全日制硕士(含学术型和专业学位).ppt

Slide Title,PERIDONTALRECORD KEEPING,1,PERIODONTALRECORD KEEPING,Consensus Reports from the 1996 World Workshop in Periodontics,published in a special supplement to JADA,Sept 1998,Providing the most appropriate periodontal treatments requires making an accurate diagnosis,assessing risk,performing optimum treatment,and monitoring the patient.,2,PERIODONTAL RECORD KEEPING,KEY COMPONENTS OF,PERIODONTAL RECORD KEEPING,1.Comprehensive Health History,2.Comprehensive Charting and documentation,3.Radiographs,3,PERIODONTAL RECORD KEEPING,HEALTH HISTORY,ARE YOU:,ALIVE,DEAD,4,PERIODONTAL RECORD KEEPING,5PERIODONTAL RECORD KEEPING,6,PERIODONTAL RECORD KEEPING,7,PERIODONTAL RECORD KEEPING,8,PERIODONTAL RECORD KEEPING,Comprehensive exam should include an evaluation of soft tissue,bleeding,and exudate on probing,probing depths,gingival recession,mobility,furcation involvement,occlusal analysis,and TMD assessment.,JADA article April 2000,9,PERIODONTAL RECORD KEEPING,10,PERIODONTAL RECORD KEEPING,11,PERIODONTAL RECORD KEEPING,12,PERIODONTAL RECORD KEEPING,Evaluation of a complete series of diagnostic quality periapical and bite wing radiographs is necessary for diagnosis and treatment planning.,JADA article April 2000,13,PERIODONTAL RECORD KEEPING,14,PERIODONTAL RECORD KEEPING,Full Mouth Intraoral Radiographic Examination,(FMX),A set of intraoral radiographs consisting of 14 to 22 periapial and posterior bite wing films intended to display the crown and roots of all teeth,periapical,areas and alveolar bone crest.,FDA Guidelines,15,PERIODONTAL RECORD KEEPING,Feb 2001 JADA:ADA Council on,Scientific Affairs,The FDA guidelines.are not meant to be considered as practice standards.,The guidelines,published in 1989,direct dentists to exercise professional judgement when prescribing diagnostic radiographs for dental patients.,16,PERIODONTAL RECORD KEEPING,Fall 1996 Journal of the MA Dental Society,OHI should be provided at each appointment during initial therapy.The patients progress should be evaluated,and the plaque control program should be modified to fit the needs of individual patients.,A reevaluation interval is necessary to allow time for the tissues to heal and respond to initial therapy.Usually 4 to 6 weeks.,17,PERIODONTAL RECORD KEEPING,Fall 1996 Journal of the MA Dental Society,(Continued),Clinical examination at reevaluation appointments should be similar to that of the initial examination.,18,PERIODONTALRECORD KEEPING,American Academy of Periodontics,Classifications:,CPT 1Gingivitis,2Slight Periodontitis,3Medium Periodontitis,4Advanced Periodontitis,OR,Slight-Moderate-Severe(Advanced),19,PERIODONTAL RECORD KEEPING,PSR,Periodontal Screening and Recording,1.Good System if used appropriately and,according to the guidelines.,2.Dentists can not redefine the parameters.,3.Recommended by the ADA and American,Academy of,Periodontology,.,20,PERIODONTAL RECORD KEEPING,PSR,Code*-Denotes clinical abnormalities including but not limited to:,a.,furcation,invasion,b.mobility,c.,mucogingival,problems,d.recession extending to the colored area of,the probe 3.5 mm or greater.),21,PERIODONTAL RECORD KEEPING,PSR,Code 0-Appropriate preventative care,Code 1-Oral hygiene instruction and,appropriate therapy,including,subgingival plaque removal.,22,PERIODONTAL RECORD KEEPING,PSR,Code 2-OHI and appropriate therapy,including,subgingival,plaque removal,plus removal of calculus and correction of plaque-retentive margins of restorations.,23,PERIODONTAL RECORD KEEPING,PSR,Code 3-A comprehensive periodontal examination and charting of the affected sextant is necessary to determine an appropriate treatment plan.This examination and documentation should include but not be limited to identification of probing depths,mobility,gingival recession,mucogingival problems,and,furcation,invasions as well as appropriate radiographs.,24,PERIODONTAL RECORD KEEPING,PSR,Code 3(continued),If two or more sextants score code 3,a comprehensive full mouth examination and charting is indicated.Should therapy be indicated and performed,a comprehensive examination is necessary to assess the results of therapy and need for further treatment.,25,PERIODONTAL RECORD KEEPING,PSR,Code 4-A comprehensive full mouth periodontal examination and charting is necessary to determine an appropriate treatment plan.This examination and documentation should include but not be limited to identification of probing depths,mobility,gingival recession,mucogingival,problems,and,furcation,invasions as well as appropriate radiographs.,26,PERIODONTAL RECORD KEEPING,PSR,Code*-If an abnormality exists in the presence of codes 0,1,and 2,specific notation and/or treatment for that condition is warranted.If an abnormality exists in the presence of code 3 or 4,a comprehensive periodontal examination and charting is necessary to determine an appropriate treatment plan.,27,PERIODONTALRECORD KEEPING,Chart/define Recommendations to Patients,What Did You Discuss with the Patient,On Follow-up Visit,Did They Comply?,Frequency of Recall Visits(4 months-6 Months),Reevaluate Phase I Treatment,Patient Should be Recharted,28,PERIODONTAL RECORD KEEPING,WHEN TO REFER,General Dentists should refer patients who are on 2,3,or 4 month periodontal recalls who continue to show signs of periodontitis with deep pocketing,bleeding or probing,purulence,or any signs of disease progression for specialty periodontal therapy.,JADA article April 2000,29,PERIODONTAL RECORD KEEPING,CONCLUSION,If it is not in the chart,it didnt happen!,30,