Index [content.schweitzer-online.de] file350 Index Barrier sealants, 180, 180f application, 150, 150f Bartonella henselae, 95 Biofilm, bacteria in, 21 Biomaterials, synthetic, 268

349

Veterinary Periodontology, First Edition. Brook A. Niemiec.© 2013 John Wiley & Sons, Inc. Published 2013 by John Wiley & Sons, Inc.

Abscessesgingival, 94periodontal

acute, 91–93chronic, 93–95clinical appearance of, 91–93,

92f, 93fdiagnosis, 93–94, 94fetiology, 91, 91f, 92ftreatment, 94–95

Acellular afibrillar cementum (ACC), 14Acellular extrinsic fiber cementum

(AEFC), 14Acellular intrinsic fiber cementum

(AIFC), 14Advanced non-surgical therapy,

154–67, 154f, 155fmechanical (ultrasonic) therapy,

164–65options for, 156SRP, hand, 156–57, 156f

AEFC. See Acellular extrinsic fiber cementum

After-Five (curette), 321Age, gingival tissues and, 10AIFC. See Acellular intrinsic fiber

cementumAir abrasion units, 333Allografts

DFDBA, 267, 268, 268fperiodontal regeneration, 267–68, 268f

Alveolar bone, 14–15, 15farchitecture, 254, 255fGTR, 268loss

horizontal, 54, 55f, 254–56mobility and, 64patterns of, 254–56, 256fperiodontitis and patterns of,

52–56, 52f, 53f, 54f, 55f, 56fvertical, 54–56, 55f, 254

osseous form, 254, 255fosteomyelitis, 75radiographic evaluation of, 109, 110fregeneration, 268remodeling, 15–16, 15f, 16fwalled pockets, 256

Alveolar crest fiber group, 12Alveologingival gingival fiber group, 5Amantadine, 307American Veterinary Dental College

(AVDC), 134Anatomy

feline and brachycephalic differences in, 310

furcation, 289–90periodontal, radiographic

appearance of normal, 112, 113fAnesthesia

duration, 305–6general, prophylaxis and, 131hypotension and, 306hypothermia and, 305–6mechanical scaling and, 165NAD, 130–33, 130f, 131f, 132f, 133fregional, 311safe, 305–6, 311

Anglesdental cleaning, 161–62, 161f, 162fprophy, 332, 332f

Angulation curettes, 321Antibiotics

anti-inflammatory effect, 170in dental procedures, 187–88dislodgement, 173feline caudal stomatitis, 99improved wound healing and, 170indications, 188local delivery of, 188local usage of, 170–73mixture, 170, 171fosteoclast function and, direct

reduction of, 170in periodontal disease, 186t

implications for, 187–88initial therapy, 170–73, 186–88

periodontal pocket, 170–72, 171f, 172f, 173f

potential alternative uses of, 188selection, appropriate, 186–87

Anti-inflammatories, 299antibiotics and, 170feline caudal stomatitis, 100

Antimicrobials, 300

Antiseptic rinses, 179, 179fchlorhexidine, 179

Apical fiber group, 12Apically displaced flap surgery, 222–24,

223f, 224f, 225fArea-specific curettes, 320–21, 320fAspiration, 306Atorvastatin, 300Attachment

gingival, 6, 7–8, 8f, 56periodontal flaps to increase/

replace, 228GTR and determining, 274–75loss, 51

CEJ and, 56periodontal disease and, 56

osseous surgery and determining, 274–75

Autograftsfree connective tissue, 232, 232f, 233ffree gingival

obtain graft from donor site, 230–31, 231f

prepare recipient site, 229–30, 230ftechnique for, 229–31, 230f, 231ftransfer/immobilize graft, 231,

231fperiodontal regeneration, 267

AVDC. See American Veterinary Dental College

Azithromycin, 188

Bacteremia, 187Bacteria, 20–21

behavior, 21–22in biofilm, 21exposure, sulcal epithelium and, 82gingival fluid, 35plaque, 21saliva and, 44

Bacteriology of periodontal disease, 35–36

Barrier membranes, periodontal regeneration

first generation membranes, 265–66second generation membranes, 266,

266f

Index

Niemiec_bindex.indd 349Niemiec_bindex.indd 349 10/1/2012 11:07:31 PM10/1/2012 11:07:31 PM

COPYRIG

HTED M

ATERIAL

350 Index

Barrier sealants, 180, 180fapplication, 150, 150f

Bartonella henselae, 95Biofilm, bacteria in, 21Biomaterials, synthetic, 268Biomodification, root surface,

250–52, 251fBioresorbable membranes, 266Bisphosphonates, 300BMPs. See Bone morphogenic proteinsBone grafting materials, 266–67Bone morphogenic proteins (BMPs),

