PROSTHODONTICS - American College of Prosthodontists

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14 Parameters of Care Tupac et al2. Class II – characterized by moderately compromised tooth condition and occlusal scheme. This classdisplays noted continuation of the physical degradation of one or both of the criteria.3. Class III – characterized by substantially compromised tooth condition requiring the reestablishmentof the occlusal scheme without a change in the occlusal vertical dimension, with or without substantiallocalized adjunctive therapy.4. Class IV – characterized by severely compromised tooth condition requiring the reestablishmentof the occlusal scheme with a change in the occlusal vertical dimension, with or without extensiveadjunctive therapy.This diagnostic system will help identify those conditions that require clinical techniques associatedwith advanced prosthodontic training. These diagnostic categories will help standardize treatmentregimens and will help provide outcome data for diagnosis/treatment combinations.Terminal dentition describes a condition in which there are insufficient teeth to maintain functionand the arch, as a whole, will transition to the edentulous state. The etiology might be periodontaldisease, caries, trauma, insufficient teeth to maintain function, prosthodontic discomfort, and/or patientdesires. Transition to total edentulism should only be considered when the patient is fully informed ofall variables (e.g., prognosis of teeth, chance of success measured against longevity of treatment) andconsequences that affect the value of treatment. Patient desires and expectations must be considered inconjunction with the professional knowledge and judgment of the prosthodontist.It must be noted that in the treatment of the completely dentate patient, patient attitude, cooperation,and compliance are of great importance in long-term success. Successful treatment for the completelydentate patient is a mutual effort between the prosthodontist and the patient. A refractory patient is onewho presents with chronic complaints following appropriate therapy. In those instances where patientexpectations exceed physical limitations, a mutually satisfactory result may not be possible through thecompletion of their treatment plan.General Criteria and StandardsInformed Consent: All prosthodontic procedures should be preceded by the patient’s consent. Informedconsent is obtained after the patient has been informed of the indications for the procedure(s), goalsof treatment, the known benefits and risks of the procedure(s), the factor(s) that may affect the knownrisks and complications, the treatment options, the need for active maintenance by the patient, the needfor future replacements and revisions, and the favorable outcome.Documentation: Parameters of care for prosthodontic procedures include documentation of objectivefindings, diagnosis, and patient management intervention.Coding and NomenclatureDiagnostic and procedural codes have been included in the ACP Parameters of Care only for generalguidance. The codes listed may not be all-inclusive or represent the most current or specific choices. Theinclusion of codes is not meant to supplant the use of current coding books or to relieve practitionersof their obligation to remain current in diagnostic and procedural coding. The ACP Committee onParameters of Care and Committee on Nomenclature do not endorse the use of this document as acoding manual.The diagnostic and procedural codes listed throughout this section may not be all-inclusive and shouldserve only as practice guidelines. ICD-9-CM (International Classification of Diseases, Ninth Revision, ClinicalModification) diagnostic codes may change yearly and must be reviewed and updated annually to ensureaccuracy. Specific diagnoses must be obtained from a current, recognized ICD-9-CM code source andsubstantiated by documentation in the dental record. Procedural codes listed throughout this sectionserve as a guide, which may be applicable to the treatment performed or management modality chosen.These may not be the most recent, applicable, or acceptable codes. Some dental/medical insurance2010 CDEL Re-recognition of the Specialty Report 54 of 279
December 2005, Supplement, Volume 14, Number 4 15providers have billing conventions unique to their organizations. It is the provider’s responsibility to beaware of these unique situations.Current Procedural Terminology (CPT), the recognized codes for dental/medical billing, are revisedyearly and must be reviewed and updated annually to ensure accuracy. The recent codes are acceptedby dental/medical insurance providers and should be obtained from the current year’s version of theAmerican Medical Association (AMA) CPT Manual. Current Procedural Technology C○ 2005 American MedicalAssociation. All rights reserved.Current Dental Terminology (CDT) codes, the recognized codes for dental/medical billing, are revisedevery 3 years (previously every 5 years) and should be reviewed and updated whenever the most recentversion of the American Dental Association (ADA) CDT manual is published. Current Dental TerminologyC○ 2002, 2004 American Dental Association. All rights reserved.Parameter Guidelines: Partial EdentulismICD-9-CM306.8 Other specified psychophysiological malfunction: Bruxism, Teeth grinding521 Diseases of hard tissues of teeth522 Diseases of pulp and periapical tissues523 Gingival and periodontal diseases524 Dentofacial anomalies, including malocclusion525 Other diseases and conditions of the teeth and supporting structuresA. Indications for care1. Caries [521.0-521.09 ICD-9-CM]2. Attrition [521.10-521.15 ICD-9-CM]3. Erosion [521.30-521.35 ICD-9-CM]4. Abrasion [521.20-521.25 ICD-9-CM]5. Abfraction6. Fractures/microfractures/cracks [873.6-873.7 ICD-9-CM]7. Endodontic therapy8. Intra-arch and interarch integrity [524.0-524.2 ICD-9-CM]9. Tooth mobility10. Diastemas11. Tooth malposition12. Loss of occlusal vertical dimension [524.2 ICD-9-CM]13. Esthetics14. Pathogenic occlusion [524.4 ICD-9-CM]15. Failed existing restorations16. Correction of congenital abnormalities17. Lack of mastication18. Impaired speech19. Impaired swallowing20. Lack of TM joint and orofacial muscle support21. Psychosocial factors22. Airway restriction23. Lack of intra- and interarch integrity and stability24. Patient concernsB. Therapeutic goals1. Improved mastication2. Improved speech3. Improved esthetics4. Improved swallowing2010 CDEL Re-recognition of the Specialty Report 55 of 279
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COUNCIL ON DENTAL EDUCATION AND LIC
Page 4 and 5: A. General InformationThe American
Page 7 and 8: The American College of Prosthodont
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Figure 14. Class Ipatient. (A) Pano
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Figure 16. Class KU patient. (A) Pa
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38 Clm$cation of Cumllete EdClass 1
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Figure 4. Class IV palienl. Edenlul
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THEPROCESSOFONCOGENESISIntroduction
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Figure18Finally,thefloorofthemouthn
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MANAGEMENTOFSUSPICIOUSORALLESIONSIn
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CPE Course History From 2000-2010Da
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Accreditation Standards forAdvanced
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Document Revision History (continue
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Mission Statement of theCommission
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PrefaceMaintaining and improving th
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Definitions of Terms Used in Prosth
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Educationally Qualified: An individ
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Intent: Major changes have a direct
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STANDARD 2 - PROGRAM DIRECTOR AND T
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STANDARD 4 - CURRICULUM AND PROGRAM
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Intent: Students will have in depth
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4-18 Students/Residents must be exp
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STANDARD 6 - RESEARCHAdvanced speci
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