Adjunctive periodontal therapy: a review of current techniques.

This paper has reviewed the different types of adjunctive therapeutic approaches used in the control of periodontitis. While there are many avenues of current clinical use and research, it is generally agreed that all of the modalities reviewed are adjunctive to basic mechanical control of the root surface environment in the form of SRP.

Ten-year retrospective observations of the impact of a rotary-powered brush vs manual techniques in periodontal maintenance.

The purpose of this retrospective study is to determine whether the type of home brushing instrument used by periodontal patients can affect recare compliance and tooth retention. Data from 201 cohorts, half of which used a rotary mechanical brush, were evaluated throughout 10 years. At recall, 25% of the manual and 67% of the rotary users exhibited good to very good oral hygiene, the rotary group lost 0.082 teeth/patient/year compared with 0.185 teeth/patient/year, and 92% of the rotary group maintained acceptable recare intervals compared with 51% of the manual group. The findings for the efficacy of the rotary brush for these 3 parameters are both statistically and clinically relevant.

Treatment planning for implants versus root canal therapy: a contemporary dilemma.

The predictability of implant fixtures as a long-term solution for edentulous areas has improved to the point where they have become the standard of care in many situations, in lieu of fixed prostheses. At the same time, the success rate of endodontically treated teeth, and those requiring retreatment, is very high as well. The dilemma presented to the clinician in treatment planning is when to retreat a tooth or extract and place an endosseous root-form implant. Risk assessment for prognostic evaluation plays an important role in the decision-making process. The clinical and systemic factors affecting the longevity of a tooth need be considered as well as location, bone quality and amount, and the condition of the patient's other teeth. This article attempts to provide a meaningful algorithm that will provide a basis for an appropriate choice of therapy.

Using host response modifiers in the treatment of periodontal disease. "The clinicians' view". [Interview].

While considerable advances have been made in the understanding of the tissue-destructive mechanisms involved in etiology of periodontitis, the adoption and application of this knowledge has not been generally incorporated into the daily management of patients with chronic periodontitis. A number of adjunctive pharmacotherapeutic agents have been investigated in clinical trials and several agents are used in everyday practice as adjuncts to mechanical nonsurgical periodontal therapy. The only systemic, host modulatory agent approved for the adjunctive use with nonsurgical periodontal procedures, however, is Periostat (20mg doxycycline hyclate, twice daily). In order to further understand the impact of adjunctive host modulatory therapy on patient management and its role in clinical practice, Montage Media interviewed dental professionals across the US. Each of the participants has direct experience with the use of Periostat in their clinical practice. The expectation is that, with the "real life" clinical experience reported by clinicians "in their own words" coupled with the extensive literature describing the results of controlled clinical trials of Periostat, it will be possible to hasten the adoption of evidence-based science into clinical practice.