267, 269Bone treatment, exposed root surface

and, 249, 250fBrachycephalic anatomy, 310Brain, systemic manifestations of

periodontal disease, 84Breed, periodontal disease and, 28, 73Brushing, 175

frequency, 178technique, 177–78, 178ftooth, 176

brushes for, 176–77, 176fmaterials and methods for, 176–77pastes for, 177, 177f

Bupivacaine, regional nerve block, 308Buprenorphine, 308Burs

cutting, 331–32, 331fdental, 331

Calculus, 22–23, 22f, 23fdeposits, 155detection, 157–58, 158fidentification, complete dental

cleaning and, 143, 143fperiodontal disease and, 24, 24f,

25f, 26fradiographic appearance, 117–18scaling

hand, 140–42, 141f, 142fmechanical, 142, 143f

Calculus index (CI), 348Cancer, oral, 75, 77fCaudal mandibular regional block,

310, 310fCaudal maxillary regional block,

309, 309fCaudal stomatitis, feline

antibiotics for, 99anti-inflammatories for, 100clinical signs of, 95–96, 96f, 97fcyclosporine for, 100diagnostics of, 97–98etiology of, 95extraction therapy, 98–99

feline interferon for, 100laser therapy for, 99management of, 98medical therapy for, 99–100other medications for, 100surgical therapy for, 98–99, 98f, 99f

CEJ. See Cementoenamel junctionCelecoxib, 299Cells

DAT, 9Langerhans, 5Merkel, 5PDL, 11–12WBCs, 44

Cellular intrinsic fiber cementum (CIFC), 14

Cellular mixed stratified cementum (CMSC), 14

Cementoenamel junction (CEJ), 7attachment loss and, 56

Cementum, 13–14development, 14types, 14

Ceramic-based materials, 268, 268fChemotherapy, periodontal disease

and, 30Chisels, 322, 322fChlorhexidine, 98, 165

antiseptic rinses, 179lavage, 135–36, 136f

CI. See Calculus indexCIFC. See Cellular intrinsic fiber

cementumCircular gingival fiber group, 5Citric acid

furcation, 290root conditioning, 251

Class II perio-endo lesion, 69–71, 72fCMSC. See Cellular mixed stratified

cementumCoenzyme Q10, 301

feline caudal stomatitis, 100COHAT. See Complete oral health

assessment and treatmentComplete dental cleaning

application of barrier sealant and, 150, 150f

calculus identification and, 143, 143fcalculus scaling and, 140–42chlorhexidine lavage, 135–36, 136fclient education and, 150dental charting and, 146–49dental radiographs and, 149fluoride therapy and, 145–46, 146fgoal of, 129NAD, 130–33, 130f, 131f, 132f, 133foral evaluation and, 146–49

periodontal probing, 146–49, 147f, 148f, 149f

polishing and, 143–44, 144f, 145fpostsurgical exam and consultation,

129–35, 135fprocedure for, 129–50residual plaque and, 143, 143fstaff/patient protection, 135, 135fsubgingival plaque and, 140–42sulcal lavage and, 144–45, 145fsupragingival cleaning, 136–39, 136ftreatment planning and, 150

Complete oral health assessment and treatment (COHAT), 129

Connective tissuefree, autograft, 232, 232f, 233fPDL, 11–12

Conventional flap, 228Coronally displaced flap surgery,

224–26technique, 225–26, 226f

Corticosteroids, periodontal disease and, 29–30

Craniomandibular osteopathy, periodontium in, 120, 121f

Crown, root planing and, 161–62, 161f, 162f

Curettagegingival, 195f

inadvertent, 195intentional, 194, 194ftechnique, 194variations, 194–95

inadvertent, 193subgingival, 194

Curettes, 140, 319–22, 319fAfter-Five, 321angulation, 321area-specific, 320–21, 320fextended shank, 321Gracey, 140, 157, 157f, 320–21

finishing, 321rigid, 321

mini-bladed, 321–22, 321fmini-five, 321Quetin furcation, 322universal, 140, 319, 320f

Cutting burs, 331–32, 331fCyclosporine, feline caudal stomatitis,

100

DAT cells, 9Deciduous teeth, 23, 28fDeleterious effects of periodontal

diseasechronic inflammation and, 85diabetes mellitus as, 84


Index 351

malignancies and, 84pregnancy and, 84–85

Demineralized freeze-dried bone allograft (DFDBA), 267, 268, 268f

Dental burs, 331Dental charting, 146–49Dental cleaning

angle, 161–62, 161f, 162fcomplete

application of barrier sealant and, 150, 150f

calculus identification and, 143, 143f

calculus scaling and, 140–42chlorhexidine lavage, 135–36, 136fclient education and, 150dental charting and, 146–49dental radiographs and, 149fluoride therapy and, 145–46, 146fgoal of, 129NAD, 130–33, 130f, 131f, 132f, 133foral evaluation and, 146–49periodontal probing, 146–49, 147f,

148f, 149fpolishing and, 143–44, 144f, 145fpostsurgical exam and

consultation, 129–35, 135fprocedure for, 129–50residual plaque and, 143, 143fstaff/patient protection, 135, 135fsubgingival plaque and, 140–42sulcal lavage and, 144–45, 145fsupragingival cleaning, 136–39,

136ftreatment planning and, 150

professional, 82SRP and, 164–65, 164fsupragingival, 136–39, 136f

hand scaling and, 139, 139f, 140fmechanical scalers for, 136mechanical scaling and, 137–39,

137f, 138fDental explorers, 315–17, 317fDental mirrors, 317, 317fDental procedures

antibiotic administration during, 187–88

dental cleaning, complete, 129–50ENAP, 195gingivectomy, 199–202, 200f, 201f,

202fpathologic fractures and, 76, 76fscheduling, 134SRP, 158–60subgingival scaling, 165–66, 166ftime for, 134–35

