Display options
Cite
Kwon T, Lamster IB, Levin L. Current concepts in the management of periodontitis. Int Dent J. 2020;doi: 10.1111/idj.12630.
Kwon, T., Lamster, I. B., & Levin, L. (2020). Current concepts in the management of periodontitis. International dental journal, . https://doi.org/10.1111/idj.12630
Kwon, TaeHyun, et al. "Current concepts in the management of periodontitis." International dental journal vol. (2020). doi: https://doi.org/10.1111/idj.12630
Kwon T, Lamster IB, Levin L. Current concepts in the management of periodontitis. Int Dent J. 2020 Dec 05; doi: 10.1111/idj.12630. Epub 2020 Dec 05. PMID: 33277943.
Copy Download .nbib Format: NLM
Share it on

Int Dent J. 2020 Dec 05; doi: 10.1111/idj.12630. Epub 2020 Dec 05.

Current concepts in the management of periodontitis.

International dental journal

TaeHyun Kwon, Ira B Lamster, Liran Levin

Affiliations

  1. Private Practice, Keene, NH, USA.
  2. Stony Brook University School of Dental Medicine, Stony Brook, NY, USA.
  3. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.

PMID: 33277943 DOI: 10.1111/idj.12630

Abstract

Periodontitis is a common disorder affecting >40% of adults in the United States. Globally, the severe form of the disease has a prevalence of 11%. In advanced cases, periodontitis leads to tooth loss and reduced quality of life. The aetiology of periodontitis is multifactorial. Subgingival dental biofilm elicits a host inflammatory and immune response, ultimately leading to irreversible destruction of the periodontium (i.e. alveolar bone and periodontal ligament) in a susceptible host. In order to successfully manage periodontitis, dental professionals must understand the pathogenesis, primary aetiology, risk factors, contributing factors and treatment protocols. Careful diagnosis, elimination of the causes and reduction of modifiable risk factors are paramount for successful prevention and treatment of periodontitis. Initial non-surgical periodontal therapy primarily consists of home care review and scaling and root planing. For residual sites with active periodontitis at periodontal re-evaluation, a contemporary regenerative or traditional resective surgical therapy can be utilised. Thereafter, periodontal maintenance therapy at a regular interval and long-term follow-ups are also crucial to the success of the treatment and long-term retention of teeth. The aim of this review is to provide current concepts of diagnosis, prevention and treatment of periodontitis. Both clinical and biological rationales will be discussed.

© 2020 FDI World Dental Federation.

Keywords: Biofilm; dental plaque; non-surgical periodontal therapy; oral hygiene; periodontal disease

References

  1. Slots J. Periodontitis: facts, fallacies and the future. Periodontol 2000 2017 75: 7-23. - PubMed
  2. Papapanou PN, Sanz M, Buduneli N et al. Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018 89(Suppl 1): S173-S182. - PubMed
  3. Page RC, Offenbacher S, Schroeder HE et al. Advances in the pathogenesis of periodontitis: summary of developments, clinical implications and future directions. Periodontol 2000 1997 14: 216-248. - PubMed
  4. Page RC, Eke PI. Case definitions for use in population-based surveillance of periodontitis. J Periodontol 2007 78(7 Suppl): 1387-1399. - PubMed
  5. Brunsvold MA. Pathologic tooth migration. J Periodontol 2005 76: 859-866. - PubMed
  6. Eke PI, Thornton-Evans GO, Wei L et al. Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009-2014. J Am Dent Assoc 2018 149: 576-588.e6. - PubMed
  7. Richards D. Review finds that severe periodontitis affects 11% of the world population. Evid Based Dent 2014 15: 70-71. - PubMed
  8. Kassebaum NJ, Bernabé E, Dahiya M et al. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res 2014 93: 1045-1053. - PubMed
