BOOK
Newman and Carranza's Clinical Periodontology E-Book
Michael G. Newman | Henry Takei | Perry R. Klokkevold | Fermin A. Carranza
(2018)
Additional Information
Book Details
Abstract
From basic science and fundamental procedures to the latest advanced techniques in reconstructive, esthetic, and implant therapy, Newman and Carranza's Clinical Periodontology, 13th Edition is the resource you can count on to help master the most current information and techniques in periodontology. Full color photos, illustrations, and radiographs show you how to perform periodontal procedures, while renowned experts from across the globe explain the evidence supporting each treatment and lend their knowledge on how to best manage the outcomes.
- UNIQUE! Periodontal Pathology Atlas contains the most comprehensive collection of cases found anywhere.
- Full-color photos and anatomical drawings clearly demonstrate core concepts and reinforce important principles.
- UNIQUE! Chapter opener boxes in the print book alert readers when more comprehensive coverage of topics is available in the online version of the text.
- NEW! Chapters updated to meet the current exam requirements for the essentials in periodontal education.
- NEW! Case-based clinical scenarios incorporated throughout the book mimic the new patient case format used in credentialing exams.
- NEW! Additional tables, boxes, and graphics highlight need-to-know information.
- NEW! Two new chapters cover periimplantitis and resolving inflammation.
- NEW! Section on evidence-based practice consists of two chapters covering evidence-based decision making and critical thinking.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Newman and Carranza's Clinical Periodontology | i | ||
| Copyright Page | iv | ||
| Editors | v | ||
| Contributors | vi | ||
| About the Book | xiii | ||
| About The Authors | xiv | ||
| Michael G. Newman, DDS, FACD | xiv | ||
| Henry H. Takei, DDS, MS, FACD | xiv | ||
| Perry R. Klokkevold, DDS, MS, FACD | xv | ||
| Fermin A. Carranza, DR ODONT, FACD | xv | ||
| Preface | xvi | ||
| Acknowledgments | xvii | ||
| Table Of Contents | xix | ||
| Video Contents | xxiii | ||
| Introduction: The Historical Background of Periodontology | e.i | ||
| Chapter Outline | e.i | ||
| Early Civilizations | e.i | ||
| The Classical World | e.i | ||
| The Middle Ages | e.i | ||
| The Renaissance | e.i | ||
| The Eighteenth Century | e.iii | ||
| The Nineteenth Century | e.iii | ||
| Necrotizing Ulcerative Gingivitis | e.v | ||
| The Twentieth Century | e.v | ||
| Vienna | e.v | ||
| Berlin | e.v | ||
| The United States and Other Countries | e.vi | ||
| Focal Infection | e.vi | ||
| Dental Implants | e.vi | ||
| After World War II | e.vii | ||
| The History of This Book | e.viii | ||
| References | e.viii | ||
| 1 Evidence-Based Practice | 1 | ||
| 1 Evidence-Based Decision Making | 1 | ||
| Abstract | 1.e1 | ||
| Key Words | 1.e1 | ||
| Chapter Outline | 1 | ||
| Background and Definition | 1 | ||
| Principles of Evidence-Based Decision Making | 1 | ||
| Evidence-Based Dentistry | 2 | ||
| Evidence-Based Decision-Making Process and Skills | 2 | ||
| Asking Good Questions: The PICO Process | 2 | ||
| Becoming a Competent Consumer of the Evidence | 3 | ||
| Sources of Evidence | 5 | ||
| Levels of Evidence | 6 | ||
| Searching for and Acquiring the Evidence | 7 | ||
| Appraising the Evidence | 7 | ||
| Common Ways Used to Report Results | 8 | ||
| Applying the Evidence: Evidence-Based Dentistry in Action | 8 | ||
| Evaluating the Outcomes | 8 | ||
| Conclusion | 8 | ||
| References | 9 | ||
| References | 9.e1 | ||
| 2 Critical Thinking | 10 | ||
| Abstract | 10.e1 | ||
| Keywords | 10.e1 | ||
| Chapter Outline | 10 | ||
| Twelve Tools for Assessing Evidence | 10 | ||
| Be Skeptical | 10 | ||
| Do Not Trust Biologic Plausibility | 11 | ||
| What Level of Controlled Evidence Is Available? | 11 | ||
| Did the Cause Precede the Effect? | 12 | ||
| No Betting on the Horse After the Race Is Over | 12 | ||
| What Is a Clinically Relevant Pretrial Hypothesis? | 13 | ||
| Clinically Relevant Endpoint | 13 | ||
| Common and Relevant Comparisons | 13 | ||
| Representative Study Sample | 13 | ||
| Small Type I and Type II Error Rates | 13 | ||
| Size Does Matter | 13 | ||
| Is a Better Alternative Explanation Available? | 15 | ||
| Was the Study Properly Randomized? | 16 | ||
| When to Rely on Nonrandomized Evidence | 17 | ||
| Did the Investigators Take Into Account the Placebo or Nocebo Effects? | 17 | ||
| Was Protection in Place Against Conflict of Interest? | 18 | ||
| Conclusion | 18 | ||
| References | 18 | ||
| References | 18.e1 | ||
| 2 Biologic Basis of Periodontology | 19 | ||
| I Normal Periodontium | 19 | ||
| 3 Anatomy, Structure, and Function of the Periodontium | 19 | ||
| Abstract | 19.e1 | ||
| Key Words | 19.e1 | ||
| Chapter Outline | 19 | ||
| Oral Mucosa | 19 | ||
| Gingiva | 19 | ||
| Clinical Features | 19 | ||
| Marginal Gingiva | 19 | ||
| Gingival Sulcus | 19 | ||
| Attached Gingiva | 20 | ||
| Interdental Gingiva | 20 | ||
| Microscopic Features | 21 | ||
| Gingival Epithelium | 21 | ||
| General Aspects of Gingival Epithelium Biology | 21 | ||
| Structural and Metabolic Characteristics of Different Areas of Gingival Epithelium | 24 | ||
| Oral (Outer) Epithelium | 24 | ||
| Sulcular Epithelium | 25 | ||
| Junctional Epithelium | 25 | ||
| Development of Gingival Sulcus | 26 | ||
| Renewal of Gingival Epithelium | 27 | ||
| Cuticular Structures on the Tooth | 27 | ||
| Gingival Fluid (Sulcular Fluid) | 27 | ||
| Gingival Connective Tissue | 27 | ||
| Gingival Fibers | 27 | ||
| Cellular Elements | 28 | ||
| Repair of Gingival Connective Tissue | 28 | ||
| Blood Supply, Lymphatics, and Nerves | 29 | ||
| Correlation of Clinical and Microscopic Features | 30 | ||
| Color | 30 | ||
| Physiologic Pigmentation (Melanin) | 30 | ||
| Size | 31 | ||
| Contour | 31 | ||
| Shape | 31 | ||
| Consistency | 31 | ||
| Surface Texture | 31 | ||
| Position | 32 | ||
| Continuous Tooth Eruption | 32 | ||
| Periodontal Ligament | 32 | ||
| Periodontal Fibers | 33 | ||
| Cellular Elements | 35 | ||
| Ground Substance | 35 | ||
| Functions of Periodontal Ligament | 36 | ||
| Physical Functions | 36 | ||
| Resistance to Impact of Occlusal Forces (Shock Absorption) | 36 | ||
| Transmission of Occlusal Forces to Bone | 36 | ||
| Formative and Remodeling Function | 36 | ||
| Nutritional and Sensory Functions | 37 | ||
| Regulation of Periodontal Ligament Width | 38 | ||
| Cementum | 38 | ||
| Permeability of Cementum | 39 | ||
| Cementoenamel Junction | 39 | ||
| Cementodentinal Junction | 39 | ||
| Thickness of Cementum | 39 | ||
| Cementum Resorption and Repair | 39 | ||
| Ankylosis | 41 | ||
| Exposure of Cementum to the Oral Environment | 41 | ||
| Alveolar Process | 41 | ||
| Cells and Intercellular Matrix | 43 | ||
| Socket Wall | 43 | ||
| Bone Marrow | 44 | ||
| Periosteum and Endosteum | 44 | ||