Dentin hypoplasia, periodontium in, 119, 120f

DentistryNAD, 130–33, 130f, 131f, 132f, 133f

scaling, 130sedation, 133

Dentogingival gingival fiber group, 5Dentoperiosteal gingival fiber

group, 5Dermal papilla, 8DFDBA. See Demineralized freeze-dried

bone allograftDiabetes mellitus, periodontal disease

and, 29, 29f, 84Diamond-coated files, 323Diets

nutrition, 301raw, 181tarter control, 180–81, 181f

Disease progression, 39–103gingivitis, 41–49periodontal disease, unusual forms

of, 91–103periodontal disease systemic

manifestations, 81–85periodontitis, 51–67

Doxycycline, 100, 188, 300feline caudal stomatitis, 100

Drug therapies. See also specific drugsanti-inflammatories, 299antimicrobials, 300bisphosphonates, 300inflammatory mediators, 300NSAIDS, 299–300nutraceuticals, 301PTH, 300statins, 300

Education, dental cleaning and client, 150

Electrocautery, 198–99, 199fperiodontal flap surgery, 209, 210f

Enamel matrix derivative (EMD), 269ENAP. See Excisional new attachment

procedureEndo-perio lesions, 124, 125fEpithelium

gingival, 4–5types of, 6–8

HERS, 3JE, 8–10, 9f, 10f, 11fkeratinocyte, 5non-keratinized, 5parakeratinized, 5sulcular, 6–7, 7f

bacterial exposure and, 82Etoricoxib, 299

Evaluationoral, 146–49pain, 311radiography, 111

Excisional new attachment procedure (ENAP), 195, 195f, 196f, 197f

Exposed root surfaceroot conditioning, 250–52, 251ftreatment, 249–52, 249f

bone, 249, 250fExtended shank curettes, 321Extraction therapy

feline caudal stomatitis, 98–99tooth resection with partial, 292–93tooth resection with partial,

furcation, 292–93, 294f

Fatty acids, 301FCV. See Feline calicivirusFeline anatomy, 310Feline calicivirus (FCV), 95Feline caudal stomatitis, 95–101

antibiotics for, 99anti-inflammatories for, 100clinical signs of, 95–96, 96f, 97fcyclosporine for, 100diagnostics of, 97–98etiology of, 95extraction therapy, 98–99feline interferon for, 100laser therapy for, 99management of, 98medical therapy for, 99–100other medications for, 100surgical therapy for, 98–99, 98f, 99f

Feline hyperplastic gingivitis, 101, 101fFeline interferon, 100Feline juvenile gingivitis/periodontitis

clinical features, 101, 101f, 102fdefinition, 101diagnostics, 102etiology, 101management, 102–3

FeLV, 95Fiber groups

alveolar crest, 12apical, 12gingival, 5, 6fhorizontal, 12interradicular, 12, 13foblique, 12PDL, 12–13, 12f, 13ftransseptal, 12, 13f

Files, 322, 322fdiamond-coated, 323

FIV, 95Fluoride therapy, 145–46, 146f


352 Index

Folic acid, 301Free connective tissue autograft, 232,

232f, 233fFree gingival autograft


prepare recipient site, 229–30, 230ftechnique for, 229–31, 230f, 231ftransfer/immobilize graft, 231, 231f

Free gingival autograft flap surgery, 229–31, 230f, 231f

Free gingival groove, 7, 7fFrenectomy, 234–36, 236f

technique, 236, 237fFrenotomy, 234–36, 236f

technique, 236, 237fFurcation

anatomy, 289–90class I defects, treatment, 290, 291fclassification, 289class II/III defects, treatment, 290,

291f, 292fdiagnosis, 289etiology, 289involvement, 289–95local anatomic factors, 289–90prognosis, 295Quetin, curettes, 322tooth resection with partial

extraction, 292–93, 294ftreatment, 289–95

citric acid, 290hemisection, 292, 292ftooth resection with partial

extraction, 292–93, 294f

Gabapentin, 307GCF. See Gingival crevicular fluidGE. See Gingival enlargementGeneral anesthesia, prophylaxis

and, 131Gingiva, 4–10, 4f

bacteria and, 35bleeding, 201, 201fclassification, 6–8fiber groups, 5, 6ffree, 6–7, 7ffree gingival autograft


prepare recipient site, 229–30, 230ftechnique for, 229–31, 230f, 231ftransfer/immobilize graft, 231,

231ffree gingival groove, 7, 7fgeneral histology of, 4–5interdental, 6, 8

lymphatics, 5–6MGJ, 8nerves, 5–6orthokeratinized, 5sulcus, 7tissues

age and, 10PDL and, 10–13, 10f, 11f

vascular supply, 5–6Gingival abscesses, 94Gingival attachment, 6, 7–8, 8f, 56

periodontal flaps to increase/replace, 228

Gingival crevicular fluid (GCF), 8, 41–44

composition, 9–10Gingival curettage, 193–95, 195f

inadvertent, 195intentional, 194, 194ftechnique, 194variations, 194–95

Gingival defense, 41–44Gingival enlargement (GE), 196–97,

198, 198fperiodontal flap method, 202–3,

202f, 203ftreatment and management of, 197

Gingival epithelium, 4–5types, 6–8

Gingival reattachment, 170Gingival stippling, 8, 8fGingival surgery, 193–204, 193f

gingivectomy, 195–97, 198fperiodontal flap method, 202–3,

202f, 203fGingivectomy, 195–97, 198f

equipment options, 197–99, 199fincisions, 200–201, 201flaser, 199periodontal flap method compared

