1 Periodontal assessment and diagnosis
What factors in the dental history might indicate periodontal disease is present?
What is the relevance of a patients medical history to his or her periodontal care?
Clinical periodontal examination
How do I record a BPE screening examination?
Is the BPE used for children and teenagers?
What are the methods for screening for periodontal disease?
What do I need to carry out a BPE and how often should it be recorded?
Can I probe around implants?
Why are the BPE scores inconsistent with the minimal attachment loss experienced?
Why did the BPE scores at recall not show any improvement?
How do I interpret the BPE scores to reflect the treatment needs of an individual patient?
How would I score a sextant where there are no probing depths greater than 5 mm but the furcation is detected?
What are the limitations of the BPE?
Why is it necessary to take a social history?
Comprehensive periodontal assessment
What are clinical attachment loss and clinical attachment level?
When would I carry out a radiographic assessment?
Width of attached gingiva: How much is needed?
Is there a difference between horizontal and vertical bone loss?
What are the appropriate radiographs to take?
Assessment of co-morbidities
2 Classification of periodontal diseases
What are the current possible periodontal diagnoses?
How do I reach a periodontal diagnosis? Basic checklist
Is this plaque-related periodontitis?
Is this plaque-related periodontitis?
Is this plaque-related periodontitis?
Comparing chronic and aggressive periodontitis: A diagnostic dilemma?
Conditions that may affect periodontal management
Systemic aetiological factors in periodontal disease
Systemic factors predominantly affecting the gingival tissues
Drug-induced gingival enlargement
Phenytoin-induced gingival enlargement
Calcium channel blocking drugs
Systemic factors that increase susceptibility to periodontitis
Diabetes mellitus and periodontal disease
Diagnosis of DM during periodontal examination
Effects of treatment on glycaemic control
Treatment of periodontitis in patients with DM
Nutrition and periodontitis
Risk factors for periodontal disease
Tooth-related risk factors
Periodontal disease as a risk factor for systemic disease
5 Is it periodontal disease?
Clinical Problem Solving in Periodontology and Implantology
6 Initial treatment planning
The treatment planning process
Oral hygiene methods to control plaque formation
The ability of the patient to perform these methods
The motivation of the patient
Behavioural and pharmacological support
Particular difficulties of root surface debridement
What is nonsurgical treatment?
Assessing treatment outcomes
Reasons for poor responses to treatment
Remedies for inadequate treatment outcomes
10 Surgical treatment of periodontal pocketing
Contraindications for surgery
11 Other surgical procedures
Crown lengthening surgery
What is the biologic width and why is it important?
Case 2: Biologic width invasion
Case 3: Fractured tooth with lack of crown height
What other treatment options would be possible?
Gingival procedures to remove excess gingiva (gingivectomy)
Case 1: Drug-induced gingival enlargement
Could this have been carried out by alternative surgical methods?
Root resection procedures
12 Periodontal regeneration
Overview of regenerative therapies
Guided tissue regeneration
Biologically active materials
Applications of regenerative therapies
Outcomes of periodontal regenerative treatments
13 Local and systemic antimicrobial agents
Antiseptic agents and chemical plaque control
Other antiseptic agents and plaque control
Systemic antimicrobial agents
Treatment of periodontal pocketing
Locally delivered antimicrobial agents
Surgical procedures for treating recession defects
Recession following periodontal treatment
15 Postoperative care and periodontal maintenance therapy
Managing the consequences of periodontal disease
Periodontal maintenance therapy
3 Introduction to dental implantology
16 Indications for dental implant treatment
What are the prosthodontic advantages of implant treatment?
To avoid tooth preparation and possible sequelae
Avoids mechanical risks of conventional bridges
Concurrent use of an implant as an orthodontic anchor
No need for connectors between pontic and abutment teeth
The deep complete overbiteNo need to accommodate a denture connector
Denture retention and support
Linking implant restorations together
Retrievability of the restoration
To take advantage of machined fitting parts
Why does the patient wish to replace missing teeth?
To enable wind instrument playing?
To improve masticatory function?
To improve speech function?
To regain what has been lost?
What is the problem with an existing fixed restoration or the natural teeth?
Is there a denture-related problem the patient wishes to solve?
Fixed restoration instead of removable denture?
Improved removable denture
Does the cause of missing or failing teeth have any influence on the indication for implants?
Congenital/developmental absence
Related to treatment for head and neck cancer
Does the timing of tooth loss have any influence on indication for implants?
What are the main drawbacks of implant treatment?
Cost and duration of treatment
Lack of implant product standardization
Difficulty achieving aesthetic perfection and easy access for oral hygiene
Possible need for a tooth-free period
Are there contraindications to implant treatment?
17 Assessing the patient for implant placement
What are the patients expectations and can they be safely met?
Does the treating team have the ability to meet the expectations of the patient?
Is the appropriate equipment available and are the practice premises suitable to carry out implant dentistry?
What training has been undertaken?
Is the patient able to give valid informed consent?
Can the patient afford the treatment and maintenance?
What are the time-scales for the completion of treatment?
Will the patient be able to attend for maintenance?
Might there be periods during treatment without tooth replacement and how might teeth be replaced temporarily?
What is the likelihood of being able to satisfy the aesthetic desires of the patient?
What side effects from surgery are to be expected, and what are the more unusual but significant risks?
Will treatment involve the use of animal-derived products?
Are there any pre-existing general factors that might compromise the establishment of bone and soft tissue integration?
Does the patient suffer from diabetes?
Has the patient had radiotherapy to the jaws?