| Interdental Septum | 44 | ||
| Osseous Topography | 44 | ||
| Fenestration and Dehiscence | 45 | ||
| Remodeling of Alveolar Bone | 45 | ||
| Development of the Attachment Apparatus | 46 | ||
| Cementum | 46 | ||
| Periodontal Ligament | 46 | ||
| Alveolar Bone | 47 | ||
| Physiologic Migration of the Teeth | 47 | ||
| External Forces and the Periodontium | 47 | ||
| Vascularization of the Supporting Structures | 48 | ||
| References | 49 | ||
| References | 49.e1 | ||
| 4 Aging and the Periodontium | 50 | ||
| Abstract | 50.e1 | ||
| Key Words | 50.e1 | ||
| Chapter Outline | 50 | ||
| Effects of Aging on the Periodontium | 50 | ||
| Gingival Epithelium | 50 | ||
| Gingival Connective Tissue | 52 | ||
| Periodontal Ligament | 52 | ||
| Cementum | 52 | ||
| Alveolar Bone | 52 | ||
| Bacterial Plaque | 52 | ||
| Immune and Inflammatory Responses | 53 | ||
| Effects of Aging on the Progression of Periodontal Diseases | 53 | ||
| Aging and the Response to Treatment of the Periodontium | 54 | ||
| References | 54 | ||
| References | 54.e2 | ||
| II Classification and Epidemiology of Periodontal Diseases | 55 | ||
| 5 Classification of Diseases and Conditions Affecting the Periodontium | 55 | ||
| Abstract | 55.e1 | ||
| Keywords | 55.e1 | ||
| Chapter Outline | 55 | ||
| Gingival Diseases | 55 | ||
| Dental Plaque–Induced Gingival Diseases | 55 | ||
| Gingivitis Associated With Dental Plaque Only | 57 | ||
| Gingival Diseases Modified by Systemic Factors | 58 | ||
| Gingival Diseases Modified by Medications | 58 | ||
| Gingival Diseases Modified by Malnutrition | 59 | ||
| Non–Plaque-Induced Gingival Lesions | 59 | ||
| Gingival Diseases of Specific Bacterial Origin | 59 | ||
| Gingival Diseases of Viral Origin | 60 | ||
| Gingival Diseases of Fungal Origin | 60 | ||
| Gingival Diseases of Genetic Origin | 61 | ||
| Gingival Manifestations of Systemic Conditions | 61 | ||
| Traumatic Lesions | 61 | ||
| Foreign-Body Reactions | 61 | ||
| Periodontitis | 62 | ||
| Chronic Periodontitis | 65 | ||
| Aggressive Periodontitis | 65 | ||
| Periodontitis as a Manifestation of Systemic Disease | 68 | ||
| Medication-Related Osteonecrosis of the Jaw | 71 | ||
| Necrotizing Periodontal Diseases | 73 | ||
| Necrotizing Ulcerative Gingivitis | 73 | ||
| Necrotizing Ulcerative Periodontitis | 73 | ||
| Abscesses of the Periodontium | 74 | ||
| Periodontitis Associated With Endodontic Lesions | 74 | ||
| Endodontic–Periodontal Lesions | 74 | ||
| Periodontal–Endodontic Lesions | 75 | ||
| Combined Lesions | 75 | ||
| Developmental or Acquired Deformities and Conditions | 75 | ||
| Localized Tooth-Related Factors That Modify or Predispose Individuals to Plaque-Induced Gingival Diseases or Periodontitis | 75 | ||
| Tooth Anatomic Factors | 75 | ||
| Dental Restorations and Appliances | 75 | ||
| Root Fractures | 76 | ||
| Cervical Root Resorption and Cemental Tears | 76 | ||
| Mucogingival Deformities and Conditions Around the Teeth | 77 | ||
| Mucogingival Deformities and Conditions of the Edentulous Ridges | 77 | ||
| Occlusal Trauma | 77 | ||
| References | 79 | ||
| References | 79.e6 | ||
| 6 Fundamentals in the Methods of Periodontal Disease Epidemiology | 80 | ||
| Abstract | 80.e1 | ||
| Keywords | 80.e1 | ||
| Chapter Outline | 80 | ||
| The Need for Epidemiology | 80 | ||
| Measuring the Occurrence of Conditions or Diseases | 81 | ||
| Periodontal Measures Typically Recorded Clinically | 82 | ||
| Translating Periodontal Measures Into Traditional Epidemiologic Measures of Disease Occurrence | 83 | ||
| True and Surrogate Measures of the Periodontal Condition | 83 | ||
| Challenges of Obtaining Epidemiologic Measures of Periodontal Conditions and Diseases | 83 | ||
| Epidemiologic Study Designs | 84 | ||
| Randomized Controlled Trials | 84 | ||
| Cohort Studies | 85 | ||
| Case–Control Studies | 85 | ||
| Causes | 85 | ||
| Suspected Modifiable Causative Factors for Periodontal Disease | 86 | ||
| Tobacco Smoking | 86 | ||
| Nutrition | 86 | ||
| Dental Plaque | 86 | ||
| The Cause of Periodontal Disease for the Patient Sitting in Your Chair | 86 | ||
| Diagnosis | 87 | ||
| Periodontal Conditions Versus Periodontal Diseases | 87 | ||
| Diagnostic Tests Available to Assess Periodontal Conditions | 87 | ||
| Translating Periodontal Diagnostic Test Results Into Periodontal Disease Diagnosis | 87 | ||
| Normative or Arbitrary Values to Diagnose Periodontal Disease | 87 | ||
| Risk-Based Reference Values to Diagnose Periodontal Disease | 87 | ||
| Therapeutic Reference Values to Diagnose Periodontal Disease | 87 | ||
| Periodontal Disease Diagnoses | 87 | ||
| References | 88 | ||
| References | 88.e1 | ||
| III Etiology of Periodontal Disease | 89 | ||
| 7 Periodontal Disease Pathogenesis | 89 | ||
| Abstract | 89.e1 | ||
| Keywords | 89.e1 | ||
| Chapter Outline | 89 | ||
| Histopathology of Periodontal Disease | 90 | ||
| Clinically Healthy Gingival Tissues | 90 | ||
| Histopathology of Gingivitis and Periodontitis | 91 | ||
| The Initial Lesion | 92 | ||
| The Early Lesion | 92 | ||
| The Established Lesion | 92 | ||
| The Advanced Lesion | 93 | ||
| Inflammatory Responses in the Periodontium | 94 | ||
| Microbial Virulence Factors | 94 | ||
| Lipopolysaccharide | 94 | ||
| Bacterial Enzymes and Noxious Products | 94 | ||
| Microbial Invasion | 94 | ||
| Fimbriae | 95 | ||
| Bacterial Deoxyribonucleic Acid and Extracellular Deoxyribonucleic Acid | 95 | ||
| Host-Derived Inflammatory Mediators | 96 | ||
| Cytokines | 96 | ||
| Prostaglandins | 96 | ||
| Matrix Metalloproteinases | 96 | ||
| Role of Specific Inflammatory Mediators in Periodontal Disease | 97 | ||
| Interleukin-1 Family Cytokines | 97 | ||
| Other Interleukin-1 Family Cytokines | 98 | ||
| Tumor Necrosis Factor Alpha | 98 | ||
| Interleukin-6 and Related Cytokines | 99 | ||
| Prostaglandin E2 | 99 | ||
| Matrix Metalloproteinases | 99 | ||
| Chemokines | 100 | ||
| Antiinflammatory Cytokines | 100 | ||
| Linking Pathogenesis to Clinical Signs of Disease | 100 | ||
| Alveolar Bone Resorption | 101 | ||
| Receptor Activator of Nuclear Factor-κB Ligand and Osteoprotegerin | 102 | ||
| Resolution of Inflammation | 102 | ||
| Lipoxins | 102 | ||
| Resolvins and Protectins | 102 | ||
| Immune Responses in Periodontal Pathogenesis | 103 | ||
| Innate Immunity | 103 | ||
| Saliva | 103 | ||
| Epithelial Tissues | 104 | ||
| Gingival Crevicular Fluid | 105 | ||
| Pathogen Recognition and Activation of Cellular Innate Responses | 105 | ||
| Neutrophil Function | 105 | ||
| Adaptive Immunity | 106 | ||
| Antigen-Presenting Cells | 106 | ||
| T Cells | 106 | ||
| Antibodies | 109 | ||
| Concept of Host Susceptibility | 109 | ||
| References | 111 | ||
| References | 111.e2 | ||
| 8 Biofilm and Periodontal Microbiology | 112 | ||
| Abstract | 112.e1 | ||
| Keywords | 112.e1 | ||
| Chapter Outline | 112 | ||
| The Oral Cavity From a Microbe’s Perspective | 112 | ||