with, 203, 204fprocedure for standard, 199–202,

200f, 201f, 202ftechniques, 199

Gingivitis, 22, 51disease progression, 41–49etiology, 41, 42ffeline hyperplastic, 101, 101ffeline juvenile


key clinical point, 43, 43fnormal features of, 41, 41fperiodontitis and, 51

scoring index, 47–48, 48fstages

features and clinical signs of, 44–48stage I, 44stage II, 44–46, 45fstage III, 46, 46f, 47fstage IV, 46–47, 47f

therapy, 48–49Gingivoplasty, 201, 201fGingivostomatitis. See Caudal

stomatitisGracey curette, 140, 157, 157f, 320–21

finishing, 321rigid, 321

Graftsadditives, GTR, 269–70allografts

DFDBA, 267periodontal regeneration, 267–68,

268fautografts

free connective tissue, 232, 232f, 233f

free gingival, 229–31periodontal regeneration, 267

bone grafting materials, 266–67xenografts, periodontal regeneration,

268Growth factors, 270Guided tissue regeneration (GTR),

254–82, 265alveolar bone, 268case selection for, 258–60determination of new attachment,

274–75factors, 269–70graft additives, 269–70periodontal splinting, 275–81preoperative diagnostics and, 257–59,

257f, 258f, 259f, 260f, 261fprognosis for, 260–61responses to treatment, 268–70techniques, 270–71, 271f, 272f, 273f,

274f, 275f, 276f, 277f, 278f, 279ftransplantation, 270treatment planning for, 258–60

Halitosis, 65Hand-pieces, 330–31, 330f, 331f

high-speed, 333Hand scaling

calculus, 140–42, 141f, 142fcombined mechanical and, 166–67equipment for, 139, 139ftechnique for, 139, 140f

Heart, systemic manifestations of periodontal disease, 83


Index 353

Hematologic derangements, periodontal disease and, 30

Hemisection, furcation, 292, 292fHertwig’s epithelial root sheath

(HERS), 3Hoe scalers, 317, 319fHomecare

activeantiseptic rinses and, 179, 179fbarrier sealants, 180, 180ftooth brushing and, 176–78

discussions/instructions, 175passive

raw diets and, 181tarter control diets and, 180–81,

181ftarter control treats and, 181–82,

182fwater additives and, 182

types, 176–83Home plaque control, 175–83

goals of, 175–76Horizontal fiber group, 12Host modulation therapies, 299–302

drug therapies, 299–301anti-inflammatories, 299antimicrobials, 300bisphosphonates, 300inflammatory mediators, 300NSAIDS, 299–300nutraceuticals, 301PTH, 300statins, 300

Howship’s lacunae, 15, 16fHypercementosis, 121, 122fHyperparathyroidism, periodontium

in, 120, 121fHypotension, 306, 311Hypothermia, 305–6, 311

prevention, 306

Ibuprofen, 300Implantology, 124, 126fInadvertent curettage, 193, 195Indomethacin, 299Inflammation

chronic, periodontal disease and, 85periodontal, 30–31

Inflammatory mediators, 300Instrumentation

osseous surgery, 262periodontal, 313–33

abrasive points, 332, 332fcutting burs, 331–32, 331fdental burs, 331hand, 315–23hand-pieces, 330–31, 330f, 331f

mechanical scalers, 324–28polishing, 332–33power equipment, 330–33rotary scalers, 327

Instrumentsperiodontal hand

chisels, 322, 322fcurettes, 319–22dental explorers, 315–17, 317fdental mirrors, 317, 317fdiamond-coated files, 323files, 322, 322fhoe scalers, 317, 319fknives, 323, 323fperiodontal probes, 315, 316fQuetin furcation curettes, 322scalers, 317, 318f

polishingair abrasion units, 333paste, 333prophy angles, 332, 332fprophy cups, 332–33, 332f

Interdental knife, 323, 323fInterferon, feline, 100Intermediate cementum, 14Interradicular fiber group, 12, 13f

Jaw, pathologic fracture, 71–74, 73f, 74f, 75f

Junctional epithelium (JE), 8–10, 9f, 10f, 11f

Juvenile onset periodontitis, 101, 102f

Keratinocyte epithelium, 5Ketamine, 307Ketoprofen, 300Kidneys, systemic manifestations of

periodontal disease, 82–83Kirkland knife, 323, 323fKnives, 323, 323f

Lactoferrin, 100feline caudal stomatitis, 100

Lamina propria, 4Langerhans cells, 5Laser irradiation, 251–52Laser therapy

feline caudal stomatitis, 99gingivectomy, 199

Lateral sliding (pedicle) flap surgery, 233f, 234f, 235f, 236f

flap preparation and, 233–34, 234f, 235f

flap transfer/closure and donor site protection, 234, 235f, 236f

recipient site preparation and, 233, 233f, 234f

Lavagechlorhexidine, 135–36, 136fsulcal, 144–45, 145f

Lesionsclass II perio-endo, 69–71, 72fendo-perio, 124, 125fradiography, 114, 119

Lethargy, periodontal disease and, 66Levamisole, 100

feline caudal stomatitis, 100Lidocaine, 307

regional nerve block, 308Liver, systemic manifestations of

periodontal disease, 82–83Lungs, systemic manifestations of

periodontal disease, 83–84Lymphatics, gingival, 5–6

Malignancies, periodontal disease and, 84

MBP. See Milk basic proteinMechanical scalers, 136, 324–28

sonic, 326sonic scalers, 326, 326ftips, 326–27, 327fultrasonic, 324–26

Mechanical scaling, 137–39, 137f, 138fanesthesia and, 165calculus, 142, 143fcombined hand and, 166–67equipment needed for, 165subgingival procedure, 165–66, 166f