  9. Frencken JE, Sharma P, Stenhouse L et al. Global epidemiology of dental caries and severe periodontitis - a comprehensive review. J Clin Periodontol 2017 44(Suppl 18): S94-S105. - PubMed
  10. International Diabetes Federation. Global diabetes data report 2010-2045. Available from: https://diabetesatlas.org/data/. Accessed May 9, 2020. - PubMed
  11. World Health Organization. WHO fact sheet on hypertension. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension. Accessed May 9, 2020. - PubMed
  12. World Health Organization. WHO fact sheet on depression. Available from: https://www.who.int/news-room/fact-sheets/detail/depression. Accessed May 9, 2020. - PubMed
  13. World Health Organization. WHO factsheet on asthma. Available from: https://www.who.int/news-room/fact-sheets/detail/asthma. Accessed May 9, 2020. - PubMed
  14. Beck JD, Papapanou PN, Philips KH et al. Periodontal medicine: 100 years of progress. J Dent Res 2019 98: 1053-1062. - PubMed
  15. Borges T de F, Regalo SC, Taba M Jr et al. Changes in masticatory performance and quality of life in individuals with chronic periodontitis. J Periodontol 2013 84: 325-331. - PubMed
  16. Graziani F, Music L, Bozic D et al. Is periodontitis and its treatment capable of changing the quality of life of a patient? Br Dent J 2019 227: 621-625. - PubMed
  17. Socransky SS, Haffajee AD, Cugini MA et al. Microbial complexes in subgingival plaque. J Clin Periodontol 1998 25: 134-144. - PubMed
  18. Socransky SS, Haffajee AD. Periodontal microbial ecology. Periodontol 2000 2005 38: 135-187. - PubMed
  19. Haffajee AD, Socransky SS. Microbial etiological agents of destructive periodontal diseases. Periodontol 2000 1994 5: 78-111. - PubMed
  20. Mohanty R, Asopa SJ, Joseph MD et al. Red complex: polymicrobial conglomerate in oral flora: a review. J Family Med Prim Care 2019 8: 3480-3486. - PubMed
  21. Mysak J, Podzimek S, Sommerova P et al. Porphyromonas gingivalis: major periodontopathic pathogen overview. J Immunol Res 2014 2014: 476068. - PubMed
  22. Singhrao SK, Harding A, Poole S et al. Porphyromonas gingivalis periodontal infection and its putative links with Alzheimer’s disease. Mediators Inflamm 2015 2015: 137357. - PubMed
  23. Sharma A. Virulence mechanisms of Tannerella forsythia. Periodontol 2000 2010 54: 106-116. - PubMed
  24. Dashper SG, Seers CA, Tan KH et al. Virulence factors of the oral spirochete Treponema denticola. J Dent Res 2011 90: 691-703. - PubMed
  25. Birkedal-Hansen H. Role of matrix metalloproteinases in human periodontal diseases. J Periodontol 1993 64(Suppl 5S): 474-484. - PubMed
  26. Taubman MA, Kawai T. Involvement of T-lymphocytes in periodontal disease and in direct and indirect induction of bone resorption. Crit Rev Oral Biol Med 2001 12: 125-135. - PubMed
  27. Taubman MA, Valverde P, Han X et al. Immune response: the key to bone resorption in periodontal disease. J Periodontol 2005 76(11 Suppl): 2033-2041. - PubMed
  28. Socransky SS, Haffajee AD, Goodson JM et al. New concepts of destructive periodontal disease. J Clin Periodontol 1984 11: 21-32. - PubMed
  29. Löe H, Anerud A, Boysen H et al. Natural history of periodontal disease in man. Rapid, moderate and no loss of attachment in Sri Lankan laborers 14 to 46 years of age. J Clin Periodontol 1986 13: 431-445. - PubMed
  30. Haffajee AD, Socransky SS. Attachment level changes in destructive periodontal diseases. J Clin Periodontol 1986 13: 461-475. - PubMed
  31. Goodson JM, Tanner AC, Haffajee AD et al. Patterns of progression and regression of advanced destructive periodontal disease. J Clin Periodontol 1982 9: 472-481. - PubMed
  32. Camelo-Castillo AJ, Mira A, Pico A et al. Subgingival microbiota in health compared to periodontitis and the influence of smoking. Front Microbiol 2015 6: 119. - PubMed
