Changing concepts in periodontics.
This article has concentrated on aspects of periodontics where research over the last decade has demonstrated that old concepts are outmoded and for the patient's benefit should be changed in clinical practice. The following statements were made. Periodontal pockets do not need to be reduced surgically to a 3 mm limit to save teeth. Bone and soft tissues do not need to be sculptured to uniform horizontal atrophy at the level of the deepest pocket. Treated teeth can be maintained without loss of periodontal support with less than perfect plaque control if professional tooth cleaning every 3 months is practiced. Furcation involvement complicates the treatment of periodontitis, but such teeth have a better prognosis than has been commonly thought. Deep pockets have a relatively good prognosis after treatment. The problem is access for efficient root planing. Advanced periodontitis can be stopped in most patients. Gingival curettage does not improve the results of scaling and root planing. Support for teeth can be maintained without attached gingiva. Gingival blanching in response to lip pull is meaningless. Splinting is not needed for most teeth with increased mobility after periodontal therapy. It was acknowledged that in other controversial aspects of periodontics scientific information still is not available to support firm concepts that may guide clinical practice. One problem in dentistry is the lag that often exists between the publication of research findings and their application in clinical practice if there is no inherent economic reward in the new procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
D000543:Alveoloplasty / Q000379:methods; D018407:Bacterial Physiological Phenomena; D003773:Dental Plaque / Q000382:microbiology / Q000517:prevention & control; D012534:Dental Scaling; D005881:Gingiva / Q000473:pathology; D005893:Gingivoplasty / Q000379:methods; D006801:Humans; D010510:Periodontal Diseases / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D010514:Periodontal Pocket / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D010516:Periodontal Splints; D010518:Periodontitis / Q000382:microbiology / Q000517:prevention & control; D014081:Tooth Extraction; D014086:Tooth Mobility / Q000628:therapy; D014092:Tooth Root / Q000473:pathology / Q000601:surgery; D014945:Wound Healing