| Bacteria and Their Biofilm Mode of Living | 117 | ||
| Structure of a Mature Dental Plaque Biofilm | 119 | ||
| Accumulation of a Dental Plaque Biofilm | 122 | ||
| Formation of the Pellicle | 123 | ||
| Initial Adhesion/Attachment of Bacteria | 124 | ||
| Phase 1: Transport to the Surface | 124.e1 | ||
| Phase 2: Initial Adhesion | 124.e1 | ||
| Phase 3: Strong Attachment | 124.e1 | ||
| Colonization and Plaque Maturation | 124 | ||
| Factors That Affect Supragingival Dental Plaque Formation | 126 | ||
| Topography of Supragingival Plaque | 126 | ||
| Surface Microroughness | 127 | ||
| Individual Variables That Influence Plaque Formation | 127 | ||
| Variation Within the Dentition | 128 | ||
| Impact of Gingival Inflammation and Saliva | 128 | ||
| Impact of Patient’s Age | 128 | ||
| Spontaneous Tooth Cleaning | 129 | ||
| De Novo Subgingival Plaque Formation | 129 | ||
| Characteristics of Biofilm Bacteria (Life in “Slime City”) | 129 | ||
| Metabolism of Dental Plaque Bacteria | 129 | ||
| Communication Between Biofilm Bacteria | 130 | ||
| Interactions Among Dental Plaque Bacteria | 130 | ||
| Biofilms and Antimicrobial Resistance | 131 | ||
| Bacterial Transmission and Translocation | 131 | ||
| Nonbacterial Inhabitants of the Oral Cavity | 133 | ||
| Viruses | 133 | ||
| Herpesviruses | 133.e1 | ||
| Papillomaviruses | 133.e1 | ||
| Picornaviruses/Enteroviruses | 133.e1 | ||
| Retroviruses | 133.e1 | ||
| Clinical Manifestations of Oral Viral Diseases | 133 | ||
| Oral Ulcers | 133 | ||
| Oral Tumors | 133 | ||
| Other Oral Pathologies | 133 | ||
| Periodontitis | 135 | ||
| Fungi | 136 | ||
| Protozoa | 136 | ||
| Archaea | 137 | ||
| Microbiologic Specificity of Periodontal Diseases | 137 | ||
| Nonspecific Plaque Hypothesis | 137 | ||
| Specific Plaque Hypothesis | 138 | ||
| Ecologic Plaque Hypothesis | 138 | ||
| Keystone Pathogen Hypothesis and Polymicrobial Synergy and Dysbiosis Model | 139 | ||
| Complicating Factors | 139 | ||
| Criteria for the Identification of Periodontopathogens | 140.e1 | ||
| The Transition From Health to Disease | 140 | ||
| Host Susceptibility | 141 | ||
| Pathogenic Bacteria | 142 | ||
| Beneficial Species | 143 | ||
| Periodontal Health | 143 | ||
| Gingivitis | 145 | ||
| Chronic Periodontitis | 146 | ||
| Localized Aggressive Periodontitis | 146 | ||
| Aggressive Periodontitis | 147 | ||
| Necrotizing Periodontal Diseases | 147 | ||
| Abscesses of the Periodontium | 147 | ||
| Peri-implantitis | 147 | ||
| Virulence Factors of Periodontopathogens | 148 | ||
| Adhesive Surface Proteins and Fibrils | 149 | ||
| Tissue Destruction–Promoting Factors | 149 | ||
| Strategies for Evading Host Immunity | 149 | ||
| Future Advances in Periodontal Microbiology | 150 | ||
| References | 150 | ||
| References | 150.e4 | ||
| 9 Practical Molecular Biology of Host–Microbe Interactions | 151 | ||
| Abstract | 151.e1 | ||
| Keywords | 151.e1 | ||
| Chapter Outline | 151 | ||
| Microbe-Associated Molecular Patterns | 151 | ||
| Toll-Like Receptors | 153 | ||
| Toll-like Receptor-4–Lipopolysaccharide Recognition | 154 | ||
| Toll-like Receptor-2–Lipoprotein/Lipoteichoic Acid/Peptidoglycan Recognition | 154 | ||
| Toll-like Receptor-9–CpG-DNA Recognition | 154 | ||
| Role of Toll-like Receptors in Periodontitis | 154 | ||
| Nucleotide-Binding Oligomerization Domain–Like Receptors | 155 | ||
| NOD1/NOD2–Peptidoglycan Recognition | 155 | ||
| NLRP3–Inflammasome Complex | 155 | ||
| Role of NOD-like Receptors in Periodontitis | 155 | ||
| Complement System | 156 | ||
| Complement–Pattern-Recognition Receptor Signaling | 156 | ||
| Classical/Lectin/Alternative Pathways | 156 | ||
| Role of Complement in Periodontitis | 156 | ||
| Antimicrobial Peptides | 157 | ||
| Defensins and Cathelicidin LL-37 | 157 | ||
| Role of Antimicrobial Peptides in Periodontitis | 158 | ||
| Immunomodulatory Therapies | 158 | ||
| References | 158 | ||
| References | 158.e1 | ||
| 10 Resolution of Inflammation | 159 | ||
| Abstract | 159.e1 | ||
| Keywords | 159.e1 | ||
| Chapter Outline | 159 | ||
| Inflammation | 159 | ||
| Acute Inflammation Is Self-Limited | 160 | ||
| Specialized Lipid Mediators | 160 | ||
| Lipoxins | 161 | ||
| Resolvins | 161 | ||
| Protectins | 162 | ||
| Maresins | 162 | ||
| Unresolved Chronic Inflammation in Periodontal Diseases | 162 | ||
| Systemic Link | 163.e1 | ||
| Type 2 Diabetes | 163.e1 | ||
| Cardiovascular Diseases | 163.e1 | ||
| Cancer | 163.e2 | ||
| Pregnancy Outcomes | 163.e2 | ||
| Therapeutic Actions of Resolution Mediators | 163 | ||
| Final Remarks | 163 | ||
| References | 165 | ||
| References | 165.e2 | ||
| 11 Precision Dentistry | 166 | ||
| Chapter Outline | 166 | ||
| Genomic Advances in the 21st Century | 167 | ||
| Patterns in Populations and Pedigrees | 167 | ||
| Searching for Answers in the DNA | 170 | ||
| Genetic Basis for Individual Differences in Disease Risk | 172 | ||
| Periodontitis in Genetic Syndromes and Other Diseases | 173 | ||
| Nonsyndromic Aggressive and Chronic Periodontitis | 173 | ||
| Challenges and Opportunities for the Future | 177 | ||
| Precision Dentistry: Using Genetics for Personalized Treatment | 179 | ||
| Pharmacogenomics and Individualized Dentistry | 179 | ||
| Acknowledgments | 180 | ||
| References | 180 | ||
| References | 180.e2 | ||
| 12 Smoking and Periodontal Disease | 181 | ||
| Abstract | 181.e1 | ||
| Keywords | 181.e1 | ||
| Chapter Outline | 181 | ||
| The Smoking Epidemic | 181 | ||
| Effects of Smoking on the Prevalence and Severity of Periodontal Diseases | 182 | ||
| Gingivitis | 182 | ||
| Periodontitis | 182 | ||
| Effects of Smoking on the Etiology and Pathogenesis of Periodontal Disease | 184 | ||
| Microbiology | 184 | ||
| Immune–Inflammatory Responses | 186 | ||
| Physiology | 186 | ||
| Effects of Smoking on the Response to Periodontal Therapy | 187 | ||
| Nonsurgical Therapy | 187 | ||
| Surgical Therapy and Implants | 187 | ||
| Maintenance Therapy | 188 | ||
| Effects of Smoking Cessation on Periodontal Treatment Outcomes | 188 | ||
| References | 189 | ||
| References | 189.e3 | ||
| 13 The Role of Dental Calculus and Other Local Predisposing Factors | 190 | ||
| Abstract | 190.e1 | ||
| Keywords | 190.e1 | ||
| Chapter Outline | 190 | ||
| Calculus | 190 | ||
| Supragingival and Subgingival Calculus | 190 | ||
| Prevalence | 190 | ||
| Composition | 191 | ||
| Inorganic Content | 191 | ||
| Organic Content | 192 | ||
| Attachment to the Tooth Surface | 192 | ||
| Formation | 192 | ||
| Theories Regarding the Mineralization of Calculus | 194 | ||
| Role of Microorganisms in the Mineralization of Calculus | 194 | ||
| Etiologic Significance | 194 | ||
| Materia Alba, Food Debris, and Dental Stains | 195 | ||
| Other Predisposing Factors | 195 | ||
| Iatrogenic Factors | 195 | ||
| Margins of Restorations | 196 | ||
| Retained Cement and Periimplantitis | 197 | ||
| Contours and Open Contacts | 198 | ||
