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| Fundamentals | |
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| Introduction | |
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| Periodontal Diseases | |
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| The Clinical Course of Untreated Periodontitis | |
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| Periodontitis-Concepts of Therapy | |
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| Structural Biology | |
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| Gingiva | |
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| Epithelial Attachment | |
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| Connective Tissue Attachment | |
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| Root Cementum | |
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| Osseous Support Apparatus | |
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| Blood Supply of the Periodontium | |
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| Innervation of the Periodontium | |
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| The Coordinated Functions of the Periodontal Structures | |
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| Etiology and Pathogenesis | |
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| Periodontitis-A Multifactorial Disease | |
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| Microbiology | |
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| Biofilm-Plaque Formation on Tooth and Root Surfaces | |
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| Supragingival Plague | |
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| Natural Factors Favoring Plaque Retention | |
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| Iatrogenic Factors Favoring Plaque Retention | |
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| Subgingival Plaque | |
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| Bacterial Invasion Into Tissue? | |
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| Classification of Oral Microorganisms | |
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| Cell Walls of Gram-positive and Gram-negative Bacteria | |
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| Periodontitis-Classical or Opportunistic Infection? | |
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| Putative Periodontopathic Bacteria | |
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| Virulence Factors | |
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| Virulence Transfer | |
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| Marker Bacteria in Periodontitis | |
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| Pathogenic "Single Fighters" vs. Pathogenic Complexes? | |
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| Endotoxins-Lipopolysaccharide (LPS) | |
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| Interaction Between LPS and the Host | |
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| Pathogenesis-Reactions and Defense Capabilities of the Host | |
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| New Concepts of Pathogenesis - Therapeutic and Diagnostic Consequences | |
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| Host Response-Mechanisms and "Participants" | |
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| Non-specific, Congenital Immunity-the First Line of Defense | |
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| Specific, Acquired Immunity-the Second Line of Defense | |
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| Components of the Immune System-Summary | |
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| Interactions Between Non-specific and Specific Immunity | |
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| Regulatory Cell Surface Molecules: Markers, Receptors | |
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| Cytokines | |
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| Eicosanoids-Prostaglandins and Leukotrienes | |
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| Enzymatic Mechanisms-Matrix Metalloproteinases | |
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| Risk for Periodontitis-the Susceptible Host | |
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| Genetic Risk Factors-Diseases, Defects, Variations | |
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| Alterable Risk Factors, Modifying Co-Factors | |
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| Initial Inflammatory Reactions | |
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| Histology | |
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| Molecular Biology | |
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| Destruction of Connective Tissue | |
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| Bone Resorption | |
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| Pathogenesis-Clinical Features: From Gingivitis to Periodontitis | |
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| Cyclic Course of Periodontitis | |
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| Periodontal Infections and Systemic Diseases | |
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| Etiology and Pathogenesis-Summary | |
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| Indices | |
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| Papilla Bleeding Index-PBI | |
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| Periodontal Indices | |
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| Community Periodontal Index of Treatment Needs-CPITN | |
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| Periodontal Screening and Recording-PSR | |
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| Epidemiology | |
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| Epidemiology of Gingivitis | |
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| Epidemiology of Periodontitis | |
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| WHO Studies | |
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| Disease Entities and Diagnosis | |
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| Types of Plaque-associated Periodontal Diseases | |
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| Gingivitis-Periodontitis | |
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| Classification of Periodontal Diseases-Nomenclature | |
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| Gingivitis | |
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| Histopathology | |
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| Clinical Symptoms | |
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| Mild Gingivitis | |
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| Moderate Gingivitis | |
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| Severe Gingivitis | |
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| Ulcerative Gingivitis/Periodontitis | |
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| Histopathology | |
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| Clinical Symptoms-Bacteriology | |
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| Ulcerative Gingivitis (NUG) | |
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| Ulcerative Periodontitis (NUP) | |
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| Ulcerative Gingivoperiodontitis-Therapy | |
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| Hormonally Modulated Gingivitis | |
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| Severe Pregnancy Gingivitis-Gravid Epulis | |
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| Pregnancy Gingivitis and Phenytoin | |
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| Periodontitis | |
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| Pathobiology-The Most Important Forms of Periodontitis | |
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| Type II | |
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| Type III B | |
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| Type III A | |
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| Type IV B | |
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| Pathomorphology-Clinical Degree of Severity | |
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| Pockets and Loss of Attachment | |
