Reevaluation of Initial Therapy: When Is the Appropriate Time?

Abstract

The concept of periodontal reevaluation of initial therapy needs to be revisited. From interviewing selective periodontists and reviewing the literature, it is apparent that the time period to perform a reevaluation is an ambiguous topic. This seems to be a dichotomy because today everything in dental medicine and medicine is evidence based. When reviewing selective literature sources, it was found that either a time period for reevaluation was given that was different in almost every publication, or a time period was not given but the subject of reevaluation was addressed. The objective of this commentary is to define reevaluation and to determine the best time interval after initial therapy to perform a reevaluation based on classic and current literature. Some questions that need to be addressed are the following: 1) Does too short of a time frame for reevaluation lead to the overtreatment of patients? 2) Is there a danger in reevaluating over too long of a time frame that will lead to disease progression and the return of pathogenic microbial flora? This would mean unnecessary periodontal breakdown could be occurring without appropriate further treatment. Many concerns need to be addressed, including when the appropriate time period is to measure the effects of initial therapy. After this time period, the stability of the periodontium should be evaluated rather than the effects of therapy.

Periodontal Treatment Downregulates Protease-Activated Receptor 2 in Human Gingival Crevicular Fluid Cells

“…The posttreatment phase lasted for 6 weeks (15). Within this period, patients received weekly professional plaque control (reinforcement of oral hygiene instructions, supragingival scaling, and prophylaxis) until the reassessment.…”

Relationship Between Initial Probing Depth and Residual Pockets Following Mechanical Periodontal Treatment

“…Ancak ilerlemiş KP olgularında artmış cep derinliğine bağlı olarak yıkı-mın şiddetlenmesi, derin ceplerde kolonize olan patojen mikroorganizmalara ulaşılamaması, bu mikroorganizmaların dişeti bağ dokusuna invaze olması ve konak savunma cevabının da hastalık patogenezinde dolaylı rol oynaması sonucunda MPT'nin etkinliği sınırlı kalabilmektedir (23,26,27). Bu sebeple MPT sonrası periodontal dokuların iyileşmesinin değerlendirilmesi ileri periodontal tedavinin planlanmasında önem taşır (10). MPT sonrası dokuların iyileşmesi ve bu iyileşmenin takibi için gerekli olan süre, hastanın tekrarlayan gereksiz tedaviye maruz kalmasına sebep olacak kadar kısa olmaması gerektiği gibi, periodontal mikrofloranın patojenik özellik kazanmasına izin verecek kadar da uzun olmamalıdır (10).…”

The Effect of Scaling and Root Planing on Glycaemic Control, Periodontal Status and Gingival Crevicular f luid TN f - α Levels in an Indian Population- To Reveal the Ambivalent Link

“…Based on the rate of healing, it has been cited that three months post treatment is a suitable interval for the primary evaluation of initial non-surgical therapy, even in areas with preliminary deep lesions [27]. Also, to estimate the glycaemic control, HbA1c was used in this study.…”