Periodontal Maintenance, Prognosis, and Outcome Assessment
What this domain tests
Supportive periodontal care, recall intervals, prognostic assessment, and outcome measures.
Core rules
- Maintenance begins after active therapy and re-evaluation. It includes plaque control, risk-factor review, probing, and selective subgingival debridement.
- Recall interval is risk-based: low risk 6–12 months, moderate 3–6 months, high 2–3 months.
- High-risk features: residual pockets 5 mm or deeper, bleeding on probing, smoking, diabetes, poor compliance, and a history of Grade C disease.
- Outcomes: pocket depth 4 mm or less, no bleeding on probing, attachment gain, stability of bone, and tooth survival.
- Prognosis is not a fixed label; it changes with maintenance and risk-factor control.
Worked example
A patient with Stage III Grade C periodontitis, smoking 20 per day, and residual 6-mm pockets with bleeding after SRP should be placed on a 3-month recall, with smoking cessation support and reinstruction. A nonsmoking patient with Stage II Grade A disease, all pockets 4 mm or less, and no bleeding can be seen at 6–12 months.
Traps
- Using a single recall interval for every patient.
- Equating a good initial response with a good long-term prognosis.
- Ignoring bleeding on probing as a risk marker; its absence is more informative than its presence.
- Confusing disease stability with cure.