INFORMATIVE ARTICLES
Translating Clinical Outcomes to Patient Value: An Evidence-Based Treatment Approach
By Robert S. Levine, DDS
Richard A. Shanaman, D.D.S
(International Journal of Periodontics & Restorative Dentistry, Vol 15, No. 2, 1995)
In this review, the clinical outcomes and success criteria for regenerative periodontal therapies have been divided into six broad categories (Chart 1). In addition to the clinical objectives set out by Task Forces 1 to 3, this task force identified five outcomes that are treatment objectives of both patients and clinicians.
1. Ease of care is defined as personal and professional plaque control and periodontal maintenance. Criteria of success for this outcome include ease of maintenance, absence of inflammation (no bleeding on probing), shallow proving depths, absence of subjective symptoms, and overall plaque control. The consensus of the group was that the ease of personal plaque control at home and professional prophylaxis should be clearly improved by the procedure for it to satisfy these criteria. Therefore, the achievement of effective plaque control should not be hindered or made more difficult for the patient. The provision of supportive periodontal therapy (SPT) should also be simplified technically.
2. Esthetics was defined by objective as well as subjective methods. Positive patient feedback is an important criterion of success for esthetics, comfort, and health, Esthetics, a desired outcome with teeth and implants, is based on success criteria such as recession (facially), gingival color, and interproxinal spacing (avoiding creation of the "black triangle"). Success criteria associated specifically with implants include the achievement of an acceptable emergence profile and alveolar ridge contours.
3. Comfort, as an outcome, was determined to be successfully achieved if positive patient feedback and decreased tenderness, mobility, and sensitivity could be established posttreatment.
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