Scribd
Upload
80 views7 pages

Treatment Planning: 6. Maintenance Phase

There are three types of orthodontic retention devices: positioners, removable appliances, and fixed appliances. Endodontically treated teeth should be re-evaluated at 6 months, 12 months, and 24 months to check for tenderness, probing depths, and radiographic changes. Periodontal maintenance visits should occur every 3, 4, or 6 months depending on disease severity and susceptibility. Caries recall should include patient education, fluoride varnish, and radiographs every 6-18 months depending on caries risk. Removable prosthodontics need annual evaluation and potential relining to address bone resorption from loose fitting dentures.

Uploaded by

Sheila Judd
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
80 views7 pages

Treatment Planning: 6. Maintenance Phase

There are three types of orthodontic retention devices: positioners, removable appliances, and fixed appliances. Endodontically treated teeth should be re-evaluated at 6 months, 12 months, and 24 months to check for tenderness, probing depths, and radiographic changes. Periodontal maintenance visits should occur every 3, 4, or 6 months depending on disease severity and susceptibility. Caries recall should include patient education, fluoride varnish, and radiographs every 6-18 months depending on caries risk. Removable prosthodontics need annual evaluation and potential relining to address bone resorption from loose fitting dentures.

Uploaded by

Sheila Judd
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 7

Treatment 6.

MAINTENANCE
PHASE
Planning

JK Mitchell, DDS, MEd


Maintenance Phase

ORTHODONTICS
ENDODONTICS
PERIODONTICS
CARIES
R E M O VA B L E P R O S T H O D O N T I C S

JK Mitchell, DDS
Orthodontic Retention
Mainten
ance

23

There are three basic types of


orthodontic retention devices:
1. Positioner- Not only a retainer, this Positioner
type can be used for final
adjustments as the teeth fit
completely into appliance. Especially
important that patient wear it right
after active appliances removed to
hold teeth while bone and PDL final
remodeling takes place Removable
2. Removable- all elements are passive
(no springs, etc) so it just holds the
teeth in place.
3. Fixed- Usually placed only on the
lower anterior teeth for long term
retention. Frequently worn until
final growth and development Fixed appliance
occurs in early 20’s.

JK Mitchell, DDS
Endodontic Evaluation
Mainten
ance

25

 Generally, re-eval an
endodontically treated tooth at
6 months, 12 months, and 24
months.
 How? The usual way:
 Percussion- should not be tender
 Palpation- should not be tender
 Probing- should not have probing
depths out of “normal” for this
patient
 Radiographs- tricky. You’d like
the see any lesion getting smaller
and less radiolucent. But in the
absence of other symptoms, it’s
not a big concern.

JK Mitchell, DDS
Periodontal Maintenance
Mainten
ance

26

 This is a complex topic, but to


keep it simple, here are the
basics:
 If you have ever treated the
patient for periodontal
disease, they are always
scheduled for a periodontal
maintenance (D4910) visit,
not a prophy (D1110).
 Based on the severity and
susceptibility of the patient,
schedule the patient for recall
every 3, 4, or 6 months.

JK Mitchell, DDS
Caries
Mainten
ance

27

Caries recall for three reasons:


1. Reinforce pt education on diet,
home care (use of F) and xylitol.
2. Office F- best is varnish
3. Evaluate for new lesions with exam
and radiographs.

Interval can be different for


different reasons:
1. Radiographs- every 6, 12 (high
risk) or 18 months (mod risk)
depending on risk level
2. F varnish and exam- every 3
months (high risk) 6 months (mod
risk).

JK Mitchell, DDS
Removable Prosthodontics
Mainten
ance

28

 This is a complex topic, but


here’s the short version: once
the teeth are gone, the bone
starts to resorb, and dentures
accelerate this process
somewhat.
 As the bone resorbs, the
denture no longer fits, so it is
even looser and even more
damaging to the bone.
 Fairly regularly (at annual exam),
these need to be evaluated for This is a fairly severe case of bone resorption on the
mandibular lower and maxillary upper. Why? The
fit, and if they are loose, be remaining lower natural teeth push up against the front
relined (have more acrylic of the maxillary denture, causing resorption there. And
processed onto the tissue side of the lower partial denture pivots downward, causing
the denture). resorption there. This patient had not had these
evaluated for over 20 years…she figured since the teeth
were gone, she had no more worries!

JK Mitchell, DDS

You might also like