  33. Haffajee AD, Socransky SS. Relationship of cigarette smoking to the subgingival microbiota. J Clin Periodontol 2001 28: 377-388. - PubMed
  34. Chigasaki O, Takeuchi Y, Aoki A et al. A cross-sectional study on the periodontal status and prevalence of red complex periodontal pathogens in a Japanese population. J Oral Sci 2018 60: 293-303. - PubMed
  35. Persson L, Bergström J, Ito H et al. Tobacco smoking and neutrophil activity in patients with periodontal disease. J Periodontol 2001 72: 90-95. - PubMed
  36. Shivanaikar SS, Faizuddin M, Bhat K. Effect of smoking on neutrophil apoptosis in chronic periodontitis: an immunohistochemical study. Indian J Dent Res 2013 24: 147. - PubMed
  37. White PC, Hirschfeld J, Milward MR et al. Cigarette smoke modifies neutrophil chemotaxis, neutrophil extracellular trap formation and inflammatory response-related gene expression. J Periodontal Res 2018 53: 525-535. - PubMed
  38. Grossi SG, Zambon JJ, Ho AW et al. Assessment of risk for periodontal disease. I. Risk indicators for attachment loss. J Periodontol 1994 65: 260-267. - PubMed
  39. Nociti FH, Casati MZ, Duarte PM. Current perspective of the impact of smoking on the progression and treatment of periodontitis. Periodontol 2000 2015 67: 187-210. - PubMed
  40. Müller Campanile V, Megally A, Campanile G et al. Risk factors for recurrence of periodontal disease in patients in maintenance care in a private practice. J Clin Periodontol 2019 46: 918-926. - PubMed
  41. Ryder MI, Couch ET, Chaffee BW. Personalized periodontal treatment for the tobacco- and alcohol-using patient. Periodontol 2000 2018 78: 30-46. - PubMed
  42. Emrich LJ, Shlossman M, Genco RJ. Periodontal disease in non-insulin-dependent diabetes mellitus. J Periodontol 1991 62: 123-131. - PubMed
  43. Mealey BL, Oates TW. Diabetes mellitus and periodontal diseases. J Periodontol 2006 77: 1289-1303. - PubMed
  44. Schmidt AM, Weidman E, Lalla E et al. Advanced glycation endproducts (AGEs) induce oxidant stress in the gingiva: a potential mechanism underlying accelerated periodontal disease associated with diabetes. J Periodontal Res 1996 31: 508-515. - PubMed
  45. Lalla E, Lamster IB, Schmidt AM. Enhanced interaction of advanced glycation end products with their cellular receptor RAGE: implications for the pathogenesis of accelerated periodontal disease in diabetes. Ann Periodontol 1998 3: 13-19. - PubMed
  46. Lalla E, Lamster IB, Drury S et al. Hyperglycemia, glycoxidation and receptor for advanced glycation endproducts: potential mechanisms underlying diabetic complications, including diabetes-associated periodontitis. Periodontol 2000 2000 23: 50-62. - PubMed
  47. Lalla E, Lamster IB, Stern DM et al. Receptor for advanced glycation end products, inflammation, and accelerated periodontal disease in diabetes: mechanisms and insights into therapeutic modalities. Ann Periodontol 2001 6: 113-118. - PubMed
  48. Lamster IB, Cheng B, Burkett S et al. Periodontal findings in individuals with newly identified pre-diabetes or diabetes mellitus. J Clin Periodontol 2014 41: 1055-1060. - PubMed
  49. Jeffcoat MK, Howell TH. Alveolar bone destruction due to overhanging amalgam in periodontal disease. J Periodontol 1980 51: 599-602. - PubMed
  50. Jansson L, Ehnevid H, Lindskog S et al. Proximal restorations and periodontal status. J Clin Periodontol 1994 21: 577-582. - PubMed
  51. Koral SM, Howell TH, Jeffcoat MK. Alveolar bone loss due to open interproximal contacts in periodontal disease. J Periodontol 1981 52: 447-450. - PubMed
  52. Glickman I, Smulow JB. Effect of excessive occlusal forces upon the pathway of gingival inflammation in humans. J Periodontol 1965 36: 141-147. - PubMed
  53. Ericsson I, Lindhe J. Effect of longstanding jiggling on experimental marginal periodontitis in the beagle dog. J Clin Periodontol 1982 9: 497-503. - PubMed