| Materials | 199 | ||
| Design of Removable Partial Dentures | 199 | ||
| Restorative Dentistry Procedures | 199 | ||
| Malocclusion | 199 | ||
| Periodontal Complications Associated With Orthodontic Therapy | 200 | ||
| Plaque Retention and Composition | 200 | ||
| Gingival Trauma and Alveolar Bone Height | 200 | ||
| Tissue Response to Orthodontic Forces | 201 | ||
| Extraction of Impacted Third Molars | 202 | ||
| Habits and Self-Inflicted Injuries | 203 | ||
| Trauma Associated With Oral Jewelry | 203 | ||
| Toothbrush Trauma | 203 | ||
| Chemical Irritation | 204 | ||
| Smokeless Tobacco | 204 | ||
| Radiation Therapy | 206 | ||
| References | 207 | ||
| References | 207.e2 | ||
| IV Relationship between Periodontal Disease and Systemic Heath | 208 | ||
| 14 Influence of Systemic Conditions | 208 | ||
| Abstract | 208.e1 | ||
| Keywords | 208.e1 | ||
| Chapter Outline | 208 | ||
| Endocrine Disorders and Hormonal Changes | 208 | ||
| Diabetes Mellitus | 208 | ||
| Oral Manifestations | 209 | ||
| Bacterial Pathogens | 210 | ||
| Polymorphonuclear Leukocyte Function | 211 | ||
| Altered Collagen Metabolism | 211 | ||
| Metabolic Syndrome | 212 | ||
| Female Sex Hormones | 212 | ||
| Puberty | 212.e1 | ||
| Menstruation | 212.e1 | ||
| Pregnancy | 212.e1 | ||
| Hormonal Contraceptives | 212.e2 | ||
| Menopause | 212.e2 | ||
| Hyperparathyroidism | 212.e2 | ||
| Hematologic Disorders and Immune Deficiencies | 213 | ||
| Leukocyte (Neutrophil) Disorders | 213 | ||
| Neutropenia | 213 | ||
| Agranulocytosis | 213 | ||
| Leukemia | 214 | ||
| The Periodontium in Leukemic Patients | 214 | ||
| Leukemic Infiltration | 214 | ||
| Bleeding | 216 | ||
| Oral Ulceration and Infection | 216 | ||
| Anemia | 218.e1 | ||
| Thrombocytopenia | 218.e1 | ||
| Antibody Deficiency Disorders | 218.e2 | ||
| Genetic Disorders | 218 | ||
| Chédiak–Higashi Syndrome | 218.e2 | ||
| Lazy Leukocyte Syndrome | 218.e2 | ||
| Leukocyte Adhesion Deficiency | 218.e2 | ||
| Papillon–Lefèvre Syndrome | 218.e2 | ||
| Down Syndrome | 218.e3 | ||
| Stress and Psychosomatic Disorders | 218 | ||
| Psychosocial Stress, Depression, and Coping | 218 | ||
| Stress-Induced Immunosuppression | 219 | ||
| Influence of Stress on Periodontal Therapy Outcomes | 219 | ||
| Psychiatric Influence of Self-Inflicted Injury | 219 | ||
| Nutritional Influences | 219 | ||
| Fat-Soluble Vitamin Deficiency | 220.e1 | ||
| Vitamin A Deficiency | 220.e1 | ||
| Vitamin D Deficiency | 220.e1 | ||
| Vitamin E Deficiency | 220.e1 | ||
| Water-Soluble Vitamin Deficiency | 220.e1 | ||
| B-Complex Deficiency | 220.e1 | ||
| Vitamin C Deficiency | 220.e2 | ||
| Possible Etiologic Factors | 220.e2 | ||
| Epidemiologic Studies | 220.e2 | ||
| Gingivitis | 220.e2 | ||
| Periodontitis | 220.e2 | ||
| Summary | 220.e3 | ||
| Protein Deficiency | 220.e3 | ||
| Medications | 220 | ||
| Bisphosphonates | 220 | ||
| Bisphosphonates and Periodontal Bone Loss | 223 | ||
| Corticosteroids | 223 | ||
| Other Systemic Conditions | 224.e1 | ||
| Osteoporosis | 224.e1 | ||
| Congenital Heart Disease | 224.e2 | ||
| Tetralogy of Fallot | 224.e2 | ||
| Eisenmenger Syndrome | 224.e2 | ||
| Hypophosphatasia | 224.e2 | ||
| Metal Intoxication | 224.e3 | ||
| Bismuth Intoxication | 224.e3 | ||
| Lead Intoxication | 224.e3 | ||
| Mercury Intoxication | 224.e3 | ||
| Other Chemicals | 224.e3 | ||
| Conclusion | 224 | ||
| References | 224 | ||
| References | 224.e5 | ||
| 15 Impact of Periodontal Infection on Systemic Health | 225 | ||
| Chapter Outline | 225 | ||
| Pathobiology of Periodontitis | 225 | ||
| Focal Infection Theory Revisited | 226 | ||
| Evidence-Based Clinical Practice | 226 | ||
| Subgingival Environment as a Reservoir for Bacteria | 228 | ||
| Periodontal Disease and Mortality | 228 | ||
| Periodontal Disease, Coronary Heart Disease, and Atherosclerosis | 228 | ||
| Effects of Periodontal Infection | 229 | ||
| Ischemic Heart Disease | 229 | ||
| Systemic Infections | 230 | ||
| Daily Activity | 230 | ||
| Thrombogenesis | 230 | ||
| Atherosclerosis | 231 | ||
| Role of Periodontal Disease in Atherosclerotic Myocardial or Cerebral Ischemia | 231 | ||
| Role of Periodontal Disease in Erectile Dysfunction | 233 | ||
| Periodontal Disease and Stroke | 233 | ||
| Periodontal Infection Associated With Stroke | 233 | ||
| Periodontal Disease and Diabetes Mellitus | 233 | ||
| Periodontal Infection Associated With Glycemic Control in Diabetes | 234 | ||
| Periodontal Disease and Pregnancy Outcome | 235.e1 | ||
| Bacterial Vaginosis | 235.e1 | ||
| Role of Periodontitis | 235.e2 | ||
| Periodontal Disease and Chronic Obstructive Pulmonary Disease | 235.e3 | ||
| Periodontal Disease and Acute Respiratory Infections | 235.e4 | ||
| Periodontal Disease and Asthma | 235 | ||
| Periodontal Medicine in Clinical Practice | 235 | ||
| Periodontal Disease and Systemic Health | 235 | ||
| Patient Education | 235 | ||
| Conclusions | 236 | ||
| References | 236 | ||
| References | 236.e3 | ||
| V Gingival Pathology | 237 | ||
| 16 Defense Mechanisms of the Gingiva | 237 | ||
| Abstract | 237.e1 | ||
| Keywords | 237.e1 | ||
| Chapter Outline | 237 | ||
| Sulcular Fluid | 237 | ||
| Methods of Collection | 237 | ||
| Permeability of Junctional and Sulcular Epithelia | 237 | ||
| Amount | 238 | ||
| Composition | 238 | ||
| Cellular Elements | 239 | ||
| Electrolytes | 239 | ||
| Organic Compounds | 239 | ||
| Cellular and Humoral Activity in Gingival Crevicular Fluid | 239 | ||
| Clinical Significance | 239 | ||
| Circadian Periodicity | 239 | ||
| Sex Hormones | 239 | ||
| Mechanical Stimulation | 239 | ||
| Smoking | 239 | ||
| Periodontal Therapy | 239 | ||
| Drugs in Gingival Crevicular Fluid | 239 | ||
| Leukocytes in the Dentogingival Area | 240 | ||
| Saliva | 240 | ||
| Antibacterial Factors | 241 | ||
| Salivary Antibodies | 241 | ||
| Enzymes | 241 | ||
| Salivary Buffers and Coagulation Factors | 241 | ||
| Leukocytes | 241 | ||
| Role in Periodontal Pathology | 242 | ||
| References | 242 | ||
| References | 242.e2 | ||
| 17 Gingival Inflammation | 243 | ||
| Abstract | 243.e1 | ||
| Keywords | 243.e1 | ||
| Chapter Outline | 243 | ||
| Stage I Gingival Inflammation: The Initial Lesion | 243 | ||
| Stage II Gingival Inflammation: The Early Lesion | 244 | ||
| Stage III Gingival Inflammation: The Established Lesion | 244 | ||
| Stage IV Gingival Inflammation: The Advanced Lesion | 247 | ||
| References | 247 | ||
| References | 247.e1 | ||
| 18 Clinical Features of Gingivitis | 248 | ||
| Keywords | 248.e1 | ||
| Chapter Outline | 248 | ||
| Course and Duration | 248 | ||
| Description | 248 | ||
| Clinical Findings | 249 | ||
| Gingival Bleeding on Probing | 249 | ||
| Gingival Bleeding Caused by Local Factors | 250 | ||
| Chronic and Recurrent Bleeding | 250 | ||
| Gingival Bleeding Associated With Systemic Changes | 251 | ||
| Color Changes in the Gingiva | 251 | ||
| Color Changes With Gingivitis | 251 | ||
