Reevaluation of initial therapy: when is the appropriate time?
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.
Segelnick
Stuart L
SL
Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY, USA. eperiodr@aol.com
Weinberg
Mea A
MA
D003773:Dental Plaque / Q000382:microbiology; D012534:Dental Scaling; D004846:Epithelial Attachment / Q000473:pathology; D005881:Gingiva / Q000473:pathology; D006801:Humans; D017063:Outcome Assessment, Health Care; D010510:Periodontal Diseases / Q000175:diagnosis* / Q000628:therapy*; D010512:Periodontal Index; D012008:Recurrence; D013997:Time Factors; D014086:Tooth Mobility / Q000175:diagnosis