  54. Anderegg CR, Metzler DG. Tooth mobility revisited. J Periodontol 2001 72: 963-967. - PubMed
  55. Lang NP, Löe H. The relationship between the width of keratinized gingiva and gingival health. J Periodontol 1972 43: 623-627. - PubMed
  56. Leknes KN, Lie T, Selvig KA. Cemental tear: a risk factor in periodontal attachment loss. J Periodontol 1996 67: 583-588. - PubMed
  57. Bower RC. Furcation morphology relative to periodontal treatment: furcation root surface anatomy. J Periodontol 1979 50: 366-374. - PubMed
  58. Moskow BS, Canut PM. Studies on root enamel (2). Enamel pearls. A review of their morphology, localization, nomenclature, occurrence, classification, histogenesis and incidence. J Clin Periodontol 1990 17: 275-281. - PubMed
  59. Romeo U, Palaia G, Botti R et al. Enamel pearls as a predisposing factor to localized periodontitis. Quintessence Int 2011 42: 69-71. - PubMed
  60. DeSanctis M, Murphy KG. The role of resective periodontal surgery in the treatment of furcation defects. Periodontol 2000 2000 22: 154-168. - PubMed
  61. Richman C. Is gingival recession a consequence of an orthodontic tooth size and/or tooth position discrepancy? “A paradigm shift”. Compend Contin Educ Dent 2011 32: e73-79. - PubMed
  62. Kassab MM, Cohen RE. The etiology and prevalence of gingival recession. J Am Dent Assoc 2003 134: 220-225. - PubMed
  63. Kwon T, Levin L. Cause-related therapy: a review and suggested guidelines. Quintessence Int 2014 45: 585-591. - PubMed
  64. Kwon T, Salem DM, Levin L. Nonsurgical periodontal therapy based on the principles of cause-related therapy: rationale and case series. Quintessence Int 2019 50: 370-376. - PubMed
  65. Kwon T, Kim DM, Levin L. Successful nonsurgical management of post-orthodontic gingival enlargement with intensive cause-related periodontal therapy. N Y State Dent J 2015 81: 21-23. - PubMed
  66. Kwon T, Wang JCW, Levin L. Home care is therapeutic. Should we use the term “Home-care Therapy” Instead of “Instructions”? Oral Health Prev Dent 2020 18: 397-398. - PubMed
  67. Oosterwaal PJ, Matee MI, Mikx FH et al. The effect of subgingival debridement with hand and ultrasonic instruments on the subgingival microflora. J Clin Periodontol 1987 14: 528-533. - PubMed
  68. Matia JI, Bissada NF, Maybury JE et al. Efficiency of scaling of the molar furcation area with and without surgical access. Int J Periodontics Restorative Dent 1986 6: 24-35. - PubMed
  69. Winkel EG, Van Winkelhoff AJ, Timmerman MF et al. Amoxicillin plus metronidazole in the treatment of adult periodontitis patients. A double-blind placebo-controlled study. J Clin Periodontol 2001 28: 296-305. - PubMed
  70. Haffajee AD, Socransky SS, Gunsolley JC. Systemic anti-infective periodontal therapy. A systematic review. Ann Periodontol 2003 8: 115-181. - PubMed
  71. Liaw A, Miller C, Nimmo A. Comparing the periodontal tissue response to non-surgical scaling and root planing alone, adjunctive azithromycin, or adjunctive amoxicillin plus metronidazole in generalized chronic moderate-to-severe periodontitis: a preliminary randomized controlled trial. Aust Dent J 2019 64: 145-152. - PubMed
  72. Borges I, Faveri M, Figueiredo LC et al. Different antibiotic protocols in the treatment of severe chronic periodontitis: a 1-year randomized trial. J Clin Periodontol 2017 44: 822-832. - PubMed
  73. McGowan K, McGowan T, Ivanovski S. Optimal dose and duration of amoxicillin-plus-metronidazole as an adjunct to non-surgical periodontal therapy: a systematic review and meta-analysis of randomized, placebo-controlled trials. J Clin Periodontol 2018 45: 56-67. - PubMed
  74. Zandbergen D, Slot DE, Niederman R et al. The concomitant administration of systemic amoxicillin and metronidazole compared to scaling and root planing alone in treating periodontitis: =a systematic review=. BMC Oral Health 2016 16: 27. - PubMed
