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Overview :
The Periodontal Treatment Need System (PTNS) can be used to
determine the periodontal therapeutic needs in a population. It can be used to
estimate the manpower and costs needed to address the problems found on
examination.
Classification
Criteria
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plaque
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calculus and/or overhang
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inflammation
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pocket depth
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Class
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no
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no
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no
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not applicable
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0
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yes
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no
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yes
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<= 5 mm
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A
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yes
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yes
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yes
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<= 5 mm
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B
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yes
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yes
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yes
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> 5 mm
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C
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Patient Assessment
Classes 0 and A are assigned based on assessment of the entire
mouth.
Classes B and C are assigned based on oral quadrants.
• Normally the
mouth is divided into 4 quadrants (left maxillary, right maxillary, left
mandibular, right mandibular).
• If less than
8 teeth are present on the maxilla or mandible, then this is taken as one
quadrant.
• If 4 teeth or
less are in the mouth as a whole, then the mouth is considered to have one
quadrant.
Probing:
• Each tooth is
probed on all surfaces.
• If a pocket
deeper than 5 mm is found, then the whole quadrant is scored as C.
• A pocket
deeper than 5 mm mesially to the central incisors is not scored as C, if it is
the only C pocket in that quadrant, AND if the other quadrant on the same jaw
has been scored as C.
Treatment Plan
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Class
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Treatment
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Time to Complete
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0
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no treatment needed
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0
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A
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oral hygiene instructions
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60 minutes
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B
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scaling and removal of calculus and overhangs
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30 minutes per
quadrant for scaling
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C
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surgery
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60 minutes per
quadrant for surgery
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A patient with Class B disease also requires Class A
management.
A patient with Class C disease also requires Class A and
Class B management.
The maximum
time estimates for a person with all teeth present and severe periodontal
disease involving all quadrants would be 7 hours (1 hour for each quadrant for
surgery, 30 minutes for each quadrant for cleaning, and 1 hour for training, or
4 + 2 + 1).
Limitations:
• The time
estimates seem overly generous except for the surgery on severely affected
areas.
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