Table of Contents

 

 

 

 

About the Authors

4

 

Preface to the 3rd Edition

5

Chapter 1

Introduction to Health and Disease, Evidence-Based Decision Making

 

 

Health and Disease

7

 

Disease Categories

7

 

Diagnosis and Classification

8

 

Evidence-Based Decision Making

10

 

Sources of Systematic Reviews

11

 

Equivalence Testing

11

 

Superiority Testing

11

Chapter 2

Anatomy, Histology, and Physiology of the Periodontium

 

 

Functions of the Periodontium

13

 

Surface Characteristics of the Periodontium

13

 

Cell Layers Comprising Oral Epithelium

14

 

Clinically-Healthy Gingiva

15

 

Supporting Structures Beneath the Gingiva

16

 

Attachment Apparatus

18

 

Blood Supply

18

 

Innervation

18

 

Biologic Width

19

 

Passive Eruption

19

 

Crevicular Fluid

19

Chapter 3

Etiology and Classification of the Periodontal Diseases

 

 

Concepts of Etiology

21

 

Biofilms

23

 

Putative Periodontal Pathogens

23

 

Features of Periodontal Pathogens

23

 

Dental Calculus

23

 

Pathogenic Potential of Calculus

24

 

Risk Factors - Local and Systemic

25

 

Classification of Periodontal Diseases and Conditions

28

 

Classification System

29

 

Distinguishing Characteristics - Gingivitis, Periodontitis, Other Periodontal Diseases and Conditions

35

Chapter 4

Clinical Assessment, Diagnosis, Treatment Planning, and Therapeutic Endpoints

 

 

Risk Assessment

39

 

Components of the Clinical Periodontal Examination

39

 

Instruments and Materials for Periodontal Assessment

43

 

Radiographic Examination

43

 

Periodontal Screening and Recording™ Examination

44

 

Adjunctive Diagnostic Techniques

44

 

Dentolegal Considerations

45

 

Periodontal Treatment Planning

45

 

Sample Periodontal Treatment Plans

47

 

Periodontal Prognosis

51

 

Therapeutic Endpoints

52

Chapter 5

Prevention of Disease and the Maintenance of Health

 

 

Personal Plaque Control

55

 

Toothbrushing Methods

55

 

Interproximal Cleaning

55

 

Antimicrobial Agents

57

 

Dentifrices

57

 

ADA Seal of Acceptance

58

 

Maintenance of Periodontal Therapy

58

 

Components of the Maintenance Visit

58

 

Compliance of the Periodontal Patient

59

 

Biologic Modulation to Control Recurrent Disease

59

 

Retreating and Referral

60

Chapter 6

Nonsurgical Therapy: Scaling and Root Planing, Occlusal and Antibiotic Therapy

 

 

Scaling and Root Planing

61

 

Occlusal Therapy

66

 

Force Control

69

 

Antibiotic Therapy

71

 

Suggested Systemic Antibiotic Regimens

73

 

Local Antibiotic Therapy

74

 

Periodontal Conditions Requiring Chemotherapeutic Treatment

74

Chapter 7

Surgical Treatment: Principles

 

 

Basic Principles

75

 

Categories of Surgery

75

 

When is Surgery Necessary?

75

 

Aseptic Technique

76

 

Flap Surgery

77

 

Types of Flaps

78

 

Anatomic Landmarks

80

 

Wound Closure

82

 

Wound Healing

83

Chapter 8

Surgical Treatment: Resective and Regenerative Procedures

 

 

Healing of Flaps by Repair, Reattachment, New Attachment, and New Attachment Apparatus

87

 

Long Junctional Epithelium

87

 

Gingivectomy

87

 

Electrosurgery

89

 

Apically-Positioned Flap

89

 

Positive and Negative Bony Architecture

90

 

Classification of Osseous Defects

91

 

Osseous Surgery

91

 

Crown Lengthening

95

 

Periodontal Regeneration

97

 

Materials for Regenerative Therapy

101

 

Techniques Used in Regenerative Therapy

102

Chapter 9

Surgical Treatment: Periodontal Plastic Surgery

 

 

Periodontal Plastic Surgery Procedures

105

 

Aesthetic Evaluation

105

 

Gingival Recession

106

 

Alveolar Ridge Defects

107

 

Excessive Gingival Display

108

 

Procedures Available in Periodontal Plastic Surgery

109

 

Aesthetic Problems / Solutions

110

 

Types of Grafts

111

 

Ovate Pontics

114

 

Frenectomy

117

 

Socket Preservation

118

 

Treatment Planning for Aesthetic Therapy

118

Chapter 10

Periodontal Emergencies

 

 

Diagnosis of Periodontal Emergencies

121

 

Signs, Symptoms, and Treatment of Periodontal Emergencies

122

 

Periodontal Abscess

122

 

Periocoronitis

122

 

Acute Herpetic Gingivostomatitis

123

 

Necrotizing Ulcerative Gingivitis

123

 

Differential Diagnosis of an Endodontic and Periodontal Abscess

124

 

Bisphosphonate Related Osteonecrosis of the Jaw (BRONJ)

125

Chapter 11

Considerations in Implant Dentistry

 

 

Biomechanics

127

 

Socket Grafting in Implant Therapy

127

 

Signs of a Healthy and Ailing Implant

129

 

Managing the Atrophic Ridge

131

 

Lateral Ridge Augmentation by GBR

131

 

Vertical Ridge Augmentation by GBR

132

 

Imaging Techniques - Cone Beam CT

133

 

Protocol for Implant Maintenance

133

 

Appendix

 

 

Abbreviations, Acronyms, and Symbols

138

 

Natural Products: Herbal and Dietary Supplements

142

 

Dentifrice Products

145

 

Sample Prescriptions

155

 

Internet Resources

162

 

Selected Readings - General

162

 

Selected Readings - Specific

163

 

Keyword Index

175