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| Intra-alveolar Defects, Infrabony Pockets | |
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| Furcation Involvement | |
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| Histopathology | |
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| Additional Clinical and Radiographic Symptoms | |
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| Chronic Periodontitis-Mild to Moderate | |
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| Chronic Periodontitis-Severe | |
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| Aggressive Periodontitis-Ethnic Contributions? | |
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| Aggressive Periodontitis-Acute Phase | |
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| Aggressive Periodontitis-Initial Stage | |
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| Prepubertal Periodontitis-PP (Aggressive Periodontitis) | |
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| Oral Pathologic Alterations of Gingiva and Periodontium | |
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| Primarily Gingival Alterations (Type I B) | |
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| Gingival and Periodontal Alterations (Type IV A/B) | |
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| Phenytoin-Induced Gingival Overgrowth | |
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| Dihydropyridine-induced Gingival Overgrowth | |
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| Cyclosporine-induced Gingival Overgrowth | |
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| Gingival Hyperplasia Following Combined Drug Therapies | |
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| Benign Tumors-Epulis | |
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| Benign Tumors-Fibrosis, Exostosis | |
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| Malignant Tumors | |
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| Gingivosis/Pemphigoid | |
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| Pemphigus vulgaris | |
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| Lichen planus: Reticular and Erosive | |
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| Leukoplakia, Pre-Cancerous Lesions-Oral Granulomatosis | |
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| Herpes-Herpetic Gingivostomatitis | |
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| Periodontitis with Systemic Diseases (Type IV)-Diabetes Type I and Type II | |
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| Periodontitis Associated with Systemic Diseases (Type IV B) Down Syndrome, Trisomy 21, "Mongolism" | |
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| Pre-pubertal Periodontitis Associated with Systemic Disease Papillon-Lefevre Syndrome (Type IV B) | |
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| Papillon-Lefevre Syndrome-"An Exception for Every Rule" | |
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| HIV Infection-AIDS | |
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| HIV Disease-Epidemiology | |
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| Classification and Clinical Course of HIV Disease | |
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| Oral Manifestations of HIV Disease | |
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| Bacterial Infections in HIV | |
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| Fungal Infections | |
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| Viral Infections | |
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| Neoplasms | |
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| HIV-Associated Lesions of Unknown Etiology | |
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| Invasion and Replication of the HI Virus-Hurdles for Systemic Medical Treatment | |
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| Treatment of the HIV Patient-Pharmacologic Aspects | |
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| HIV-Treatment of Opportunistic Infections | |
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| Infection Prevention and Post-exposure Prevention-The Dental Team | |
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| Treatment of HIV-Periodontitis | |
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| Gingival Recession | |
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| Fenestration and Dehiscence of the Alveolar Bone | |
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| Clinical Symptoms | |
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| Recession-Localized | |
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| Recession-Generalized | |
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| Clinical Situations Resembling Recession | |
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| Recession-Diagnosis | |
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| Measurement of Recession (Jahnke) | |
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| Classification of Recession (Miller) | |
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| Consequences of Recession | |
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| Data Collection-Diagnosis-Prognosis | |
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| Data Collection-Examinations | |
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| General Patient Health History | |
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| Special Patient Health History | |
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| Classic Clinical Findings | |
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| Pocket Probing-Probing Depth, Clinical Attachment Loss | |
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| Pocket Probing-Periodontal Probes | |
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| Pocket Probing Depths-Interpretation of the Measured Values | |
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| Furcation Involvement-Horizontal and Vertical Furcation Invasion | |
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| Tooth Mobility-Functional Analysis | |
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| Radiography | |
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| Additional Diagnosis-Tests | |
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| Microbial Diagnosis-Test Methods | |
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| Microbial Pocket Diagnosis-Dark Field and Phase Contrast Microscopy | |
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| Microbial Pocket Diagnosis-Cultures | |
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| New Diagnostic Tests-Evaluation | |
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| Molecular Biological Tests | |
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| Bacterial Probe Test-Practical IAI Pado Test | |
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| DNA/RNA Probe Tests-IAI Pado Test 4.5 | |
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| Immunological Tests-Antigen-Antibody Reactions | |
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| Enzymatic Bacterial Tests-BANA Test | |
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| Tests of the Host Response-Risks | |
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| Genetic Risk-Test for IL-1 Gene Polymorphism | |
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| IL-1 Gene Test-Technique, Evaluation | |
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| Risk Factor IL-1-positive Genotype-Additional Risk Factors | |
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| Poor Oral Hygiene as a Risk Factor-Bleeding on Probing (BOP) | |
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| Periodontal Risk Assessment-Individual Risk Profile | |
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| Diagnostic Data Collection-Periodontal Charting, I and II | |
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| Computer-Enhanced Charting-the Florida Probe System | |
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| Diagnosis | |
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| Prognosis | |
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| Prevention-Prophylaxis | |
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| