Periodontal Maintenance Therapy Dentistry 565 Evidencedbased periodontics

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Periodontal Maintenance TherapyDentistry 565
Evidenced-based periodontics

• Online Module (15) for May 15, 2006.

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What is PMT?

• PMT Periodontal MaintenanceTherapy
• also know as
• supportive periodontal therapy (SPT)
• preventive maintenance
• recall maintenance
• procedures performed at selected intervals to
  assist the periodontal patient in maintaining
  oral health

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Rationale for PMT

• tooth loss inversely proportional to SPT
  frequency
• reduced risk of future attachment loss despite
  incomplete plaque removal
• monitoring
• plaque removal

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Therapeutic goals for PMT

• To prevent or minimize the recurrence and
  progression of periodontal disease in patients
  who have been previously treated for periodontal
  diseases.
• To prevent or reduce the incidence of tooth loss
  by monitoring the dentition and any prosthetic
  replacements of the natural teeth.
• To increase the probability of locating and
  treating, in a timely manner, other diseases or
  conditions within the oral cavity.

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Components of PMT appointment

• update medical/dental histories
• extraoral/intraoral soft tissue examination
• dental examination
• periodontal evaluation

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Components of PMT appointment

• radiographic review
• assessment of disease status

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Components of PMT appointment

• assessment of personal oral hygiene
• removal of dental plaque and calculus from
  supragingival and subgingival regions
• behavioral modification
• root planing
• occlusal adjustment
• Antimicrobial agents
• Surgical treatment

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Components of PMT appointment

• communication
• planning

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Frequency of PMT

• For most patients presenting with gingivitis but
  without history of attachment loss- performed on
  a semiannual basis.
• For patients with a history of periodontitis, PMT
  should be performed at intervals of less than 6
  months - most commonly every 3 months.

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Duration of PMT appointment

• teeth
• cooperation
• oral hygiene
• systemic health
• frequency
• instrumentation
• history
• sulci

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The effect of plaque and frequency of recall on
PMT.
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Compliance

• 16 comply with PMT
• 49 comply erratically with PMT
• 34 never reported for PMT

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Who is best at providing PMT?

• general dentist
• periodontist

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Summary

• Successful periodontal therapy with PMT
• PMT follows active periodontal therapy
• PMT under the supervision of a dentist
• An interval of 3 months between appointments

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Sample Test Question

• Which of the following is the MOST
  appropriate PMT interval for patients following
  active periodontal therapy?
• 3 months
• 4 months
• 5 months
• 6 months

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Answer A

• Patients who have received active periodontal
  therapy should obtain PMT 4 times per year, since
  this interval will result in a decreased
  likelihood of progressive disease, compared to
  patients receiving PMT on a less frequent basis.