Mechanical (ultrasonic) therapy, 164–65

Melanocytes, 5Meloxicam, 299Merkel cells, 5MGJ. See Mucogingival junctionMilk basic protein (MBP), 301Mini-bladed curettes, 321–22, 321fMini-five (curette), 321Modified Widman flap surgery,

216–19technique, 218–19, 218f, 219f

Morphine, 308Mortality, periodontal disease and, 85Mucogingival junction (MGJ), 8

NAD. See Non-anesthetic dentistryNeoplasia, periodontal disease and, 30Nerve blocks, 306

regional, 307–8caudal, 309, 309fcaudal mandibular, 310, 310frostral mandibular, 309–10, 309frostral maxillary, 308–9, 308f

Nerves, gingival, 5–6


354 Index

Non-anesthetic dentistry (NAD), 130–33, 130f, 131f, 132f, 133f

scaling, 130Non-keratinized epithelium, 5Non-specific plaque hypothesis, 30Non-surgical therapy

advanced, 154–67, 154f, 155fmechanical (ultrasonic) therapy,

164–65options for, 156SRP, hand, 156–57, 156f

combined mechanical/hand methods of, 166–67

NSAIDS, 299–300, 307Nutraceuticals, 180–81, 301Nutrition, 301

raw diets, 181tarter control diets, 180–81, 181f

Oblique fiber group, 12Ocular damage, periodontal disease

and, 75, 77fOdontogenesis, periodontium, 3–4, 4fONFs. See Oronasal fistulasOpiates, 307–8Oral cancer, periodontal disease and,

75, 77fOral cavity, plaque accumulation and,

23–28, 26f, 27fOral evaluation, 146–49Oral exam, 131

periodontal flap surgery and, 210Oral hygiene, 307Oronasal fistulas (ONFs), 69, 69f,

70f, 71fOrthodontic treatment, 126f, 127Orthokeratinized gingiva, 5Osseous form, 254, 255fOsseous surgery, 254–82

case selection, 258–60determination of new attachment,

274–75periodontal splinting, 275–81preoperative diagnostics, 257–59,

257f, 258f, 259f, 260f, 261fprognosis for, 260–61radiographs, 257–58reactive

instrumentation for, 262osseous remodelling and, 264–65,

264ftechnique for, 262–63, 263f, 264f

sounding, 257, 259ftreatment

planning, 258–60responses to, 268–70

types, 260

Osteoclast function, antibiotics and, 170

Osteomyelitisalveolar bone, 75periodontal disease and, 75–78,

78f, 79fOsteoplasty, 249, 250fOxytalan fibers, 13

Pain considerations, 306–10acute, 307caudal mandibular regional block,

310, 310fcaudal maxillary regional block, 309,

309fchronic, 307, 311evaluation, 311regional nerve blocks, 307–8rostral mandibular regional block,

309–10, 309frostral maxillary regional block,

308–9, 308fscoring, 311

Palatine flap, 227–28Papilla

dermal, 8preservation flap, 228, 229f

Papilla preservation flap surgery, 228, 229f

Parakeratinized epithelium, 5Parathyroid hormone (PTH), 300Pasteurella multocida, 95Pathologic conditions, radiography,

114–19, 114f, 115f, 116f, 117f, 118f, 119f, 120f

Pathologic fracturesdental procedures and, 76, 76fjaw, 71–74, 73f, 74f, 75f

Patientdental cleaning and protecting,

135, 135fmanagement, for periodontal

therapy, 305–11feline and brachycephalic

anatomical differences in, 310postoperative care, 310

manipulation, safety concerns, 306pain considerations, 306–10

acute, 307caudal mandibular regional block,

310, 310fcaudal maxillary regional block,

309, 309fchronic, 307, 311evaluation, 311evaluation and scoring, 311regional nerve blocks, 307–8

rostral mandibular regional block, 309–10, 309f

rostral maxillary regional block, 308–9, 308f

scoring, 311safety concerns, 305–6

PDL. See Periodontal ligamentPedicle flap surgery. See Lateral sliding

flap surgeryPellicle, 19Periodontal abscesses

acute, 91–93chronic, 93

treatment of, 94–95clinical appearance of, 91–93, 92f,

93fdiagnosis, 93–94, 94fetiology, 91, 91f, 92ftreatment, 94–95

Periodontal anatomy, radiographic appearance of normal, 112, 113f

Periodontal diagnostic strip, 133Periodontal disease, 51

advanced, 66antibiotics in, 186–88, 186t

implications for, 187–88assessing, 307attachment loss and, 56bacteriology of, 35–36breed and, 28, 73calculus and, 24, 24f, 25f, 26fchronic inflammation and, 85classification, 60, 60f, 61f

