation
• p. 379: McGuire and Nunn
• p. 379: McGuire
• p. 379: Kwok and Caton’s19 system focuses on only periodontal factors, although it gives consideration to both local and systemic risk factors, which need to be reassessed over time.
• p. 379: A recent systematic review25 concluded that the most critical aspect when dealing with a nonvital tooth is “tissue preservation.”
• p. 380: A strong association has been noted between the crowning of endodontically treated teeth and their long-term survival.
• p. 381: Multiple patient-level factors play a significant role in the prognosis of teeth. These can be divided into 3 main categories: biologic risks, environmental risks, and financial and behavioral/personal risks (Table 1). A fourth significant factor relates to the quality of the dental treatment and the frequency and quality of oral health maintenance
• p. 381: These can be best assessed by the various caries risk assessment (CAMBRA [caries management by risk assessment])52–56 and periodontal risk assessment57,58 tools available
• p. 381: Because only some risk factors can be diminished or even eliminated, these should be divided into modifiable and nonmodifiable risk factors
• p. 382: Criteria for analysis. Four main criteria and 2 additional factors that may compromise these criteria are evaluated:
• p. 382: requires 2 steps of analysis.
• p. 382: Step 1. Each tooth is evaluated for each of the 4 criteria independently
• p. 382: The single most severe of these criteria determines the tooth’s class (Table 2).
• p. 382: Anatomic risk factors and/or iatrogenic compromising factors may result in a drop of a class for an individual tooth. More than 2 such findings in a tooth may require a further drop in class (Table 3).
• p. 382: Patient-level risk factors may result in a decreased prognosis for the dentition. Therefore, a drop of 1 class for all teeth
• p. 382: Treatment planning is a multistage process that involves the analysis of each tooth from various aspect
• p. 382: Understanding of caries progression by using the CAMBRA protocol should help clinicians assess caries