Have bisphosphonates ever been prescribed?
Is it possible to communicate effectively to obtain a reliable history?
Does the patient have communication problems?
Is the patient likely to tolerate surgery, anaesthetic, and anxiety management techniques with acceptable risk?
How will the patient be anaesthetized?
Is there a risk from ionizing radiation in pregnancy?
Will it be possible to access the oral cavity to perform the required diagnostic, surgical, and prosthodontic procedures with acceptable risk?
Does the patient have a compromised airway protective reflex?
Does the patient have a reduced oral aperture or mandibular opening range?
Is the patient able to cooperate during assessment and treatment?
Is the patient able to recline in the dental chair to allow the operator to work in a safe and acceptable position?
Is the oral environment stable and disease-free?
Does the patient have a dry mouth?
Has there been a course of orthodontic treatment?
Are tooth positions stable?
Is gingival architecture mature?
Is there any evidence of pulpal/periapical disease, active caries, heavily restored teeth at risk of mechanical failure, or tooth wear?
What is the risk of future peri-implantitis?
Does the patient have good oral hygiene?
Is there a history of previous periodontitis or peri-implantitis?
Is the patients age relevant?
Has craniofacial growth ceased?
Are there age-related co-morbidities?
Is there any risk of compromised wound healing due to underlying medical conditions or the effect of current or past therapies?
Are there any lifestyles or habits that might influence treatment options or that might pose a risk to implant restoration longevity?
What are the aesthetic goals?
What is the ideal soft tissue frame of the teeth to be replaced?
Which teeth are to be replaced in part-dentate patients?
Does acceptable lip and facial support rely largely on the presence of a removable prosthesis?
What are the diagnoses and constraints for treatment and maintenance?
What is the overall treatment objective?
Is the final restoration to be fixed or removable by the patient?
What are the occlusal objectives?
Is the proposed restoration protected in excursions?
Is there space within an existing tooth-borne occlusal scheme to accommodate the proposed arrangement of teeth to be replaced?
Is there space within the prosthetic envelope of a denture to accommodate overdenture attachments?
What are the ideal implant positions to satisfy the aesthetic, occlusal, and hygiene goals?
How deeply placed should implants be?
What should the mesiodistal position of implants be?
What should the buccolingual position of implants be?
What should the trajectory of the implants be?
What are the requirements to facilitate access for oral hygiene?
How many implants for overdentures?
What support is intended for the overdenture?
What moderating factors indicate a departure from one implant per missing tooth for fixed restorations?
Edentate fixed restoration
Is satisfactory volume and quality of bone available to house the chosen implant products in the selected positions?
How much bone will remain after a tooth is extracted?
What can radiography show?
What are the ideal implant product features to satisfy the aesthetic, occlusal, and hygiene goals?
How long should the implants be?
How wide should implants be?
What about other implant product features?
If bone and/or soft tissue is lacking, can it be created?
It is anticipated that initial implant stability in existing bone cannot be achieved
It is anticipated that the implant will gain adequate primary stability from existing bone
It is anticipated that peri-implant soft tissue will be lacking
Will the peri-implant soft tissue be appropriate?
Is the peri-implant tissue attached mucosa or mobile alveolar mucosa?
How will the patient make the transition to implant restoration?
Immediate final restoration using implants
Provisional fixed restoration borne by implants
Provisional fixed restoration borne by teeth
Provisional removable restoration
No provisional restoration
If bone or soft tissue is lacking, is it possible to proceed, accepting the risk of compromise?
What are other possible compromise outcomes?
What are the aesthetic risks?
What is the stage-by-stage plan of treatment?
19 Basic surgery for implant placement
Surgical placement of an implant to replace an upper first molar
What is the diagnosis and what factors will determine the prognosis of this tooth?
What replacement restorations would you consider and why?
Describe the surgical technique pertinent to molar region
What factors would you consider when planning an implant to replace a maxillary and a mandibular molar?
Immediate implant placement to replace two upper premolars
Describe the surgical technique, with particular consideration for immediate implant placement
What is the prognosis for these teeth?
What replacement restorations would you consider and why?
What surgical protocols would you consider for implant placement? Discuss the risks and benefits
Replacement of an upper central incisor with a dental implant
Describe the surgical technique most appropriate for the highly demanding aesthetic zone
What important factors would you assess when replacing implants in the aesthetic zone?
What replacement restorations would you consider and why?
20 Managing bone deficiencies for implant surgery
Surgical placement of an implant with simultaneous guided bone regeneration
What important factors would you consider when placing implants with simultaneous GBR?
Describe the surgical technique of simultaneous GBR
Surgical placement of an implant after staged augmentation with block bone graft
Describe the surgical technique for block bone grafting
21 Restorative options in implant dentistry
What are the techniques for transferring the implant position to a working cast?
What is an implant abutment and what are the various available types?
What are the methods of attaching a restoration to the dental implant?
Single-tooth posterior replacement
Posterior cement-retained crown
Posterior screw-retained crown
Anterior cement-retained crown
Anterior screw-retained crown
What restorative options can be considered for an edentulous patient?
Implant-retained removable overdenture options
Implant-supported fixed prosthesis option
Describe the various prosthetic complications and failures associated with implant restorations
What are the common aesthetic failures when replacing teeth with dental implants?
What is peri-implant disease? Describe its aetiology and discuss the recommended treatment
Clinical case examples of implant failures
Section 1. Periodontal assessment and diagnosis
Section 2. Periodontal treatment
Section 3. Introduction to dental implantology
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