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Decision Trees in Periodontal Surgery: Resective Versus Regenerative Periodontal Surgery

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Advances in Periodontal Surgery

Abstract

Traditionally, periodontal surgical procedures such as osseous resective surgery and open flap debridement have been used as a treatment modality in order to control the progression of periodontal disease. The advent of new tools such as microscopes, cone beam computed tomography, and new surgical techniques has fundamentally changed treatment philosophy and rationale from one of resective toward a regenerative approach. This chapter will focus on recent scientific literature, exploring and discussing the newest tools, techniques, and materials which has changed the way we treat periodontal disease today. Due to the sensitivity in case selection for utilization of these techniques, a decision tree for periodontal resective and regenerative therapy has been suggested based on recent literature.

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References

  1. Isidor F et al (1985) New attachment—reattachment following reconstructive periodontal surgery. J Clin Periodontol 12:728–735

    PubMed  Google Scholar 

  2. Wikesjö UM, Selvig KA (1999) Periodontal wound healing and regeneration. Periodontology 19:21–39

    Google Scholar 

  3. Wikesjö UM et al (1992) Significance of early healing events on periodontal repair: a review. J Periodontol 63:158–165

    PubMed  Google Scholar 

  4. Nibali L et al (2015) Minimally invasive non-surgical approach for the treatment of periodontal intrabony defects: a retrospective analysis. J Clin Periodontol 42:853–859

    PubMed  Google Scholar 

  5. Klein F et al (2001) Radiographic defect depth and width for prognosis and description of periodontal healing of infrabony defects. J Periodontol 72:1639–1646

    PubMed  Google Scholar 

  6. Cortellini P et al (1998) Treatment of deep and shallow intrabony defects A multicenter randomized controlled clinical trial. J Clin Periodontol 25:981–987

    PubMed  Google Scholar 

  7. Lee S-B et al (2013) The effect of diabetes on bone formation following application of the GBR principle with the use of titanium domes. Clin Oral Implants Res 24(1):28–35

    PubMed  Google Scholar 

  8. Stavropoulos A et al (2004) Smoking affects the outcome of guided tissue regeneration with bioresorbable membranes: a retrospective analysis of intrabony defects. J Clin Periodontol 31:945–950

    PubMed  Google Scholar 

  9. Tonetti MS et al (1995) Effect of cigarette smoking on periodontal healing following GTR in infrabony defects. J Clin Periodontol 22:229–234

    PubMed  Google Scholar 

  10. Matuliene G et al (2008) Influence of residual pockets on progression of periodontitis and tooth loss: Results after 11 years of maintenance. J Clin Periodontol 35:685–695

    PubMed  Google Scholar 

  11. Jeffcoat MK (1992) Radiographic methods for the detection of progressive alveolar bone loss. J Periodontol 63(4 suppl):s367–s372

    Google Scholar 

  12. Reddy MS et al (1992) A semi-automated computer- assisted method for measuring bone loss adjacent to dental implants. Clin Oral Implants Res 3:28–31

    PubMed  Google Scholar 

  13. Molander B et al (1995) Panoramic and restrictive intraoral radiography in comprehensive oral radio-graphic diagnosis. Eur J Oral Sci 103:191–198

    PubMed  Google Scholar 

  14. Jeffcoat MK (1994) Current concepts in periodontal disease testing. J Am Dent Assoc 125:1071–1078

    PubMed  Google Scholar 

  15. Kapila SD, Nervina JM (2015) CBCT in orthodontics: assessment of treatment outcomes and indications for its use. Dentomaxillofac Radiol 44(1):20140282

    PubMed  Google Scholar 

  16. Rios HF et al (2017) The use of cone-beam computed tomography in management of patients requiring dental implants: An American Academy of Periodontology Best Evidence Review. J Periodontol 88(10):946–959

    Google Scholar 

  17. Mandelaris GA et al (2017) Cone-beam computed tomography and interdisciplinary dentofacial therapy: An American Academy of Periodontology Best Evidence Review Focusing on Risk Assessment of the Dentoalveolar Bone Changes Influenced by Tooth Movement. J Periodontol 88(10):960–977

    PubMed  Google Scholar 

  18. Kim DM, Bassir SH (2017) When is cone-beam computed tomography imaging appropriate for diagnostic inquiry in the management of inflammatory periodontitis? An American Academy of Periodontology best evidence review. J Periodontol 88(10):978–998

    PubMed  Google Scholar 

  19. Prakash N et al (2015) Visibility of lamina dura and periodontal space on periapical radiographs and its comparison with cone beam computed tomography. Contemp Clin Dent 6:21–25

    PubMed  PubMed Central  Google Scholar 

  20. de Faria Vasconcelos K et al (2012) Detection of periodontal bone loss using cone beam CT and intraoral radiography. Dentomaxillofac Radiol 41:64–69

    PubMed  PubMed Central  Google Scholar 

  21. Raichur PS et al (2012) Comparison of radiovisiography and digital volume tomography to direct surgical measurements in the detection of infrabony defects. J Clin Exp Dent 4:e43–e47

    PubMed  PubMed Central  Google Scholar 

  22. Qiao J et al (2014) The accuracy of cone-beam computed tomography in assessing maxillary molar furcation involvement. J Clin Periodontol 41:269–274

    PubMed  Google Scholar 

  23. Darby I et al (2015) Comparison of clinical and cone beam computed tomography measurements to diagnose furcation involvement. Int J Dent Hyg 13:241–245

    PubMed  Google Scholar 

  24. Walter C et al (2010) Accuracy of three-dimensional imaging in assessing maxillary molar furcation involvement. J Clin Periodontol 37:436–441

    PubMed  Google Scholar 

  25. Marinescu AG et al (2013) Reliability of CBCT as an assessment tool for mandibular molars furcation defects [Proceedings of the Fifth International Conference on Lasers in Medicine: Biotechnologies Integrated in Daily Medicine, 19–21 Sep 2013, Timisoara, Romania]. Proc SPIE 8925(2014):892509J

    Google Scholar 

  26. Woelber JP et al (2018) Accuracy and usefulness of CBCT in Periodontology: a systematic review of the literature. Int J Periodontics Restorative Dent 38(2):289–297

    PubMed  Google Scholar 

  27. Belcher JM (2001) A perspective on periodontal microsurgery. Int J Periodontics Restorative Dent 21:191–196

    PubMed  Google Scholar 

  28. Sitbon Y, Attathom T (2014) Minimal intervention dentistry II: part 6. Microscope and microsurgical techniques in periodontics. Br Dent J 216(9):503–509

    PubMed  Google Scholar 

  29. Yadav VS et al (2018) Periodontal microsurgery: Reaching new heights of precision. J Indian Soc Periodontol 22(1):5–11

    PubMed  PubMed Central  Google Scholar 

  30. Sunell S, Maschak L (1996) Positioning for clinical dental hygiene care. Preventing back, neck and shoulder pain. PRO 30:216–219. [PubMed: 9611451]

    Google Scholar 

  31. Sunell S, Rucker LM (2003) Ergonomic risk factors associated with clinical dental hygiene practice. PRO 37:159–166

    Google Scholar 

  32. Ryo M, Schigeaki K (2001) HDTV single camera 3D system and its application in microsurgery. Stereoscopic displays and virtual reality systems. Proc SPIE 2177:31–34

    Google Scholar 

  33. Harrel S, Rees T (1995) Granulation tissue removal in routine and minimally invasive procedures. Compend Contin Educ Dent (Jamesburg, NJ: 1995) 16:960

    Google Scholar 

  34. Cortellini P, Tonetti MS (2007) A minimally invasive surgical technique with an enamel matrix derivative in the regenerative treatment of intra-bony defects: a novel approach to limit morbidity. J Clin Periodontol 34:87–93

    PubMed  Google Scholar 

  35. Cortellini P, Tonetti MS (2009) Improved wound stability with a modified minimally invasive surgical technique in the regenerative treatment of isolated interdental intrabony defects. J Clin Periodontol 36:157–163

    PubMed  Google Scholar 

  36. Harrel SK et al (2017) Videoscope assisted minimally invasive surgery (VMIS): 36-Month Results. J Periodontol 88:528–535