  75. Nibali L, Koidou VP, Hamborg T et al. Empirical or microbiologically guided systemic antimicrobials as adjuncts to non-surgical periodontal therapy? A systematic review. J Clin Periodontol 2019 46: 999-1012. - PubMed
  76. Teughels W, Feres M, Oud V et al. Adjunctive effect of systemic antimicrobials in periodontitis therapy: a systematic review and meta-analysis. J Clin Periodontol 2020 47(Suppl 22): 257-281. - PubMed
  77. Bland PS, Goodson JM, Gunsolley JC et al. Association of antimicrobial and clinical efficacy: periodontitis therapy with minocycline microspheres. J Int Acad Periodontol 2010 12: 11-19. - PubMed
  78. Williams RC, Paquette DW, Offenbacher S et al. Treatment of periodontitis by local administration of minocycline microspheres: a controlled trial. J Periodontol 2001 72: 1535-1544. - PubMed
  79. Grossi SG, Goodson JM, Gunsolley JC et al. Mechanical therapy with adjunctive minocycline microspheres reduces red-complex bacteria in smokers. J Periodontol 2007 78: 1741-1750. - PubMed
  80. Matesanz-Pérez P, García-Gargallo M, Figuero E et al. A systematic review on the effects of local antimicrobials as adjuncts to subgingival debridement, compared with subgingival debridement alone, in the treatment of chronic periodontitis. J Clin Periodontol 2013 40: 227-241. - PubMed
  81. Machtei EE, Hirsh I, Falah M et al. Multiple applications of flurbiprofen and chlorhexidine chips in patients with chronic periodontitis: a randomized, double blind, parallel, 2-arms clinical trial. J Clin Periodontol 2011 38: 1037-1043. - PubMed
  82. Lecic J, Cakic S, Janjic Pavlovic O et al. Different methods for subgingival application of chlorhexidine in the treatment of patients with chronic periodontitis. Acta Odontol Scand 2016 74: 502-507. - PubMed
  83. Caton JG, Ciancio SG, Blieden TM et al. Treatment with subantimicrobial dose doxycycline improves the efficacy of scaling and root planing in patients with adult periodontitis. J Periodontol 2000 71: 521-532. - PubMed
  84. Caton JG, Ciancio SG, Blieden TM et al. Subantimicrobial dose doxycycline as an adjunct to scaling and root planing: post-treatment effects. J Clin Periodontol 2001 28: 782-789. - PubMed
  85. El-Sharkawy H, Aboelsaad N, Eliwa M et al. Adjunctive treatment of chronic periodontitis with daily dietary supplementation with omega-3 Fatty acids and low-dose aspirin. J Periodontol 2010 81: 1635-1643. - PubMed
  86. Castro Dos Santos NC, Andere NM, Araujo CF et al. Omega-3 PUFA and aspirin as adjuncts to periodontal debridement in patients with periodontitis and type 2 diabetes mellitus: randomized clinical trial [published online ahead of print Feb 26, 2020] J Periodontol 2020. https://doi.org/10.1002/JPER.19-0613 - PubMed
  87. Botero JE, Yepes FL, Ochoa SP et al. Effects of periodontal non-surgical therapy plus azithromycin on glycemic control in patients with diabetes: a randomized clinical trial. J Periodontal Res 2013 48: 706-712. - PubMed
  88. Haas AN, Seleme F, Segatto P et al. Azithromycin as an adjunctive treatment of aggressive periodontitis: radiographic findings of a 12-month randomized clinical trial. Am J Dent 2012 25: 215-219. - PubMed
  89. Mascarenhas P, Gapski R, Al-Shammari K et al. Clinical response of azithromycin as an adjunct to non-surgical periodontal therapy in smokers. J Periodontol 2005 76: 426-436. - PubMed
  90. O’Rourke VJ. Azithromycin as an adjunct to non-surgical periodontal therapy: a systematic review. Aust Dent J 2017 62: 14-22. - PubMed
  91. Oliveira AMSD, Costa FO, Nogueira LMR et al. Azithromycin and full-mouth scaling for the treatment of generalized stage III and IV periodontitis: a 6-month randomized comparative clinical trial. Braz Dent J 2019 30: 429-436. - PubMed
