Author: Bateman, Geoffrey; Saha, Shuva; Chapple, Iain L.C.
Title: Contemporary Periodontal Surgery: An Illustrated Guide to the Art Behind the Science
This book aims to provide an evidence-based and highly illustrative approach to a comprehensive repertoire of surgical procedures, including: basic principles, resective surgery, regenerative techniques and periodontal/peri-implant plastic surgery. It emphasizes the importance of case selection and planning to successful outcomes and extols the benefits of microsurgical instrumentation. The distinction between periodontal and other forms of oral surgery is made, principally that in periodontal surgery, the contour and quality of the tissues post-operatively is vital to longer-term success and therefore careful soft tissue management is pivotal.
ISBN: 978-1-85097-123-8
204 pp; 283 illus
Contents
1. Principles and Practice of Periodontal Surgery 1: Case Selection and Planning
2. Principles and Practice of Periodontal Surgery 2: Basic Surgical Principles
3. Surgical Management of Gingival Overgrowth
4. Access Flaps for Surgical Root Surface Debridement
5. Regenerative Periodontal Techniques
6. Periradicular Surgery
7. Resective Hard Tissue Surgery
8. Crown-lengthening Surgery
9. Mucogingival Grafting Procedures—An Overview
10. Hard Tissue Surgery (Ridge Augmentation) for Dental Implants
11. Soft Tissue Surgery Around Dental Implants
Foreword
Periodontal surgery; an integral element of the clinical practice of periodontology is both a science and an art. It spans a broad range of procedures involving the supporting tissues of the teeth, and has been extended in recent years to include soft tissue surgery in relation to dental implants. Contemporary Periodontal Surgery: An Illustrated Guide to the Art behind the Science concludes an excellent collection of volumes on periodontology in the Quintessentials of Dental Practice series. In common with all the other Quintessentials volumes on periodontology, let alone the other titles in the series, this book is an engaging, easy to read and extensively illustrated, authoritative overview of the subject area. If you have formed the view that surgery has little, if any, part to play in the modern clinical practice of periodontology, then it is especially important that you become familiar with this book, and use it, as intended, as a close-to-hand aide memoire in your clinical environment. The few hours it takes to read this volume will be time exceedingly well spent, with the prospect of you changing your clinical practice of surgical periodontology. If every picture says a thousand words, then this neat Quintessentials-sized volume is a deceptively small sized tome on periodontology; it is a veritable feast of valuable information of immediate practical relevance. Intrigued? Well, read on, enjoy and learn; this book—a scientific and artful text on modern periodontal surgery—will exceed your expectations.
Congratulations to the authors and editor on adding to the excellence of the Quintessentials series.
Nairn Wilson, Editor-in-Chief
Preface
Contemporary Periodontal Surgery is a book that aims to take the practitioner on a journey through the fundamentals of careful case selection and holistic pre-surgical planning, through the informed consent process and into the intricacies of periodontal microsurgery and post-surgical care, in an illustrated and stepwise manner. One of the key factors that differentiates periodontal surgery from other forms of oral surgery, is that the condition, shape and contours of the marginal and interproximal tissues post-surgery are fundamental outcome measures of the success of the operation. If a patient is unable to effect high standards of home care following periodontal surgery due to poor tissue contours, the surgery is likely to fail in the medium to longer term. Thus, delicate tissue management and attention to detail when closing surgical wounds is a pre-requisite for success, as is the use of magnification, good field illumination and microsurgical instrumentation. These are a vital component of contemporary periodontal surgery.
One of the key paradigms which differentiate the best surgeon from the average surgeon is the working philosophy that “the feasibility of an operation is not an indication for its execution”; in other words, just because an operation is technically feasible does not mean that it is the correct thing to do for every patient in every situation. Competent surgeons think beyond the operation to its consequences and in particular the relative suitability of other approaches: sometimes the correct decision is the decision not to operate. A further consideration is that as a general guide, surgery has no place in the management of medical conditions; these require medical management, unless all medical options have failed. In this scenario, surgery is a last resort and as such should be contemplated with great caution.
This text therefore aims to provide the reader with a clear guide to planning periodontal surgery and an illustrated approach to the execution of a range of periodontal surgical procedures. The core principles underpinning treatment decisions and planning are discussed alongside the fundamentals of preparing the patient and the surgeon for the operation. A number of tips are provided to ensure patient comfort and the creation of an optimal operative field, thereby ensuring a smooth procedure, which minimises the risk of unforeseen events.
The procedures covered include resective procedures for diseased or unsightly tissues, mucoperiosteal flap access procedures and plastic surgery procedures designed to regenerate and replace lost or inflamed tissues. Finally, procedures executed to augment hard and soft tissues in preparation for implant placement are discussed.
Outcomes of Reading This Text
This text will not focus on the aetiology of lesions or conditions requiring surgical management; this is covered in earlier books in this series. It is hoped that having read this text the reader will be able to:
• Appreciate the alternative approaches to surgical intervention and when these may be more appropriate than the proposed surgery for a particular patient.
• Understand that managing medical conditions surgically is inadvisable and should only be contemplated as a last resort. Thus, no operation should be contemplated without a clear diagnosis, and clear surgical objectives that will benefit the patient.
• Understand the scope of periodontal surgery and the principles underpinning its safe practice.
• Appreciate the aims and objectives, indications and contraindications for periodontal surgery.
• Understand the impact of a patient’s medical history upon the decision to operate or not.
• Understand and appreciate the need for and importance of informed consent.
• Appreciate the importance of sterile and aseptic technique.
• Understand the importance of and stages required for, pre-surgical and surgical planning.
• Be able to interpret the findings of routine clinical investigations (eg, blood test results) and use these to inform their case planning.
• Be familiar with analgesic methods and those necessary to obtain, maintain and manage haemorrhage.
• Value and understand the tangible additional benefits of using appropriate magnification and field illumination.
• Appreciate the complications that may arise during an operation and immediately afterwards as well as in the medium and longer term.
• Have good knowledge of the principles of surgical flap design and execution as well as debridement and closure.
• Understand the differences between different flap compositions and designs and what may be most appropriate for different situations.
• Appreciate the importance of delicate handling of tissues and meticulous surgical technique to minimise tissue trauma.
• Advise their patient about immediate and longer term post-operative care.
• Identify their limitations and when to refer for advice or treatment by specialists.
• Be prepared to commit to regular review and re-appraisal of the patient and take long term responsibility for surgical outcomes.
Reviews
“In summary, this book provides a well-written synopsis of periodontal surgical procedures and suggests therapeutic approaches for the treatment of patients with moderate-to-advanced periodontal disease. The book is lavishly illustrated and provides a concise but thorough overview of our current knowledge of periodontal surgery. If you wish to have a concise up-to-date review of periodontal surgical procedures, this book will serve you well.”
Robert Schifferle, DDS, MMsc, PhD
The New York State Dental Journal April 2008
© 2007
