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Maintenance Phase (Supportive Periodontal Treatment) Maintenance therapy after active treatment includes not only the care that patients receive through personal oral hygiene but also by the recall visits and re-evaluations done by the dental team.

RATIONALE FOR SUPPORTIVE PERIODONTAL THERAPY

Rationale for maintenance phase is to prevent or minimize the recurrence of periodontal diseases by controlling factors known to contribute to the disease process The main aim of long-term therapy is to provide supervised control for the patient in order to maintain a healthy and functional, natural dentition for life. It is only with proper maintenance, including early detection and treatment of recurrent periodontal diseases that such an objective can be achieved.

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CAUSES FOR RECURRENCE OF PERIODONTAL DISEASE

1. Incomplete subgingival plaque removal. 2. Nature of dentogingival unit. 3. Improper restorations placed after the periodontal treatment was completed. 4. Failure of the patient to return for periodic recall visits. 5. Presence of some systemic diseases that may affect host resistance to previously acceptable levels of plaque.

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GOALS OF SUPPORTIVE PERIODONTAL TREATMENT

1. To prevent or minimize the recurrence and progression of periodontal disease in patients who have been previously treated for gingivitis, periodontitis and for peri-implantitis. 2. To prevent or reduce the incidence of tooth loss by monitoring the dentition and by any prosthetic replacement of the natural teeth. 3. To increase the probability and treating in a timely manner, other diseases or conditions found in the oral cavity.

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OBJECTIVES OF MAINTENANCE PHASE

1. Preservation of alveolar bone support (radiographically). 2. Maintenance of stable, clinical attachment level. 3. Reinforcement and re-evaluation of proper home care. 4. Maintenance of a healthy and functional oral environment.

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PARTS OF MAINTENANCE PHAS Part–I: Examination Part–II: Treatment Part–III: Schedule Next Procedure

SEQUENCE OF MAINTENANCE VISITS

CE PHASE

SEQUENCE OF MAINTENANCE VISITS

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PROCEDURES TO BE PERFORMED AT RECALL

PROCEDURES TO BE PERFORMED AT RECALL

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DETERMINATION OF MAINTENANCE RECALL INTERVALS Patient be seen initially for recall treatment 2 to 4 weeks following treatment (for transitional procedures). After 3 or 4 such sessions the interval can be extended to 3 months, but may be varied according to the patient’s needs. Following FACTORS may be considered in determining the recall intervals: 1. Severity of disease:

The more severe the disease, the more frequently the patient is recalled. 2. Effectiveness of home care:

Good home care decreases the frequency of recall. 3. Degree of control of inflammation achieved:

As the tissue regain the total health, the frequency decreases.