AVDC, 134deleterious effects

chronic inflammation and, 85diabetes mellitus as, 84malignancies and, 84pregnancy and, 84–85

diagnostic and/or prognostic importance

clinical signs of, 57–66, 65f, 66ffunctional exposure and, 57–64,

62f, 63fmobility and, 64–65

etiology of, 18–31human, 36infectious cause of, 35initial therapy, 105–88

antibiotics and, 170–73, 186–88complete dental cleaning in,

129–50home plaque control and,

175–83lethargy and, 66local and regional consequences of,

69–79


Index 355

ocular damage and, 75, 77foral cancer and, 75, 77fosteomyelitis and, 75–78, 78f, 79f

mortality and, 85normal, 60, 60fpathogenesis of, 18–31pathologic jaw fracture and, 71–74,

73f, 74f, 75fperiodontopathogens, 36, 36tplaque and, 175predisposing factors, 23–29prevalence of, 81radiation therapy and, 27–28radiography, 114–19, 114f, 115f,

116f, 117f, 118f, 119f, 120fstaging

periodontitis and, 56–58, 56f, 57f, 58f, 59f

stage 1, 60, 60fstage 2, 60, 61fstage 3, 60, 61fstage 4, 60, 61f

systemic influences on progression of, 28–30

chemotherapy and, 30corticosteroids and, 29–30diabetes mellitus and, 29, 29fhematologic derangements and, 30neoplasia and, 30

systemic manifestations, 81–85affected organs/systems, 82–84brain, 84heart, 83liver and kidneys, 82–83lungs, 83–84pathogenesis of, 81–82

theories, 30tooth resorption in, 120–21, 122ftreatment, 66–67unusual forms of, 91–103

feline caudal stomatitis as, 95–100feline juvenile gingivitis/

periodontitis as, 101–3periodontal abscesses, 91–95

Periodontal flap method, 202–3, 202f, 203f

gingivectomy compared with, 203, 204f

Periodontal flap surgery, 206–46apically displaced flap, technique for,

222–24, 223f, 224f, 225fattached gingiva, 228conventional flap, 228coronally displaced flap, 224–26

technique, 225–26, 226fenvelope flap creation, 211–13, 212f,

213f, 214f

equipment needs, 208–10scalpel blade, 208suture, 208

flap types, 211apically displaced, 222–24conventional, 228coronally displaced, 224–26lateral sliding (pedicle), 233–34,

233f, 234f, 235f, 236fmodified Widman, 216–19palatine, 227–28papilla preservation, 228, 229fregenerative surgery, 228semilunar, 227, 227fspecific, 216–36undisplaced, 219–20

free connective tissue autograft, 232, 232f, 233f

free gingival autograft, 229–31, 230f, 231f

frenectomy/frenotomy, 234–36, 236ffull flap, 213–15, 215f, 216ffull thickness flaps, 211, 216goals of, 206indications, 206–7, 207f, 208f, 209finterdental incision, 213lateral sliding (pedicle) flap, 233f,

234f, 235f, 236fflap preparation and, 233–34,

234f, 235fflap transfer/closure and donor

site protection, 234, 235f, 236frecipient site preparation and, 233,

233f, 234fmodified Widman flap, 216–19

technique, 218–19, 218f, 219foral exam, 210palatine flap, 227–28papilla preservation flap, 228, 229fpartial thickness flaps, 211, 215–16

technique for, 216, 216f, 217fperiodontal pockets and, 206, 207f

results of, 207–8postoperative care, 244–46regenerative surgery flaps, 228semilunar flap, 227, 227fsounding, 210–11, 210fsulcal incision, 211–13, 212f, 213f,

214ffull flap, 213–15

surgical preparation, 210–11suture patterns, 236–40, 237f, 238f,

239f, 240fanchor, 242–44, 246fcontinuous sling, 242, 244f, 245f,

246fdirect loop suture, 240, 240f

interdental ligation, 240–41, 240f, 241f, 242f

interrupted sling pattern, 242, 243f

sling ligation patterns, 241–44undisplaced flap, technique, 220–21,

220f, 221f, 222fPeriodontal hand instruments,

instruments for diagnosischisels, 322, 322fcurettes, 319–22dental explorers, 315–17, 317fdental mirrors, 317, 317fdiamond-coated files, 323files, 322, 322fhoe scalers, 317, 319fknives, 323, 323fperiodontal probes, 315, 316fQuetin furcation curettes, 322scalers, 317, 318f

Periodontal inflammation, 30–31Periodontal instrumentation, 313–33

abrasive points, 332, 332fcutting burs, 331–32, 331fdental burs, 331hand, 315–23hand-pieces, 330–31, 330f, 331fmechanical scalers, 324–28polishing, 332–33power equipment, 330–33rotary scalers, 327

Periodontal ligament (PDL), 3cells, 11–12connective tissue, 11–12fiber groups, 12–13, 12f, 13fgingival tissues and, 10–13, 10f, 11f

Periodontal pocketsalveolar bone, 256antibiotics, 170–72, 171f, 172f, 173f5mm standard, 206one-walled, 261periodontal flap surgery and, 206,

