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
|
plaque
|
calculus and/or overhang
|
inflammation
|
pocket depth
|
Class
|
|
no
|
no
|
no
|
not applicable
|
0
|
|
yes
|
no
|
yes
|
<= 5 mm
|
A
|
|
yes
|
yes
|
yes
|
<= 5 mm
|
B
|
|
yes
|
yes
|
yes
|
> 5 mm
|
C
|
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.
(1) Normally the mouth is divided into 4 quadrants (left maxillary, right maxillary, left mandibular, right mandibular).
(2) If less than 8 teeth are present on the maxilla or mandible, then this is taken as one quadrant.
(3) If 4 teeth or less are in the mouth as a whole, then the mouth is considered to have one quadrant.
Probing:
(1) Each tooth is probed on all surfaces.
(2) If a pocket deeper than 5 mm is found, then the whole quadrant is scored as C.
(3) 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
|
Class
|
Treatment
|
Time to Complete
|
|
0
|
no treatment needed
|
0
|
|
A
|
oral hygiene instructions
|
60 minutes
|
|
B
|
scaling and removal of calculus and overhangs
|
30 minutes per quadrant for scaling
|
|
C
|
surgery
|
60 minutes per quadrant for surgery
|
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.