| Metallic Pigmentation | 252 | ||
| Color Changes Associated With Systemic Factors | 252 | ||
| Changes in Gingival Consistency | 252 | ||
| Calcified Masses in the Gingiva | 252 | ||
| Toothbrushing | 253 | ||
| Changes in Gingival Surface Texture | 253 | ||
| Changes in Gingival Position | 253 | ||
| Traumatic Lesions | 253 | ||
| Gingival Recession | 254 | ||
| Positions of the Gingiva | 254 | ||
| Clinical Significance | 255 | ||
| Changes in Gingival Contour | 255 | ||
| References | 255 | ||
| References | 255.e3 | ||
| 19 Gingival Enlargement | 256 | ||
| Abstract | 256.e1 | ||
| Keywords | 256.e1 | ||
| Chapter Outline | 256 | ||
| Terminology and Classification | 256 | ||
| Diagnosis | 257 | ||
| Types of Gingival Enlargement | 257 | ||
| Inflammatory Enlargement of Gingiva Due to Gingivitis | 257 | ||
| Clinical Manifestations | 257 | ||
| Etiology | 257 | ||
| Histopathology | 258 | ||
| Treatment | 259 | ||
| Drug-Induced Overgrowth of Gingiva | 259 | ||
| Anticonvulsants | 260 | ||
| Calcium Channel Blockers | 260 | ||
| Immunosuppressants | 260 | ||
| Histopathology | 260 | ||
| Pathogenesis of Drug-Induced Gingival Overgrowth | 260 | ||
| Treatment | 261 | ||
| Gingival Overgrowth Associated With Systemic Conditions | 262 | ||
| Pregnancy-Associated Gingival Overgrowth | 262 | ||
| Clinical Manifestations | 262 | ||
| Etiology | 262 | ||
| 3 Clinical Periodontics | 374 | ||
| I Diagnosis, Prognosis, and Treatment Plan | 374 | ||
| 31 Levels of Clinical Significance | 374 | ||
| Abstract | 374.e1 | ||
| Keywords | 374.e1 | ||
| Chapter Outline | 374 | ||
| Tangible Versus Intangible Benefits | 374 | ||
| Size of the Treatment Effect | 375 | ||
| Defining Four Levels of Clinical Significance | 375 | ||
| Clinical Significance Level 1 | 375 | ||
| Clinical Significance Level 2 | 376 | ||
| Clinical Significance Level 3 | 376 | ||
| Clinical Significance Level 4 | 377 | ||
| Summary | 377 | ||
| References | 377 | ||
| References | 377.e1 | ||
| 32 Periodontal Examination and Diagnosis | 378 | ||
| Abstract | 378.e1 | ||
| Keywords | 378.e1 | ||
| Chapter Outline | 378 | ||
| Overall Appraisal of the Patient | 378 | ||
| Health History | 378 | ||
| Dental History | 381 | ||
| Chief Complaint and Current Illness | 381 | ||
| Photographic Documentation | 381 | ||
| Clinical Examination | 381 | ||
| Examination of Extraoral Structures | 381 | ||
| Examination of the Oral Cavity | 382 | ||
| Examination of the Periodontium | 382 | ||
| Visual Periodontal Examination | 383 | ||
| Visual Examination of Biofilm and Calculus | 383 | ||
| Visual Examination of the Gingiva | 383 | ||
| Gingival Recession | 384 | ||
| Tactile Periodontal Examination | 385 | ||
| Tactile Examination of the Marginal Gingiva | 385 | ||
| Marginal Bleeding | 386 | ||
| Suppuration | 386 | ||
| Tactile Examination of the Gingival Crevice | 387 | ||
| Probing Around Implants | 387 | ||
| When Not to Probe | 387 | ||
| Probing Depth | 387 | ||
| Automatic and Electronic Periodontal Probing | 388.e1 | ||
| Probing Force | 388.e1 | ||
| Probe Angulation | 388.e1 | ||
| Bleeding on Probing | 388 | ||
| Pain on Probing | 389 | ||
| Attachment Loss | 389 | ||
| Attachment Level | 389 | ||
| Attached Gingiva | 389 | ||
| Periodontal Charting | 390.e1 | ||
| Use of Clinical Indices in Dental Practice | 390.e1 | ||
| Periodontal Pockets | 390.e1 | ||
| Signs and Symptoms | 390.e1 | ||
| Detection of Periodontal Pockets | 390.e1 | ||
| Determination of Disease Activity | 390.e1 | ||
| Alveolar Bone Loss | 390.e1 | ||
| Furcation Invasion | 390.e1 | ||
| Periodontal Abscess | 390.e3 | ||
| Periodontal Abscess and Gingival Abscess | 390.e3 | ||
| Periodontal Abscess and Periapical Abscess | 390.e3 | ||
| Examination of the Teeth and Implants | 390 | ||
| Wasting Disease of the Teeth | 390 | ||
| Dental Stains | 391 | ||
| Hypersensitivity | 391 | ||
| Proximal Contact Relations | 391 | ||
| Tooth Mobility | 391 | ||
| Trauma From Occlusion | 392 | ||
| Pathologic Migration of the Teeth | 392 | ||
| Sensitivity to Percussion | 392 | ||
| Dentition With the Jaws Closed | 392 | ||
| Functional Occlusal Relationships | 393 | ||
| Radiographic Examination | 393 | ||
| Laboratory Aids to Clinical Diagnosis | 393 | ||
| Periodontal Diagnosis | 393 | ||
| Assessment of Biofilm Control and Patient Education | 396 | ||
| Conclusion | 396 | ||
| References | 396 | ||
| References | 396.e2 | ||
| 33 Radiographic Aids in the Diagnosis of Periodontal Disease | 397 | ||
| Abstract | 397.e1 | ||
| Keywords | 397.e1 | ||
| Chapter Outline | 397 | ||
| Normal Interdental Bone | 397 | ||
| Radiographic Techniques | 397 | ||
| Bone Destruction in Periodontal Disease | 398 | ||
| Bone Loss | 399 | ||
| Amount | 399 | ||
| Distribution | 399 | ||
| Pattern of Bone Destruction | 399 | ||
| Radiographic Appearance of Periodontal Disease | 402 | ||
| Periodontitis | 402 | ||
| Interdental Craters | 402 | ||
| Furcation Involvement | 403 | ||
| Periodontal Abscess | 403 | ||
| Clinical Probing | 404 | ||
| Localized Aggressive Periodontitis | 405 | ||
| Trauma From Occlusion | 405 | ||
| Digital Intraoral Radiography | 406 | ||
| Advanced Imaging Modalities | 406 | ||
| Conclusion | 408 | ||
| References | 409 | ||
| References | 409.e3 | ||
| 34 Clinical Risk Assessment | 410 | ||
| Abstract | 410.e1 | ||
| Keywords | 410.e1 | ||
| Chapter Outline | 410 | ||
| Definitions | 410 | ||
| Risk Factors for Periodontal Disease | 410 | ||
| Tobacco Smoking | 410 | ||
| Diabetes | 410 | ||
| Pathogenic Bacteria and Microbial Tooth Deposits | 410 | ||
| Risk Determinants/Background Characteristics for Periodontal Disease | 411 | ||
| Genetic Factors | 411 | ||
| Age | 411 | ||
| Gender | 411 | ||
| Socioeconomic Status | 412 | ||
| Stress | 412 | ||
| Risk Indicators for Periodontal Disease | 412.e1 | ||
| Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome | 412.e1 | ||
| Osteoporosis | 412.e1 | ||
| Infrequent Dental Visits | 412.e1 | ||
| Risk Markers/Predictors for Periodontal Disease | 412.e1 | ||
| Previous History of Periodontal Disease | 412.e1 | ||
| Bleeding on Probing | 412.e1 | ||
| Clinical Risk Assessment for Periodontal Disease | 412.e1 | ||
| Conclusion | 412 | ||
| References | 412 | ||
| References | 412.e4 | ||
| 35 Determination of Prognosis | 413 | ||
| Abstract | 413.e1 | ||
| Keywords | 413.e1 | ||
| Chapter Outline | 413 | ||
| Definitions | 413 | ||
| Types of Prognosis | 413 | ||
| Overall Versus Individual Tooth Prognosis | 414 | ||
| Factors in Determination of Prognosis | 414 | ||
| Overall Clinical Factors | 414 | ||
| Patient Age | 414 | ||
| Disease Severity | 414 | ||
| Biofilm Control | 417 | ||
| Patient Compliance and Cooperation | 418 | ||
| Systemic and Environmental Factors | 418 | ||
| Smoking | 418 | ||
| Systemic Disease or Condition | 418 | ||
| Genetic Factors | 418 | ||
| Stress | 418 | ||
| Local Factors | 418 | ||
