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A Journal on Forensic Medicine
Minerva Medicolegale 2001 December;121(4): 267-75
Over-treatment in periodontal disease
Arbarello P., Cameriere R., Frati P., Froldi R., Premate A.
The aim of the study was to highlight the growing risk of over-treatment in periodontal disease, namely the use of treatments that were not foreseen to start with and are not strictly necessary. This leads to increased costs but does not correspond to any effective clinical benefit. The cases examinated highlight these drawbacks. In the first case, a 45-year- old male patinet was diagnosed with mobility in all his teeth, swollen and bleeding gums and very bad oral hygiene. Attention was focused on explaining the important of collaboration and the possible uselessness of intervention without active participation. Having commenced initial periodontal treatment, neither the results nor the patient's attitude lived up to expectations. Having again discussed the new situation with the patient, the latter confirmed his intention to collaborate, re-evaluating the value of recommencing periodontal treatment which led to mobile prostheses and involved extra and pointless costs for the patient. The second case involves a 50-year-old female patient who requested an assessment of recent periodontal treatment owing to acute periodontitis. The treatment had involved considerable financial and physical costs, given that a series of operations had been performed. Our assessment highlighted that the majority of the work was not necessary and would not have any useful long-term results. An analysis of these cases underlines the importance of obtaining valid consent after adequate information has been provided.