Restoring Periodontal Support: A Review of Why, When and How

Timothy J. Hempton, DDS; José Nart, DDS; and Vikram Likhari, DDS

June 2007 Issue - Expires Tuesday, June 30th, 2009

Inside Dentistry

Abstract

Periodontitis results in the loss of clinical attachment and can lead to tooth loss. Recognition of attachment loss is accomplished via negative changes in probing depths as well as a comparison of radiographs taken at two different intervals in time. The risk for continued attachment loss can be reduced or reversed by periodontal therapeutic intervention. Unfortunately, not all attempts to arrest or reverse attachment loss are successful. Avoiding periodontal surgical treatment altogether and moving in the direction of implant therapy on a regular basis may become a trend followed by many practitioners. However, in some situations, access flap therapy to restore lost periodontal support can lead to a more positive prognosis for teeth. The parameters described in this article favor an improved prognosis for periodontally involved teeth that are treated with access flap surgery. These factors should provide a positive influence on dentists' decision-making process relative to tooth retention. The purpose of this article is to review clinical characteristics, radiographic findings, and systemic considerations that would provide a compelling argument to restore lost periodontal support via flap surgery to facilitate tooth retention. How materials such as bone grafts, barrier membranes, and growth factors such as enamel matrix proteins are employed to affect wound healing are reviewed. In addition, two clinical surgical cases treated with adjunctive usage of enamel matrix proteins are presented.

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The author reports no conflicts of interest associated with this work.

Queries for the author may be directed to justin.romano@broadcastmed.com.