  92. Baltacioglu E, Aslan M, Saraç Ö et al. Analysis of clinical results of systemic antimicrobials combined with nonsurgical periodontal treatment for generalized aggressive periodontitis: a pilot study. J Can Dent Assoc 2011 77: b97. - PubMed
  93. Machtei EE, Younis MN. The use of 2 antibiotic regimens in aggressive periodontitis: comparison of changes in clinical parameters and gingival crevicular fluid biomarkers. Quintessence Int 2008 39: 811-819. - PubMed
  94. Akincibay H, Orsal SO, Sengün D et al. Systemic administration of doxycycline versus metronidazole plus amoxicillin in the treatment of localized aggressive periodontitis: a clinical and microbiologic study. Quintessence Int 2008 39: e33-39. - PubMed
  95. Salvi GE, Stähli A, Schmidt JC et al. Adjunctive laser or antimicrobial photodynamic therapy to non-surgical mechanical instrumentation in patients with untreated periodontitis: a systematic review and meta-analysis. J Clin Periodontol 2020 47: 176-198. - PubMed
  96. Roncati M, Gariffo A. Systematic review of the adjunctive use of diode and Nd:YAG lasers for nonsurgical periodontal instrumentation. Photomed Laser Surg 2014 32: 186-197. - PubMed
  97. Sgolastra F, Severino M, Gatto R et al. Effectiveness of diode laser as adjunctive therapy to scaling root planning in the treatment of chronic periodontitis: a meta-analysis. Lasers Med Sci 2013 28: 1393-1402. - PubMed
  98. Invernici MM, Salvador SL, Silva PHF et al. Effects of Bifidobacterium probiotic on the treatment of chronic periodontitis: a randomized clinical trial. J Clin Periodontol 2018 45: 1198-1210. - PubMed
  99. Ikram S, Hassan N, Raffat MA et al. Systematic review and meta-analysis of double-blind, placebo-controlled, randomized clinical trials using probiotics in chronic periodontitis. J Investig Clin Dent 2018 9: e12338. - PubMed
  100. de Andrade DP, Carvalho ICS, Gadoi BH et al. Subgingival irrigation with a solution of 20% propolis extract as an adjunct to non-surgical periodontal treatment: a preliminary study. J Int Acad Periodontol 2017 19: 145-151. - PubMed
  101. El-Sharkawy HM, Anees MM, Van Dyke TE. Propolis improves periodontal status and glycemic control in patients with type 2 diabetes mellitus and chronic periodontitis: a randomized clinical trial. J Periodontol 2016 87: 1418-1426. - PubMed
  102. Zhao H, Hu J, Zhao L. Adjunctive subgingival application of Chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis. BMC Oral Health 2020 20: 34. - PubMed
  103. Sanz M, Herrera D, Kebschull M et al. Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline. J Clin Periodontol 2020 47(Suppl 22): 4-60. - PubMed
  104. Rabbani GM, Ash MM, Caffesse RG. The effectiveness of subgingival scaling and root planing in calculus removal. J Periodontol 1981 52: 119-123. - PubMed
  105. Stambaugh RV, Dragoo M, Smith DM et al. The limits of subgingival scaling. Int J Periodontics Restorative Dent 1981 1: 30-41. - PubMed
  106. Steffensen B, Webert HP. Relationship between the radiographic periodontal defect angle and healing after treatment. J Periodontol 1989 60: 248-254. - PubMed
  107. Papapanou PN, Wennström JL. The angular bony defect as indicator of further alveolar bone loss. J Clin Periodontol 1991 18: 317-322. - PubMed
  108. Schluger S. Osseous resection; a basic principle in periodontal surgery. Oral Surg Oral Med Oral Pathol 1949 2: 316-325. - PubMed
  109. Froum SJ, Coran M, Thaller B et al. Periodontal healing following open debridement flap procedures. I. Clinical assessment of soft tissue and osseous repair. J Periodontol 1982 53: 8-14. - PubMed
  110. Stahl SS, Froum SJ, Kushner L. Periodontal healing following open debridement flap procedures. II. Histologic observations. J Periodontol 1982 53: 15-21. - PubMed
