The author wishes to thank Dr. Gordon Douglass for his help in preparation of the manuscript. Orthodontics is a specialty of dentistry that deals with the diagnosis, prevention, and correction of malpositioned teeth and jaws, and misaligned bite patterns.It can also focus on modifying facial growth, known as dentofacial orthopedics.. Abnormal alignment of the teeth and jaws is common. The maxillary and mandibular anterior teeth exhibited multiple diastemas that prohibited splinting in these areas. A consultation with the restorative dentist, orthodontist, and periodontist permitted the team to develop the following treatment plan sequence: (1) scaling, root planing, and plaque control, a. orthodontics (retraction of the maxillary and mandibular anterior teeth), c. stabilization (splint teeth Nos. Having read this chapter the reader will be able to carefully plan a surgical case and identify potential pitfalls on a case-by-case basis. This helps the therapist determine what to expect as a result of the first phases of therapy (Table 1). 1. The other key aspect of good surgical management is regular practice to guard against de-skilling. Careful preoperative management and planning will often simplify surgery itself and allow a more predictable post-operative healing phase. warfarinised patient with a high INR (international normalised ratio â¥ 3.5), significantly immunocompromised patients, e.g. AFTER After aesthetic periodontal surgery the gums were positioned in a more pleasing position and contour. ï§The primary goal is to eliminate gingival inflammation and correction of conditions that cause and perpetuate it. This should be communicated to the client prior to performing surgery. Gingiva can be edematous, fibrotic, or fibrous externally with the sulcus being ulcerated (Table 1). Phobic patients or those with poor compliance are generally less suitable for periodontal surgery than others. The deepest areas in each of the 6 regions are recorded. Once the active disease processes are controlled and the patient is stable, the corrective therapy of periodontal surgery and final restorative dentistry can begin. Radiographic evaluation demonstrated advanced bone loss in the anterior region with vertical bone lesions in the posterior region (Figures 7b, 7c, and 7d). To avoid biologic width problems, the restorative dentist should relate to the periodontist any concerns regarding teeth that have inadequate crown length.16,17 This communication also can include concerns of uneven gingival levels due to recession or altered passive eruption. An example of the latter is the Oral Health Information Suite (OHIS)â¢ and the Periodontal Assessment Tool (PAT) that is a component of the OHIS. Since the introduction of implant dentistry by Professor P. I. Branmark, dentistry has had a predictable alternative for tooth replacement. Control the cause of the disease process (etiology). 5. If pockets are greater than 4 mm and the tissues are edematous, it is possible initially to decrease the pocket depth after the first root-planing visit, thus making more complete calculus removal feasible during subsequent visits. 11. The treatment plan should be used to establish the methods ... bacterial plaque and calculus is accomplished by periodontal scaling. The following case report demonstrates the integration of several different disciplines (periodontics, orthodontics, and restorative dentistry) to control the factors that cause the disease process and then correct the deformities the disease process caused. 1 This plan includes all procedures performed to attain and maintain the long-term oral health of the â¦ However, in the presence of inflammatory disease, it often leads to a more rapid progression of bone loss.10,11 This explains why a patient can have a rapid change in alveolar height or a patient with nonprogressive disease suddenly has significant bone loss. Scaling and Root Planing pocket reduction by resective and regenerative periodontal surgery, 3b. Effect of periodontal trauma upon intrabony pockets. a. periodontal surgery (flaps, osseous corrections, regenerative therapy) b. restortive dentistry (full-coverage restorations, splinting, aesthetics). 1981;1:70-74. If the problem cannot be relieved by occlusal equilibration, then other therapies such as orthodontics or restorative dentistry should be considered. If a tooth needs to be extracted early in treatment, then the extraction should be coordinated between the periodontist and the restorative dentist so any necessary provisional restorations can be constructed and the extraction site augmented at the time of extraction. Sometimes, periodontal surgery may be needed to treat certain gum diseases and conditions, such as gingivitis or periodontitis. Long-term dental health and stability were achieved.