经过全面的患者检查,包括评估牙周和种植体周围疾病以及考虑患者的需求,给出了每颗牙齿和种植体的治疗前预后。具有安全的治疗前预后的牙齿和植入物需要简单的程序,并且可以被视为功能的安全基台,并且具有可疑的治疗前预后通常需要综合治疗。这些牙齿和植入物必须通过额外的治疗,如牙髓,恢复性,和外科手术。治疗前预后无望的牙齿和植入物应在病因相关治疗的初始阶段进行提取/移植(即,感染控制)。例如,垂直牙根断裂或无法修复的龋齿和具有活动性或无法修复的错位的植入物属于绝望单位。牙周和种植体周围治疗的主要目标应该是阻止疾病进展。最新的共识声明强调,牙周炎可以成功控制,治疗后的牙齿可以终身保留。然而,对于具有不受控制的影响因素的患者,端点可能并不总是可以实现的,和低疾病活动可能是一个可接受的治疗目标。同样,由于治疗结局不完全,种植体周围炎的治疗通常需要在非手术治疗后进行手术干预.不同的手术方式可以是有效的,并导致显着改善;然而,实现种植体周围炎的完全解决是具有挑战性的,并不总是可预测的,并且可以取决于多个基线因素。因此,这项审查旨在总结有关纳入系统的理由的现有证据,与生活方式有关,临床,和影像学预后因素纳入诊断为牙周和种植体周围疾病的患者的治疗计划。
Following a comprehensive patient examination, including the assessment of periodontal and peri-implant diseases as well as considering the patient\'s needs, a pretherapeutic prognosis for each tooth and implant is given. Teeth and implants with a secure pretherapeutic prognosis require simple procedures and may be regarded as secure abutments for function and with a doubtful pretherapeutic prognosis usually need a comprehensive therapy. Such teeth and implants must be brought into the category with a secure prognosis by means of additional therapy such as endodontic, restorative, and surgical procedures. Teeth and implants with a hopeless pretherapeutic prognosis should be extracted/explanted during the initial phase of cause-related therapy (i.e., infection control). For example, teeth with vertical root fracture or unrestorable caries and implants with mobility or unrestorable malposition fall into the category of hopeless units. The primary goal of periodontal and peri-implant therapy should be to arrest disease progression. The latest consensus statement highlights that periodontitis can be successfully controlled and treated teeth can be retained for life. Nevertheless, for patients with uncontrolled contributing factors, the endpoints might not always be achievable, and low disease activity may be an acceptable therapeutic goal. Similarly, the management of peri-implantitis frequently requires surgical intervention following nonsurgical therapy due to incomplete treatment outcomes. Different surgical modalities can be effective and lead to significant improvement; however, achieving complete resolution of peri-implantitis is challenging, not always predictable, and can depend on multiple baseline factors. Therefore, this review aims at summarising available evidence on the rationale for incorporating systemic, lifestyle-related, clinical, and radiographic prognostic factors into treatment planning of patients diagnosed with periodontal and peri-implant diseases.