| Biofilm and Calculus | 418 | ||
| Subgingival Restorations | 419 | ||
| Anatomic Factors | 419 | ||
| Tooth Mobility | 419 | ||
| Caries, Tooth Vitality, and Root Resorption | 419 | ||
| Prosthetic and Restorative Factors | 419 | ||
| Prognosis of Specific Periodontal Diseases | 421 | ||
| Prognosis for Patients With Gingival Disease | 422 | ||
| Biofilm-Induced Gingival Diseases | 422 | ||
| Gingivitis Associated With Dental Plaque Only | 422 | ||
| Biofilm-Induced Gingival Diseases Modified by Systemic Factors | 422 | ||
| Biofilm-Induced Gingival Diseases Modified by Medications | 422 | ||
| Gingival Diseases Modified by Malnutrition | 423 | ||
| Non–Biofilm-Induced Gingival Lesions | 423 | ||
| Prognosis for Patients With Periodontitis | 423 | ||
| Chronic Periodontitis | 423 | ||
| Aggressive Periodontitis | 423 | ||
| Periodontitis as a Manifestation of Systemic Diseases | 423 | ||
| Necrotizing Periodontal Disease | 424 | ||
| Determination and Reassessment of Prognosis | 424 | ||
| Conclusion | 425 | ||
| References | 425 | ||
| References | 425.e1 | ||
| 36 The Treatment Plan | 426 | ||
| Abstract | 426.e1 | ||
| Keywords | 426.e1 | ||
| Chapter Outline | 426 | ||
| Overall Treatment Plan | 427 | ||
| Extracting or Preserving a Tooth | 427 | ||
| Sequence of Therapy | 427 | ||
| Explaining the Treatment Plan to the Patient | 427 | ||
| Conclusion | 429 | ||
| 37 Electronic Dental Records and Decision Support Systems | e1 | ||
| Abstract | e1.e1 | ||
| Keywords | e1.e1 | ||
| Chapter Outline | e1 | ||
| Functionalities and Components Available in Electronic Dental Records | e1 | ||
| Patient Registration | e1 | ||
| Periodontal Chart | e1 | ||
| Electronic Dental Record Use in Dental Practices | e1 | ||
| Commonly Used Electronic Dental Records | e3 | ||
| Barriers to Using Electronic Dental Records | e3 | ||
| Limited Functionality for Communication and Collaboration | e4 | ||
| Suboptimal Usability and Steep Learning Curve | e4 | ||
| Insufficient Reliability of Electronic Dental Records and Infection Control Issues | e4 | ||
| Challenges to Realizing the Full Potential of Electronic Dental Records | e4 | ||
| Standards for the Information Content of Electronic Dental Records | e4 | ||
| Data Representation and Interoperability | e4 | ||
| Benefits of Using Electronic Dental Records | e4 | ||
| Reusing Electronic Dental Records Data for Research Purposes | e4 | ||
| Clinical Decision Support Systems | e4 | ||
| Decision Support System Types | e4 | ||
| Risk-Based Decision Support Systems for Periodontal Disease | e5 | ||
| Barriers to the Adoption of Clinical Decision Support Systems | e5 | ||
| Factors That Improve the Adoption of Clinical Decision Support Systems | e5 | ||
| Future of Electronic Dental Records and Decision Support Systems in Dentistry | e5 | ||
| References | e5 | ||
| II Management of Patients with Special Needs | 431 | ||
| 38 Conscious Sedation | 431 | ||
| Abstract | 431.e1 | ||
| Keywords | 431.e1 | ||
| Chapter Outline | 431 | ||
| Rationale for Sedation During Periodontal and Implant Surgical Procedures | 431 | ||
| American Dental Association Policy Statement and Guidelines for Conscious Sedation | 431 | ||
| 4 Oral Implantology | 732 | ||
| I Biology, Diagnosis, Biomechanics, and Treatment Plan | 732 | ||
| 74 Peri-implant Anatomy, Biology, and Function | 732 | ||
| Abstract | 732.e1 | ||
| Key Words | 732.e1 | ||
| Chapter Outline | 732 | ||
| Implant Geometry (Macrodesign) | 732 | ||
| Blade Implants | 733.e1 | ||
| Pins | 733.e1 | ||
| Disk Implants | 733.e1 | ||
| Root Form (Cylindrical) Implants | 733.e1 | ||
| Transmandibular Implants | 733.e2 | ||
| Subperiosteal Implants | 733.e2 | ||
| Implant Surface Characteristics (Microdesign) | 733.e2 | ||
| Additive Processes | 733.e3 | ||
| Subtractive Processes | 733.e4 | ||
| Implant Surface Chemical Composition | 733.e4 | ||
| Implant Surface Free Energy and Microscopic Roughness | 733.e6 | ||
| Hard Tissue Interface | 733 | ||
| Initial Bone Healing | 733 | ||
| Bone Remodeling and Function | 734 | ||
| Soft Tissue Interface | 735 | ||
| Epithelium | 735 | ||
| Connective Tissue | 735 | ||
| Keratinized Tissue | 736 | ||
| Vascular Supply and Inflammation | 738 | ||
| Clinical Comparison of Teeth and Implants | 739 | ||
| Conclusion | 740 | ||
| References | 740 | ||
| References | 740.e2 | ||
| 75 Clinical Evaluation of the Implant Patient | 741 | ||
| Abstract | 741.e1 | ||
| Keywords | 741.e1 | ||
| Chapter Outline | 741 | ||
| Case Types and Indications | 741 | ||
| Edentulous Patients | 741 | ||
| Partially Edentulous Patients | 742 | ||
| Multiple Teeth | 742 | ||
| Single Tooth | 744 | ||
| Aesthetic Considerations | 744 | ||
| Pretreatment Evaluation | 744 | ||
| Chief Complaint | 745 | ||
| Medical History | 745 | ||
| Dental History | 746 | ||
| Intraoral Examination | 746 | ||
| Diagnostic Study Models | 746 | ||
| Hard Tissue Evaluation | 746 | ||
| Radiographic Examination | 749 | ||
| Soft Tissue Evaluation | 749 | ||
| Risk Factors and Contraindications | 749 | ||
| Medical and Systemic Health–Related Issues | 749 | ||
| Diabetes Mellitus | 749 | ||
| Bone Metabolic Disease | 750 | ||
| Bisphosphonate Therapy | 750 | ||
| Immune Compromise and Immune Suppression | 751 | ||
| Radiation Therapy | 751 | ||
| Psychological and Mental Conditions | 751 | ||
| Habits and Behavioral Considerations | 751 | ||
| Smoking and Tobacco Use | 751 | ||
| Parafunctional Habits | 751 | ||
| Substance Abuse | 751 | ||
| Posttreatment Evaluation | 751 | ||
| Conclusion | 752 | ||
| References | 752 | ||
| References | 752.e2 | ||
| 76 Diagnostic Imaging for the Implant Patient | 753 | ||
| Abstract | 753.e1 | ||
| Key Words | 753.e1 | ||
| Chapter Outline | 753 | ||
| Standard Projections | 753 | ||
| Periapical Radiographs | 753 | ||
| Occlusal Radiographs | 753 | ||
| Panoramic Radiographs | 754 | ||
| Cross-Sectional Imaging | 755 | ||
| Cone-Beam Computed Tomography | 755 | ||
| Multislice Computed Tomography | 755 | ||
| Interactive “Simulation” Software Programs | 757 | ||
| Patient Evaluation | 757 | ||
| Exclude Pathology | 762 | ||
| Identify Anatomic Structures | 762 | ||
| Assess Bone Quantity, Quality, and Volume | 762 | ||
| Evaluate Relation of Alveolar Ridge With Existing Teeth and Desired Implant Position | 764 | ||
| Clinical Selection of Diagnostic Imaging | 764 | ||
| Clinical Examination | 764 | ||
| Screening Radiographs | 766 | ||
| Fabrication of Radiographic and Surgical Guides | 766 | ||
| Cross-Sectional Imaging | 766 | ||
| Intraoperative and Postoperative Radiographic Assessment | 766 | ||
| Conclusion | 768 | ||
| References | 768 | ||
| References | 768.e3 | ||
| 77 Prosthetic Considerations for Implant Treatment | 769 | ||
| Abstract | 769.e1 | ||
| Keywords | 769.e1 | ||
| Chapter Outline | 769 | ||
| Implant Considerations | 769 | ||
| Understanding the Anticipated Load on the System and Its Relation to Implant Diameter | 769 | ||
