References

Caton JG, Armitage G, Berglundh T A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol. 2018; 45:S1-S8 https://doi.org/10.1111/jcpe.12935
Sanz M, Herrera D, Kebschull M Treatment of stage I-III periodontitis – the EFP S3 level clinical practice guideline. J Clin Periodontol. 2020; 47:4-60 https://doi.org/10.1111/jcpe.13290
West N, Chapple I, Claydon N BSP implementation of European S3-level evidence-based treatment guidelines for stage I–III periodontitis in UK clinical practice. J Dent. 2021; 106 https://doi.org/10.1016/j.jdent.2020.103562
Dietrich T, Ower P, Tank M Periodontal diagnosis in the context of the 2017 classification system of periodontal diseases and conditions – implementation in clinical practice. Br Dent J. 2019; 226:16-22 https://doi.org/10.1038/sj.bdj.2019.3
Herrera D, Sanz M, Kebschull M Treatment of stage IV periodontitis: The EFP S3 level clinical practice guideline. J Clin Periodontol. 2022; 49:4-71 https://doi.org/10.1111/jcpe.13639
Montero E, Molina A, Palombo D Efficacy and risks of tooth-supported prostheses in the treatment of partially edentulous patients with stage IV periodontitis. A systematic review and meta-analysis. J Clin Periodontol. 2022; 49:182-207 https://doi.org/10.1111/jcpe.13482
Gotfredsen K, Rimborg S, Stavropoulos A Efficacy and risks of removable partial prosthesis in periodontitis patients: a systematic review. J Clin Periodontol. 2022; 49:167-181 https://doi.org/10.1111/jcpe.13519
Käyser AF Shortened dental arches and oral function. J Oral Rehabil. 1981; 8:457-462 https://doi.org/10.1111/j.1365-2842.1981.tb00519.x
Gotfredsen K, Rimborg S, Stavropoulos A Efficacy and risks of removable partial prosthesis in periodontitis patients: a systematic review. J Clin Periodontol. 2022; 49:167-181 https://doi.org/10.1111/jcpe.13519
Kanno T, Carlsson GE A review of the shortened dental arch concept focusing on the work by the Käyser/Nijmegen group. J Oral Rehabil. 2006; 33:850-862 https://doi.org/10.1111/j.1365-2842.2006.01625.x
Tomasi C, Albouy JP, Schaller D Efficacy of rehabilitation of stage IV periodontitis patients with full-arch fixed prostheses: tooth-supported versus implant-supported – a systematic review. J Clin Periodontol. 2022; 49:248-271 https://doi.org/10.1111/jcpe.13511
Donos N, André Mezzomo L, Mardas N Efficacy of tooth-supported compared to implant-supported full-arch removable prostheses in patients with terminal dentition. A systematic review. J Clin Periodontol. 2022; 49:224-247 https://doi.org/10.1111/jcpe.13477
British Society of Periodontology. 2011. http//www.bsperio.org.uk/assets/downloads/Parameters_of_Care.pdf (accessed April 2024)

Prosthodontic rehabilitation of patients with stage IV periodontitis

From Volume 51, Issue 5, May 2024 | Pages 369-374

Authors

Mitul Shah

BDS, MFDS RCS Ed, MClinDent Periodontology (hons), MPerio RCS Ed

Specialist in Periodontics, Private practice, Chelsea Dental Clinic, London

Articles by Mitul Shah

Email Mitul Shah

Rajan Nansi

BDS Hons, MFDS RCS (Eng), MJDF RCS (Eng), MClinDent (Perio), MPerio RCS (Ed), FCGDent

Specialist in Periodontics, Private Practice (East Midlands); Past President (2022), British Society of Periodontology and Implant Dentistry

Articles by Rajan Nansi

Abstract

Stage IV Periodontitis is characterized by complex symptoms, including the loss of teeth, occlusal instability/collapse, ridge defects and increased tooth mobility. The management of such issues requires interdisciplinary collaboration to optimise outcomes. This article outlines the key guidelines from the recent EFP clinical practice guidelines on the efficacy of prosthodontic rehabilitation (fixed/removable) in the management of these complex patients.

CPD/Clinical Relevance: An understanding of the clinical decision making when considering tooth replacement options in stage IV periodontitis patients is important.

Article

Periodontitis is the sixth most prevalent disease in the world, affecting an estimated 1.1 billion adults globally. It is characterized by bleeding, pocketing, clinical attachment loss, radiographic signs of alveolar bone loss. The diagnosis of periodontitis has been outlined by the EFP (European Federation of Periodontology)/AAP (American Academy of Periodontology),1 alongside clinical practice guidelines,2 which have outlined evidence-based treatment strategies. These guidelines have been adapted by the British Society of Periodontology and Implant Dentistry (BSP).3

Stage IV Periodontitis describes the most severe form of the disease. The BSP implementation of the supranational EFP guidelines4 defines stage IV disease as cases where there is observable interproximal bone loss extending to the apical third of the root following the assessment of appropriate peri-apical/panoramic radiographs. This provides a concise and straightforward means of diagnosing patients within the framework of UK dentistry.

Register now to continue reading

Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Up to 2 free articles per month
  • New content available