207fresults of, 207–8

reduction, 207–8, 260treating, 157two-walled, 261walled, 256

Periodontal probes, 315, 316fPeriodontal probing, 146–49, 147f,

148f, 149fbone regrowth and, 274

Periodontal radiographyclinical applications of, 121–27, 123f,

124f, 125f, 126fvalue of, 107–11, 108f, 109f, 110f,

111f, 112f


356 Index

Periodontal regeneration, 265–68allografts, 267–68, 268fautografts, 267barrier membranes

first generation membranes, 265–66

second generation membranes, 266, 266f

bone grafting materials, 266–67non-animal products, 268, 268fxenografts, 268

Periodontal splintingGTR, 275–81osseous surgery, 275–81techniques

acrylic or composite-only splint, 279, 279f, 280f, 281f

figure-8 wiring, 279, 281flingual wiring, 281, 282f

Periodontal surgeryhypothermia and, 305–6periodontal therapy and, 259, 262fregenerative, 265–68techniques, 191–295

exposed root surface and, treatment of, 249–52, 249f

furcation involvement and treatment, 289–95

gingival, 193–204GTR, 254–82osseous, 254–82periodontal flap surgery, 206–46

treatment plan, 123Periodontal therapy, 262f

novel, 299patient management, 305–11surgery and, 259, 262ftissue engineering and, 269

Periodontitis, 51–67bone loss patterns and, 52–56, 52f,

53f, 54f, 55f, 56fclinical signs, 51–52, 52f, 53ffeline juvenile


gingivitis and, 51juvenile onset, 101, 102fperiodontal disease staging and,

56–58, 56f, 57f, 58f, 59fPeriodontium

appearance of, in specific conditions, 121f, 122f, 123f

craniomandibular osteopathy, 120, 121f

dentin hypoplasia, 119, 120fhyperparathyroidism, 120,

121fproliferative conditions, 121,

122f, 123ftooth resorption, 120–21, 122f

function of, 3–16gingiva and, 4–10, 4fodontogenesis, 3–4, 4frepair/regeneration, 4structure of, 3–16tissues of, 3, 3t

Periodontopathogens, periodontal disease, 36, 36t

Perio-endo lesion, class II, 69–71, 72f

PI. See Plaque indexPLA. See Polylactic acidPlaque

accumulation, 23–28, 26f, 27fadherence, 18–19, 19f, 20f, 21fbacteria, 21detection, 157–58, 158fformation, 19–21

pellicle, 19home control of, 175–83

goals of, 175–76non-specific plaque hypothesis, 30periodontal disease and, 175predisposing factors, 23–29

oral cavity, 23–28, 26f, 27fresidual, complete dental cleaning

and, 143, 143fspecific plaque hypothesis, 30subgingival, 140–42

Plaque index (PI), 348Polishing instruments

air abrasion units, 333paste, 333prophy angles, 332, 332fprophy cups, 332–33, 332f

Polylactic acid (PLA), 266Porphyromonas, 51Porphyromonas gingivalis, 35–36Pregabalin, 307Pregnancy, periodontal disease and,

84–85Probing, periodontal, 146–49, 147f,

148f, 149f, 315, 316fbone regrowth and, 274

Proliferative conditions, periodontium in, 121, 122f, 123f

Prophy angles, 332, 332fProphy cups, 332–33, 332fProphylaxis

dental, 129general anesthesia, 131

ProteinsBMPs, 267, 269MBPs, 301

PTH. See Parathyroid hormone

Quetin furcation curettes, 322

Radiation therapy, periodontal disease and, 27–28

Radiographyalveolar bone, 109, 110fin calculus, 117–18dental cleaning and, 149determining new attachment and,

274–75evaluation, 111in lesions, 114, 119osseous surgery, 257–58in pathologic conditions, 114–19, 114f,

115f, 116f, 117f, 118f, 119f, 120fperiodontal

clinical applications of, 121–27, 123f, 124f, 125f, 126f

value of, 107–11, 108f, 109f, 110f, 111f, 112f

periodontal anatomy, 112, 113fperiodontal disease, 114–19, 114f,

115f, 116f, 117f, 118f, 119f, 120ftechnique, 110x-ray quality and, 109–10

RANK, 16RANKL, 16Raw diets, 181Reactive osseous surgery

instrumentation for, 262osseous remodelling and, 264–65,

264ftechnique for, 262–63, 263f, 264f

Regenerationalveolar bone, 268GTR, 254–82

alveolar bone, 268case selection for, 258–60determination of new attachment,

274–75factors, 269–70graft additives, 269–70periodontal splinting, 275–81preoperative diagnostics and,

257–59, 257f, 258f, 259f, 260f, 261f

prognosis for, 260–61responses to treatment, 268–70techniques, 270–71, 271f, 272f, 273f,



Index 357

periodontalallografts, 267–68, 268fautografts, 267barrier membranes, 265–66, 266fbone grafting materials, 266–67non-animal products, 268, 268fxenografts, 268

periodontium, 4Regenerative periodontal surgery, 265

periodontal regeneration, 265–68Regenerative surgery

periodontal flaps, 228prognosis, 260–61

Regional blockscaudal mandibular, 310, 310fcaudal maxillary, 309, 309frostral mandibular, 309–10, 309frostral maxillary, 308–9, 308f

Repair, periodontium, 4Rete pegs, 4Rete Venosum, 13Root conditioning

citric acid, 251exposed root surface, 250–52, 251fproducts, 250–51tetracycline, 250

Root planing, 154–55crown and, 161–62, 161f, 162fSRP, 94, 156, 158–64, 160f, 163f,

164f, 249, 250fcleaning and, 164–65, 164fhand, 156–57, 156f, 157fpreparation for, 157procedure, 158–60