| Number of Implants | 770 | ||
| Implant-Abutment Connection | 770 | ||
| Abutment/Prosthesis Considerations for Single Units | 774 | ||
| Retention Method for Partially Edentulous Treatment: Cemented Prostheses, Screw-Retained Porcelain-Fused-to-Metal Options, Screw-Retained Full Contour Zirconia, and Hybrid Designs | 774 | ||
| Abutment Material Selection | 777 | ||
| Abutment Design and Emergence Profile | 779 | ||
| Covering the Screw Access | 780.e1 | ||
| Splinting Adjacent Implants | 780 | ||
| Management of Partially Edentulous Implant Treatment in the Aesthetic Zone | 781 | ||
| Diagnosis and Treatment Planning | 781 | ||
| Implant-Retained Provisional Restorations | 782.e1 | ||
| Tissue Shaping and Management | 782 | ||
| Customized Impression Copings | 783.e1 | ||
| Fully Edentulous: Prosthetic Considerations | 783.e1 | ||
| Edentulous Maxilla | 783.e1 | ||
| Edentulous Mandible | 783.e4 | ||
| Conclusion | 783 | ||
| References | 783 | ||
| References | 783.e8 | ||
| II Surgical Procedures | 784 | ||
| 78 Basic Implant Surgical Procedures | 784 | ||
| Abstract | 784.e1 | ||
| Keywords | 784.e1 | ||
| Chapter Outline | 784 | ||
| General Principles of Implant Surgery | 784 | ||
| Patient Preparation | 784 | ||
| Implant Site Preparation | 784 | ||
| One-Stage Versus Two-Stage Implant Placement Surgery | 784 | ||
| Two-Stage “Submerged” Implant Placement | 785 | ||
| Flap Design, Incisions, and Elevation | 786 | ||
| Implant Site Preparation | 788 | ||
| Round Bur | 788 | ||
| The 2-mm Twist Drill | 788 | ||
| Pilot Drill | 788 | ||
| The 3-mm Twist Drill | 788 | ||
| Countersink Drill (Optional) | 789 | ||
| Bone Tap (Optional) | 789 | ||
| Implant Placement | 789 | ||
| Flap Closure and Suturing | 789 | ||
| Postoperative Care | 790 | ||
| Second-Stage Exposure Surgery | 790 | ||
| Simple Circular “Punch” or Crestal Incision | 790 | ||
| Partial-Thickness Repositioned Flap | 790 | ||
| Postoperative Care | 792 | ||
| One-Stage “Nonsubmerged” Implant Placement | 792 | ||
| Flap Design, Incisions, and Elevation | 792 | ||
| Implant Site Preparation | 792 | ||
| Flap Closure and Suturing | 793 | ||
| Postoperative Care | 793 | ||
| Conclusion | 793 | ||
| References | 793 | ||
| References | 793.e2 | ||
| 79 Localized Bone Augmentation and Implant Site Development | 794 | ||
| Abstract | 794.e1 | ||
| Keywords | 794.e1 | ||
| Chapter Outline | 794 | ||
| Guided Bone Regeneration | 794.e2 | ||
| Barrier Membranes | 794.e2 | ||
| Nonresorbable Barrier Membranes | 794.e2 | ||
| Resorbable Barrier Membranes | 794.e3 | ||
| Bone Graft Materials | 794.e3 | ||
| Autogenous Bone | 794.e3 | ||
| Localized Ridge Augmentation | 794 | ||
| Flap Management | 794 | ||
| Horizontal Bone Augmentation | 795 | ||
| Particulate Bone Graft | 795 | ||
| Monocortical Block Graft | 795 | ||
| Procedure | 797 | ||
| Simultaneous Implant Placement | 797 | ||
| Complications | 799 | ||
| Alveolar Ridge Preservation/Management of Extractions | 802 | ||
| Delayed Implant Placement | 802 | ||
| Staged Implant Placement | 803 | ||
| Delayed Versus Staged Technique | 803 | ||
| Immediate Implant Placement | 803 | ||
| Conclusion | 805 | ||
| References | 805 | ||
| References | 805.e2 | ||
| 80 Advanced Implant Surgical Procedures | 806 | ||
| Abstract | 806.e1 | ||
| Key Words | 806.e1 | ||
| Chapter Outline | 806 | ||
| Maxillary Sinus Elevation and Bone Augmentation | 806 | ||
| Indications and Contraindications | 806 | ||
| Surgical Procedures for Sinus Elevation | 807 | ||
| Presurgical Evaluation of Maxillary Sinus | 807 | ||
| Simultaneous Implant Placement | 807 | ||
| Bone Graft Materials | 808 | ||
| Crestal Osteotomy Technique | 808 | ||
| Procedure | 808 | ||
| Lateral Window Technique | 809 | ||
| Risks and Complications | 812 | ||
| Supracrestal/Vertical Bone Augmentation | 813 | ||
| Guided Bone Regeneration | 813 | ||
| Distraction Osteogenesis | 815.e1 | ||
| Growth Factors in Bone Augmentation | 815.e1 | ||
| Bone Morphogenetic Proteins | 815.e1 | ||
| Autologous Platelet Concentration | 815.e1 | ||
| Conclusion | 815 | ||
| References | 816 | ||
| References | 816.e2 | ||
| 81 Aesthetic Management of Difficult Cases (Minimally Invasive Approach) | 817 | ||
| Abstract | 817.e1 | ||
| Keywords | 817.e1 | ||
| Chapter Outline | 817 | ||
| Surgical Strategy for Predictable Aesthetics | 818 | ||
| Determine the Level of Surgical Aesthetic Goal | 818.e1 | ||
| Visualize the Final Outcome | 818.e1 | ||
| Preserve Existing Tissues Important for Aesthetics | 818.e1 | ||
| Always Overbuild Bone and Soft Tissue in Augmentation Surgery | 818.e1 | ||
| Immediate Implant Placement for Predictability and Aesthetics | 818 | ||
| Surgical Management of Difficult Cases (Minimally Invasive Approach) | 820 | ||
| Components of Aesthetic Examination | 820 | ||
| Case Presentation 1 | 820 | ||
| Patient Dental History and Chief Complaint | 820 | ||
| Examination and Diagnosis | 820 | ||
| Treatment Objectives | 820 | ||
| Treatment Options | 820 | ||
| Surgical Strategy for Predictable Aesthetics | 821 | ||
| Treatment Plan and Rationale | 822 | ||
| Treatment Sequence | 822 | ||
| Surgical Procedure | 822 | ||
| Results | 822 | ||
| Case Presentation 2 | 823.e1 | ||
| Dental History and Chief Complaint | 823.e1 | ||
| Examination and Diagnosis | 823.e1 | ||
| Treatment Objectives | 823.e1 | ||
| Treatment Options | 823.e1 | ||
| Surgical Strategy for Predictable Aesthetics | 823.e2 | ||
| Treatment Plan and Rationale | 823.e3 | ||
| Treatment Sequence | 823.e3 | ||
| Surgical Procedure | 823.e3 | ||
| Results | 823.e4 | ||
| Case Presentation 3 | 823.e4 | ||
| Dental History and Chief Complaint | 823.e4 | ||
| Examination and Diagnosis | 823.e4 | ||
| Treatment Objectives | 823.e6 | ||
| Treatment Options | 823.e6 | ||
| Treatment Plan and Rationale | 823.e6 | ||
| Treatment Sequence | 823.e6 | ||
| Surgical Procedure | 823.e6 | ||
| Results | 823.e6 | ||
| Conclusion | 823 | ||
| References | 823 | ||
| References | 823.e8 | ||
| 82 Dental Implant Microsurgery | 824 | ||
| Abstract | 824.e1 | ||
| Key Words | 824.e1 | ||
| Chapter Outline | 824 | ||
| Implant Microsurgery | 824 | ||
| Microsurgical Tooth Extraction | 824 | ||
| Implant Drilling in the Extraction Site | 824 | ||
| Bone Grafting | 825 | ||
| Buccal Gingival Grafting | 826 | ||
| Immediate Provisional Fabrication | 826 | ||
| Immediate Implant Occlusion | 827 | ||
| Custom Impression Transfer Coping | 827 | ||
| Final Implant Restoration | 828 | ||
| Conclusion | 829 | ||
| References | 829 | ||
| References | 829.e1 | ||
| 83 Piezoelectric Bone Surgery | 830 | ||
| Abstract | 830.e1 | ||
| Key Words | 830.e1 | ||
| Chapter Outline | 830 | ||
| Clinical Characteristics of Ultrasonic Cutting | 831 | ||
| Microprecision | 831 | ||
| Selective Cutting | 831 | ||
| Maximum Visibility | 832 | ||
| Excellent Healing | 833 | ||
| Improved Hard Tissue Healing | 833 | ||