  111. Stahl SS, Froum SJ, Kushner L. Healing responses of human intraosseous lesions following the use of debridement, grafting and citric acid root treatment. II. Clinical and histologic observations: one year postsurgery. J Periodontol 1983 54: 325-338. - PubMed
  112. Yukna RA, Bowers GM, Lawrence JJ et al. A clinical study of healing in humans following the excisional new attachment procedure. J Periodontol 1976 47: 696-700. - PubMed
  113. Ramfjord SP, Nissle RR. The modified widman flap. J Periodontol 1974 45: 601-607. - PubMed
  114. Ramfjord SP, Knowles JW, Nissle RR et al. Results following three modalities of periodontal therapy. J Periodontol 1975 46: 522-526. - PubMed
  115. Carnevale G, Kaldahl WB. Osseous resective surgery. Periodontol 2000 2000 22: 59-87. - PubMed
  116. Canakçi CF, Canakçi V. Pain experienced by patients undergoing different periodontal therapies. J Am Dent Assoc 2007 138: 1563-1573. - PubMed
  117. Clark D, Levin L. Non-surgical management of tooth hypersensitivity. Int Dent J 2016 66: 249-256. - PubMed
  118. Feller L, Lemmer J. Tooth mobility after periodontal surgery. SADJ 2004 59: 409-411. - PubMed
  119. Checchi L, Montevecchi M, Checchi V et al. A modified papilla preservation technique, 22 years later. Quintessence Int 2009 40: 303-311. - PubMed
  120. Villar CC, Cochran DL. Regeneration of periodontal tissues: guided tissue regeneration. Dent Clin North Am 2010 54: 73-92. - PubMed
  121. Chavda S, Levin L. Human studies of vertical and horizontal alveolar ridge augmentation comparing different types of bone graft materials: a systematic review. J Oral Implantol 2018 44: 74-84. - PubMed
  122. Cortellini P, Pini Prato G, Tonetti MS. Periodontal regeneration of human infrabony defects. I. Clinical measures. J Periodontol 1993 64: 254-260. - PubMed
  123. Cortellini P, Pini Prato G, Tonetti MS. Periodontal regeneration of human infrabony defects. II. Re-entry procedures and bone measures. J Periodontol 1993 64: 261-268. - PubMed
  124. Tonetti MS, Pini Prato G, Williams RC et al. Periodontal regeneration of human infrabony defects. III. Diagnostic strategies to detect bone gain. J Periodontol 1993 64: 269-277. - PubMed
  125. Tonetti MS, Pini-Prato G, Cortellini P. Periodontal regeneration of human intrabony defects. IV. Determinants of healing response. J Periodontol 1993 64: 934-940. - PubMed
  126. Reynolds MA, Kao RT, Camargo PM et al. Periodontal regeneration - intrabony defects: a consensus report from the AAP Regeneration Workshop. J Periodontol 2015 86(2 Suppl): S105-107. - PubMed
  127. Nevins M, Camelo M, Nevins ML et al. Periodontal regeneration in humans using recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and allogenic bone. J Periodontol 2003 74: 1282-1292. - PubMed
  128. Camelo M, Nevins ML, Schenk RK et al. Periodontal regeneration in human Class II furcations using purified recombinant human platelet-derived growth factor-BB (rhPDGF-BB) with bone allograft. Int J Periodontics Restorative Dent 2003 23: 213-225. - PubMed
  129. Khoshkam V, Chan H-L, Lin G-H et al. Outcomes of regenerative treatment with rhPDGF-BB and rhFGF-2 for periodontal intra-bony defects: a systematic review and meta-analysis. J Clin Periodontol 2015 42: 272-280. - PubMed
  130. Miron RJ, Chandad F, Buser D et al. Effect of enamel matrix derivative liquid on osteoblast and periodontal ligament cell proliferation and differentiation. J Periodontol 2016 87: 91-99. - PubMed
  131. Miron RJ, Bosshardt DD, Laugisch O et al. In vitro evaluation of demineralized freeze-dried bone allograft in combination with enamel matrix derivative. J Periodontol 2013 84: 1646-1654. - PubMed
  132. Koop R, Merheb J, Quirynen M. Periodontal regeneration with enamel matrix derivative in reconstructive periodontal therapy: a systematic review. J Periodontol 2012 83: 707-720. - PubMed
