Periodontal-Restorative Interrelationships

Even with the option of dental implants, periodontists, restorative dentists, and general dentists alike continue to treat patients' natural teeth on a day-to-day basis. Procedures including crown lengthening surgery, furcation treatment, mucogingival therapy, and tooth restoration are essential treatment regimes requiring multifaceted expertise. Periodontal-Restorative Interrelationships: Ensuring Clinical Success provides guidelines for comprehensive treatment planning, and features step-by-step clinical instruction for periodontal and restorative procedures from beginning to end. As a result, the book fosters better understanding and increased efficiencies between specialties, resulting in shorter treatment times and consistently better therapeutic outcomes. Periodontal-Restorative Interrelationships: Ensuring Clinical Success begins with a careful discussion of treatment planning, comprehensively covering all variables in simple to complex cases. Subsequent chapters focus upon the most commonly encountered clinical challenges, using a systematic, easy-to-follow approach to various treatment methodologies.  All chapters are well-illustrated with clinical examples. Firmly grounded in evidence-based research, the book affords clinicians from multiple specialties a practical guide for predictable, successful results. Accessible and logically organized, Periodontal-Restorative Interrelationships is an invaluable reference for all clinicians performing these procedures.

Contributors ix Chapter 1 Examination and Diagnosis 3 Paul Fugazzotto and Sergio DePaoli Establishing an Appropriate Treatment Plan 3 Determining Periodontal Treatment Endpoints 19 Rationale for Pocket-Elimination Periodontal Surgery 20 Junctional Epithelial Adhesion or Connective Tissue Attachment? 22 The Signifi cance of Furcation Involvements 23 The Infl uence of Restorative Margins 23 Does Pocket-Elimination Therapy Work? 23 Conclusion 26 Chapter 2 The Role of Crown-Lengthening Therapy 31 Paul Fugazzotto Management of the Apico-occlusal Dimension 32 Incision Design 40 Conclusion 84 Chapter 3 Treating the Periodontally Involved Furcation 89 Paul Fugazzotto Defi nitions of Furcation Involvements 89 Diagnosing Premolar Furcation Involvements 94 Treatment of Class I Furcations 95 Treatment of Class II Furcations 98 Treatment of Class III Furcations 109 Maxillary vs. Mandibular Furcations 110 Selecting the Appropriate Treatment Modality 110 Conclusions 113 Chapter 4 The Role of Mucogingival Therapy 117 Paul Fugazzotto Indications for Mucogingival Surgery 120 Nonattached Gingival Autografts 122 Lateral Pedicle Flaps 126 Connective-Tissue Grafts 131 Guided Tissue Regeneration 133 Indications for Emdogain Use 134 Constructing a Clinically Based Treatment Decision Tree 138 Mucogingival Therapy at the Time of Crown-Lengthening Surgery 139 Conclusions 140 Chapter 5 Restoration of the Periodontally Treated Tooth 147 Frederick Hains The Feather 147 The Chamfer 150 The Shoulder 150 Periodontal Ramifi cations and Prosthetic Adaptations 154 Impressions 161 Chapter 6 Developing Treatment Algorithms for Restoration or Replacement of the Compromised Tooth 165 Paul Fugazzotto and Frederick Hains Diagnostic Requirements 165 Assessing the Individual Tooth 166 The Ability to Safely Perform Crown-Lengthening Surgery 167 Endodontic Considerations 167 Implant Receptor Site Considerations 168 Assessing Cost-Benefi t Ratios 168 Complexity of Care 172 Predictability of Care 173 The Cost of Retreatment 176 Conclusion 180 Index 183