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Reevaluation of Non-surgical Periodontal Therapy

The reevaluation is a step which occurs after nonsurgical therapy has been performed and the
tissues have been given time to heal. The dental team will perform another periodontal
assessment and gather information about the patients periodontal state. The results are
compared with the initial periodontal assessment before implementation of therapy.

Nonresponsive Disease Sites


After nonsurgical therapy has been performed a nonresponsive disease site is an area which is
still showing deeper pocket depths, continuing loss of attachment, or signs of inflammation are
still present. These areas should be rechecked with an explorer for residual calculus, this is
common in deeper pockets. The sites should be rechecked for proper self-care. If plaque is
found at the unresponsive sites an ultrasonic; unless contradicted; should be used to deplaque
the area. The patient should receive additional training and motivation to keep the site under
control.

The Need for Additional Nonsurgical Therapy


It is not uncommon for there to be a need for additional nonsurgical therapy. There can be
several factors which contribute to the need. The patients homecare is improved but is not
adequate enough to control the inflammation. Deep pockets and inflammations can cause
make it hard for calculus to be completely removed. There may be unknown systemic
condition contributing to the disease progression.

The Need for Periodontal Surgery


Patients with more a more advanced periodontal surgery usually benefit from surgical therapy
in addition to nonsurgical therapy. It is important for the patient to understand the importance
of management between the dental practice team and the periodontist. The dental team is not
able to provide the best care for the disease state that the patient presents. Surgery is almost
always performed on patients with severe cases of chronic periodontitis. These patients may
present with furcation involvement, vertical boney defects, or have a large amount of root
surface exposed.

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