Prognosis is an integral part of the periodontal practice because it directly influences treatment planning. However, there is limited direct evidence in the literature regarding the assignment of periodontal prognosis. There are several important concepts to consider in developing a system of periodontal prognosis. Traditional systems are based on tooth loss and may have limited use for patient management. On the other hand, prognosis can be based on stability of the periodontal supporting apparatus, which is influenced by more evidence-based factors and may be more useful for patient management. Other important concepts include the timing of the projection (short and long term) and the consideration of individual teeth versus the overall dentition. Historically, several authors have formulated and investigated their own prognostication systems. Results were variable, but they generally showed that systems based on tooth loss were unpredictable over the long term. Therefore, the purpose of this report is to review relevant literature and propose a new periodontal prognostication system.

Dentists need to make daily decisions regarding patient care, and these decisions should essentially be scientifically sound. Evidence-based dentistry is meant to empower clinicians to provide the most contemporary treatment. The benefits of applying the evidence-based method in clinical practice include application of the most updated treatment and stronger reasoning to justify the treatment. A vast amount of information is readily accessible with today's digital technology, and a standardized search protocol can be developed to ensure that a literature search is valid, specific and repeatable. It involves developing a preset question (population, intervention, comparison and outcome; PICO) and search protocol. It is usually used academically to perform commissioned reviews, but it can also be applied to answer simple clinical queries. The scientific evidence thus obtained can then be considered along with patient preferences and values, clinical patient circumstances and the practitioner's experience and judgment in order to make the treatment decision. This paper describes how clinicians can incorporate evidence-based methods into patient care and presents a clinical example to illustrate the process.

In this commentary, a practical system for estimating the prognosis for dental implants is presented. Evidence for factors influencing implant prognosis is reviewed. The system is based on the stability of implant supporting tissues as opposed to implant loss.