Master of Science (M.S.) in Dentistry
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College of Dental Medicine
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Nova Southeastern University
WIlliam P. Brown. 2018. Examining Practitioner Standards Regarding Periodontal Clearance for the Orthodontic Patient. Master's thesis. Nova Southeastern University. Retrieved from NSUWorks, College of Dental Medicine. (77)
Introduction: Orthodontic tooth movement relies largely on the physiology of the periodontium, which is comprised of various types of bone and soft tissues that surround and support the teeth. New orthodontic treatment modalities have emerged offering various combinations of improved esthetics and/or speed. However, the impact on standard and quality of care of these alternative treatment modalities is unclear. Institutional concern for the effects of orthodontics on a periodontally-compromised patient remains high, as evidenced by governing dental bodies mandating, and contemporary orthodontic leaders insisting, orthodontic treatment should not be carried out until active dental disease has been addressed. Therefore, this study aimed to determine if there existed an established, succinct, evidence-based criteria used by periodontists to clear a patient for orthodontic tooth movement. Methods: A survey instrument was developed and used to obtain cross-sectional data from a representative sample of U.S. periodontists that included: demographic questions, topic-related questions and case-based questions. Simple descriptive analyses, bivariate and multivariate analyses and well as qualitative analyses were used to evaluate the specific aims. Results: The average age of participants was 49.6 years old, with an average of 18 years in practice. There was an association with age and a lack of specialized clearance criteria for prospective orthodontic patients (p= 0.038). Probing depths, attachment loss and mobility were the three clinical factors considered most important in the clearance process. Increased bone loss, increased probing depths and root resorption were the three factors considered most important for cessation of orthodontic treatment. Periodontists consistently recommended oral hygiene instruction and scaling and root planning, followed by re-evaluation for possible osseous surgeries. Conclusions: Participants were consistent in their evaluation and treatment recommendations regarding periodontal issues, however, were more divided when determining cessation of orthodontic treatment. Participants largely felt knowledgeable enough about interdisciplinary treatment to make and receive recommendations regarding treatment.
Dentistry, Education, Interdisciplinary, Orthodontics, Periodontics
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