| Improved Soft Tissue Healing | 833 | ||
| Clinical Applications | 833 | ||
| Periodontal Surgery | 833 | ||
| Crown Lengthening | 834 | ||
| Tooth Extraction | 836 | ||
| Implant Site Preparation | 837 | ||
| Advanced Clinical Applications | 839.e1 | ||
| Sinus Lift | 839.e1 | ||
| Ridge Expansion | 839.e1 | ||
| Bone Harvesting | 839.e3 | ||
| Particulate Bone Chip Harvesting Technique | 839.e3 | ||
| Clinical Note | 839.e4 | ||
| Block Harvesting Technique | 839.e4 | ||
| Conclusion | 839 | ||
| References | 839 | ||
| References | 839.e7 | ||
| 84 Digitally Assisted Implant Surgery | 840 | ||
| Abstract | 840.e1 | ||
| Keywords | 840.e1 | ||
| Chapter Outline | 840 | ||
| Digitally Assisted Implant Surgery | 840 | ||
| Real-Time Micro Positioning Implant Surgery: Overview | 840 | ||
| Uses and Requirements | 840 | ||
| Sequence of Steps | 841 | ||
| Data Acquisition and Registration | 842 | ||
| Navigation and Positional Tracking | 842 | ||
| External Viewer, Augmented Reality, and Three-Dimensional Projection Screens | 842 | ||
| Technical Principles and Limitations | 844.e1 | ||
| Cone Beam Computed Tomography and Computed Tomography Scan Limitations | 844.e1 | ||
| Trackers | 844.e1 | ||
| Registration: A Mathematical Complexity | 844 | ||
| Tracking Device | 845 | ||
| Clinical Advantages of RTMIS | 845 | ||
| Challenges With RTMIS | 845 | ||
| Benefit of Ultrasound Mapping | 845 | ||
| Advantages and Limitations of Bone Ultrasound Mapping | 845.e1 | ||
| System Risk Analysis | 845.e2 | ||
| Safety | 845.e2 | ||
| Availability | 845.e2 | ||
| Robustness or Accuracy of the Whole System | 845.e2 | ||
| Conclusion | 845 | ||
| References | 845 | ||
| References | 845.e4 | ||
| III Complications | 846 | ||
| 85 Implant-Related Complications and Failures | 846 | ||
| Abstract | 846.e1 | ||
| Keyword | 846.e1 | ||
| Chapter Outline | 846 | ||
| Definitions of Implant Survival and Success | 846 | ||
| Types and Prevalence of Implant Complications | 847 | ||
| Types of Dental Implants | 848 | ||
| Surgical Complications | 848 | ||
| Hemorrhage and Hematoma | 848 | ||
| Neurosensory Disturbances | 849 | ||
| Implant Malposition | 850 | ||
| Biologic Complications | 852 | ||
| Inflammation and Proliferation | 852 | ||
| Dehiscence and Recession | 852 | ||
| Peri-Implantitis and Bone Loss | 853 | ||
| Implant Loss or Failure | 854 | ||
| Complications Related to Augmentation Procedures | 856.e1 | ||
| Autogenous Bone Harvesting and Grafting | 856.e1 | ||
| Guided Bone Regeneration | 856.e1 | ||
| Sinus Bone Augmentation | 856.e1 | ||
| Lateral Window Sinus Lift | 856.e1 | ||
| Crestal (Osteotome) Sinus Lift | 856.e2 | ||
| Complications Related to Placement and Loading Protocols | 856.e3 | ||
| Immediate Implant Placement | 856.e3 | ||
| Immediate Loading After Implant Placement | 856.e3 | ||
| Implant Placement Using a Flapless Approach | 856.e3 | ||
| Prosthetic or Mechanical Complications | 856 | ||
| Screw Loosening and Fracture | 856 | ||
| Implant Fracture | 856 | ||
| Fracture of Restorative Materials | 856 | ||
| Aesthetic and Phonetic Complications | 856 | ||
| Aesthetic Complications | 856 | ||
| Phonetic Problems | 858 | ||
| Conclusions | 858 | ||
| References | 858 | ||
| References | 858.e2 | ||
| IV Supportive Care and Results of Implant Treatment | 859 | ||
| 86 Supportive Implant Treatment | 859 | ||
| Abstract | 859.e1 | ||
| Keywords | 859.e1 | ||
| Chapter Outline | 859 | ||
| Rationale for Supportive Implant Treatment | 859 | ||
| Examination of Implants | 859 | ||
| Peri-implant Probing | 860 | ||
| Microbial Testing | 861 | ||
| Stability Measures | 861 | ||
| Implant Percussion | 862 | ||
| Radiographic Examination | 862 | ||
| Assessment of Peri-Implant Health | 862 | ||
| Evaluation of Biofilm Control | 862 | ||
| Evaluation of Peri-Implant Health and Disease | 862 | ||
| Evaluation of Implant Osseointegration | 863 | ||
| Evaluation of Implant Restorations | 864 | ||
| Implant Maintenance | 864 | ||
| Methods for Patient Oral Hygiene | 864 | ||
| Methods for Professional Recall Maintenance | 864 | ||
| Treatment of Peri-Implant Diseases | 865 | ||
| Peri-Implant Mucositis | 865 | ||
| Peri-Implantitis | 865 | ||
| Referral of Patients to the Periodontist | 866 | ||
| References | 866 | ||
| References | 866.e2 | ||
| 87 Results of Implant Treatment | 867 | ||
| Abstract | 867.e1 | ||
| Key Words | 867.e1 | ||
| Chapter Outline | 867 | ||
| Defining Implant Outcomes | 867 | ||
| Factors That Influence Implant Outcomes | 869 | ||
| Anatomic Location | 869 | ||
| Implant Design | 869 | ||
| Placement and Loading Protocols | 870 | ||
| Immediate Implant Placement | 870 | ||
| Immediate Occlusal Loading | 870 | ||
| Bone Augmentation | 870 | ||
| Risk Factors | 870 | ||
| Smoking | 871 | ||
| Diabetes | 871 | ||
| Periodontitis | 871 | ||
| Aesthetic Results and Patient Satisfaction | 871 | ||
| Conclusions | 872 | ||
| References | 872 | ||
| References | 872.e2 | ||
| 5 Atlas of Periodontal Diseases | e48 | ||
| 88 Atlas of Periodontal Diseases | e48 | ||
| Chapter Outline | e48 | ||
| Plaque-Induced Gingival Diseases | e49 | ||
| Clinical Features of Gingivitis | e49 | ||
| Melanin Pigmentation | e51 | ||
| Causes of Periodontal Diseases | e52 | ||
| Gingival Diseases Modified by Systemic Factors | e59 | ||
| Endocrine System | e59 | ||
| Sex Hormones | e59 | ||
| Gingival Diseases Associated With Blood Dyscrasias | e62 | ||
| Leukemia | e62 | ||
| Anemia | e62 | ||
| Drug-Induced Gingival Diseases | e64 | ||
| Non–Plaque-Induced Gingival Lesions | e65 | ||
| Streptococcus Species Infections | e65 | ||
| Herpesvirus Infections | e66 | ||
| Gingival Diseases of Fungal Origin | e67 | ||
| Gingival Lesions of Genetic Origin | e69 | ||
| Hereditary Gingival Fibromatosis | e69 | ||
| Gingival Manifestations of Systemic Conditions | e71 | ||
| Mucocutaneous Lesions | e71 | ||
| Other Systemic Diseases | e74 | ||
| Allergies | e78 | ||
| Traumatic Lesions: Factitious, Iatrogenic, and Accidental | e79 | ||
| Cysts and Tumors | e83 | ||
| Chronic Periodontitis | e85 | ||
| Chronic Periodontitis Modified by Systemic Factors | e88 | ||
| Diabetes Mellitus | e88 | ||
| Aggressive Periodontitis | e92 | ||
| Periodontitis as a Manifestation of Systemic Diseases | e97 | ||
| Leukemias | e97 | ||
| Genetic Disorders | e99 | ||
| Necrotizing Periodontal Diseases | e104 | ||
| Bisphosphonates | e106 | ||
| Abscesses of Periodontium | e108 | ||
| Endodontic-Periodontal Lesions | e110 | ||
| Index | 873 | ||
| A | 873 | ||
| B | 876 | ||
| C | 878 | ||
| D | 881 | ||
| E | 883 | ||
| F | 884 | ||
| G | 885 | ||
| H | 888 | ||
| I | 889 | ||
| J | 892 | ||
| K | 892 | ||
| L | 892 | ||
| M | 893 | ||
| N | 896 | ||
| O | 897 | ||
| P | 899 | ||
| Q | 906 | ||
| R | 906 | ||
| S | 907 | ||
| T | 911 | ||
| U | 912 | ||
| V | 913 | ||
| W | 913 | ||
| X | 913 | ||
| Y | 913 | ||
| Z | 913 | ||
| Inside Back Cover | ibc1 |