Root scaling/planing, exposed root surface, 249, 250f

Root surfacebiomodification, 250–52, 251fexposed

bone treatment and, 249root conditioning, 250–52, 251ftreatment of, 249–52, 249f, 250f

Rostral mandibular regional block, 309–10, 309f

Rostral maxillary regional block, 308–9, 308f

Rotary scalers, 327

Safety concernsanesthesia, 311

duration of, 305–6aspiration, 306patient, 305–6

Saliva, 44Scalers, 318f

hoe, 317, 319fmechanical, 136, 324–28

rotary, 327sonic, 326, 326fultrasonic

magnetostrictive, 325, 325fpiezoelectric, 324, 326, 326f

Scaling, 154, 252calculus, 140–42

hand, 140–42, 141f, 142fhand, 139, 139f, 140f, 324

calculus, 140–42, 141f, 142fcombined mechanical and,

166–67equipment for, 139, 139ftechnique for, 139, 140f

mechanical, 137–39, 137f, 138f, 324calculus, 142, 143fcombined hand and, 166–67equipment needed for, 165subgingival procedure, 165–66,

166fNAD, 130sonic, 136subgingival, manual, 140–41, 141fultrasonic, 156, 165

Scaling/root planing (SRP), 94, 156, 158–64, 160f, 163f, 164f, 249, 250f

cleaning and, 164–65, 164fhand, 156–57, 156f

equipment for, 157, 157fpreparation for, 157procedure, 158–60

Sedation dentistry, 133Semilunar flap, 227, 227fSharpey’s fibers, 10–11Simvastatin, 300Sonic scalers, 326, 326fSounding

osseous surgery, 257, 259fperiodontal flap surgery, 210–11,

210fSpecific plaque hypothesis, 30Spirochetes, 36SRP. See Scaling/root planingStaff, dental cleaning and protecting,

135, 135fStatins, 300Subgingival curettage, 194Subgingival plaque, 140–42Subgingival scaling

manual, 140–41, 141fprocedure, mechanical, 165–66, 166f

Subgingival tips, 327Sulcal incision, periodontal flap

surgery, 211–13, 212f, 213f, 214ffull flap, 213–15

Sulcal lavage, 144–45, 145f

Sulcular epithelium, 6–7, 7fbacterial exposure and, 82

Sulcus, gingival, 7Supragingival cleaning, 136–39, 136f

hand scaling and, 139, 139f, 140fmechanical scalers for, 136mechanical scaling and, 137–39,

137f, 138fSupragingival tips, 326–27Suture patterns, periodontal flap

surgery, 236–40, 237f, 238f, 239f, 240f

anchor, 242–44, 246fcontinuous sling, 242, 244f, 245f,

246fdirect loop suture, 240, 240finterdental ligation, 240–41, 240f,

241f, 242finterrupted sling pattern, 242, 243fsling ligation patterns, 241–44

Synthetic biomaterials, 268Systemic manifestations of periodontal

disease, 81–85affected organs/systems, 82–84brain, 84heart, 83liver and kidneys, 82–83lungs, 83–84pathogenesis of, 81–82

Tarter control diets, 180–81, 181fTarter control treats, 181–82, 182fTetracycline, 170, 300

root conditioning, 250topical, 173

TIMPs. See Tissue inhibitors of metalloproteinases

Tips, 326–27, 327fnew and specialized, 327replacement, 327, 327fsubgingival, 327supragingival, 326–27

Tissue inhibitors of metalloproteinases (TIMPs), 44

Tissuesconnective

free, autograft, 232, 232f, 233fPDL, 11–12

engineering, 269gingiva

age and, 10PDL and, 10–13, 10f, 11f

GTR, 254–82, 265alveolar bone, 268case selection for, 258–60determination of new attachment,

274–75


358 Index

Tissues (cont’d)factors, 269–70graft additives, 269–70periodontal splinting, 275–81preoperative diagnostics and,

257–59, 257f, 258f, 259f, 260f, 261f

prognosis for, 260–61responses to treatment, 268–70techniques, 270–71, 271f, 272f, 273f,


periodontium, 3, 3tTooth

brushingbrushes for, 176–77, 176fmaterials and methods for, 176–77pastes for, 177, 177f

mobilitybone loss and, 64causes, 64, 64fperiodontal disease and, 64–65

resectionadvantages, 293with partial extraction, 292–93,

294fresorption, 120–21, 122f

Transseptal fiber group, 12, 13fTreatment planning

complete dental cleaning, 150GTF, 258–60osseous surgery, 258–60

Treats, tarter control, 181–82, 182f

Ultrasonic scalersmagnetostrictive, 325, 325fpiezoelectric, 324, 326, 326f

Ultrasonic scaling, 156, 165Ultrasonic therapy, 164–65Undisplaced flap surgery, 219–21, 220f,

221f, 222fUniversal curettes, 140, 319, 320f

Vascular supply, gingival, 5–6Volatile sulfur compounds

(VSCs), 65

Water additives, 182White blood cells (WBCs), 44

Xenografts, periodontal regeneration, 268

Xerostomia, 44X-ray quality, 109–10

Zinc salts, soluble, 179, 179f




Documents

Index [content.schweitzer-online.de] file350 Index Barrier sealants, 180, 180f application, 150, 150f Bartonella henselae, 95 Biofilm, bacteria in, 21 Biomaterials, synthetic, 268