    PubMed  Google Scholar 

  37. Rasperini G et al (2013) The soft tissue wall technique for the regenerative treatment of non-contained infrabony defects: a case series. Int J Periodontics Restorative Dent 33:e79–e87. https://doi.org/10.11607/prd.1628

    Article  PubMed  Google Scholar 

  38. Rodríguez JA, Caffesse RG (2018) A new papilla preservation technique for periodontal regeneration of severely compromised teeth. Clin Adv Periodontics 8:33–38

    Google Scholar 

  39. Aslan S et al (2017) Entire papilla preservation technique in the regenerative treatment of deep intrabony defects: 1-Year results. J Clin Periodontol 44:926–932

    PubMed  Google Scholar 

  40. Kao RT et al (2015) Periodontal regeneration—intrabony defects: a systematic review from the AAP Regeneration Workshop. J Periodontol 86(2 Suppl):S77–S104

    PubMed  Google Scholar 

  41. Lin Z et al (2015) Emerging regenerative approaches for periodontal reconstruction: a systematic review from the AAP Regeneration Workshop. J Periodontol 86(2 Suppl):S134–S152

    Google Scholar 

  42. Reynolds MA et al (2015) Periodontal regeneration—intrabony defects: a consensus report from the AAP Regeneration Workshop. J Periodontol 86(2 Suppl):S105–S107

    PubMed  Google Scholar 

  43. Cochran DL et al (2015) Emerging regenerative approaches for periodontal reconstruction: a consensus report from the AAP Regeneration Workshop. J Periodontol 86(2 Suppl):S153–S156

    PubMed  Google Scholar 

  44. Sculean A et al (2015) Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 68(1):182–216

    Google Scholar 

  45. Feifei L et al (2017) Evaluation of recombinant human FGF-2 and PDGF-BB in periodontal regeneration: a systematic review and meta-analysis. Sci Rep 7:65

    Google Scholar 

  46. Roselló-Camps À et al (2015) Platelet-rich plasma for periodontal regeneration in the treatment of intrabony defects: a meta-analysis on prospective clinical trials. Oral Surg Oral Med Oral Pathol Oral Radiol 120(5):562–574

    PubMed  Google Scholar 

  47. Khoshkam V et al (2015) Outcomes of regenerative treatment with rhPDGF-BB and rhFGF-2 for periodontal intra-bony defects: a systematic review and meta-analysis. J Clin Periodontol 42(3):272–280

    PubMed  Google Scholar 

  48. Graziani F et al (2014) Does enamel matrix derivative application provide additional clinical benefits in residual periodontal pockets associated with suprabony defects? A systematic review and meta-analysis of randomized clinical trials. J Clin Periodontol 41(4):377–386

    PubMed  Google Scholar 

  49. Esposito M et al (2009) Enamel matrix derivative (Emdogain) for periodontal tissue regeneration in intrabony defects. A Cochrane systematic review. Eur J Oral Implantol 2(4):247–266

    PubMed  Google Scholar 

  50. Koop R et al (2012) Periodontal regeneration with enamel matrix derivative in reconstructive periodontal therapy: a systematic review. J Periodontol 83(6):707–720

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA

    Aniruddh Narvekar, Kevin Wanxin Luan & Fatemeh Gholami

Authors
  1. Aniruddh Narvekar
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  2. Kevin Wanxin Luan
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  3. Fatemeh Gholami
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Corresponding author

Correspondence to Aniruddh Narvekar .

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Editors and Affiliations

  1. Department of Periodontics, University of Illinois at Chicago, College Dentistry, Chicago, IL, USA

    Salvador Nares

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Narvekar, A., Luan, K.W., Gholami, F. (2020). Decision Trees in Periodontal Surgery: Resective Versus Regenerative Periodontal Surgery. In: Nares, S. (eds) Advances in Periodontal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-12310-9_2

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  • DOI: https://doi.org/10.1007/978-3-030-12310-9_2

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-12309-3

  • Online ISBN: 978-3-030-12310-9

  • eBook Packages: MedicineMedicine (R0)

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