The current status of determining periodontal prognosis

Determining the prognosis for patients and individual sites with inflammatory periodontal diseases is difficult using present methods. Traditional approaches for predicting when disease activity will occur have proved inadequate in some cases. New diagnostic tests and updated methods of traditional tests will eventually allow clinicians to improve their skills in determining prognosis; however, most of these tests are not yet proved or economically feasible. At present, if a patient is currently healthy and has no past history of attachment loss, their prognosis is favorable. The probability of periodontal breakdown occurring in these patients before the next regularly scheduled maintenance visit is slim. A history of attachment loss is the best predictor of future loss, but determining when more loss will occur is problematic. Clinical signs of inflammation, especially bleeding on probing and the presence of suppuration, also appear to predict breakdown, but to a lesser degree than previous attachment loss. It appears that the future holds much promise for improving our ability to make accurate prognoses, especially in cases of aggressive periodontal problems, but until these advances are well tested, traditional methods continue to be the standard.