  133. Nevins M, Kim S-W, Camelo M et al. A prospective 9-month human clinical evaluation of Laser-Assisted New Attachment Procedure (LANAP) therapy. Int J Periodontics Restorative Dent 2014 34: 21-27. - PubMed
  134. Nevins ML, Camelo M, Schupbach P et al. Human clinical and histologic evaluation of laser-assisted new attachment procedure. Int J Periodontics Restorative Dent 2012 32: 497-507. - PubMed
  135. Mills MP, Rosen PS, Chambrone L et al. American Academy of Periodontology best evidence consensus statement on the efficacy of laser therapy used alone or as an adjunct to non-surgical and surgical treatment of periodontitis and peri-implant diseases. J Periodontol 2018 89: 737-742. - PubMed
  136. Cohen RE. Research, Science and Therapy Committee, American Academy of Periodontology. Position paper: periodontal maintenance. J Periodontol 2003 74: 1395-1401. - PubMed
  137. Surveillance Report 2018 - Dental Checks: Intervals between Oral Health Reviews (2004) NICE Guideline CG19. London: National Institute for Health and Care Excellence (UK); 2018. Available from: http://www.ncbi.nlm.nih.gov/books/NBK551810/. Accessed January 4, 2020. - PubMed
  138. Wilson TG, Glover ME, Malik AK et al. Tooth loss in maintenance patients in a private periodontal practice. J Periodontol 1987 58: 231-235. - PubMed
  139. Wang H-L, Greenwell H, Fiorellini J et al. Periodontal regeneration. J Periodontol 2005 76: 1601-1622. - PubMed
  140. Atieh MA, Alsabeeha NHM, Faggion CM et al. The frequency of peri-implant diseases: a systematic review and meta-analysis. J Periodontol 2013 84: 1586-1598. - PubMed
  141. Levin L, Ofec R, Grossmann Y et al. Periodontal disease as a risk for dental implant failure over time: a long-term historical cohort study. J Clin Periodontol 2011 38: 732-737. - PubMed
  142. Ferreira SD, Silva GLM, Cortelli JR et al. Prevalence and risk variables for peri-implant disease in Brazilian subjects. J Clin Periodontol 2006 33: 929-935. - PubMed
  143. Renvert S, Aghazadeh A, Hallström H et al. Factors related to peri-implantitis - a retrospective study. Clin Oral Implants Res 2014 25: 522-529. - PubMed
  144. Swierkot K, Lottholz P, Flores-de-Jacoby L et al. Mucositis, peri-implantitis, implant success, and survival of implants in patients with treated generalized aggressive periodontitis: 3- to 16-year results of a prospective long-term cohort study. J Periodontol 2012 83: 1213-1225. - PubMed
  145. Cho-Yan Lee J, Mattheos N, Nixon KC et al. Residual periodontal pockets are a risk indicator for peri-implantitis in patients treated for periodontitis. Clin Oral Implants Res 2012 23: 325-333. - PubMed
  146. Kwon T, Bain PA, Levin L. Systematic review of short- (5-10 years) and long-term (10 years or more) survival and success of full-arch fixed dental hybrid prostheses and supporting implants. J Dent 2014 42: 1228-1241. - PubMed
  147. Clark D, Levin L. In the dental implant era, why do we still bother saving teeth? Dent Traumatol 2019 35: 368-375. - PubMed
  148. Monsarrat P, Blaizot A, Kémoun P et al. Clinical research activity in periodontal medicine: a systematic mapping of trial registers. J Clin Periodontol 2016 43: 390-400. - PubMed
  149. Williams RC, Offenbacher S. Periodontal medicine: the emergence of a new branch of periodontology. Periodontol 2000 2000 23: 9-12. - PubMed
  150. Sanz M, Ceriello A, Buysschaert M et al. Scientific evidence on the links between periodontal diseases and diabetes: consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. J Clin Periodontol 2018 45: 138-149. - PubMed
  151. Lamster IB, Pagan M. Periodontal disease and the metabolic syndrome. Int Dent J 2017 67: 67-77. - PubMed
  152. Beck JD, Slade G, Offenbacher S. Oral disease, cardiovascular disease and systemic inflammation. Periodontol 2000 2000 23: 110-120. - PubMed

Publication Types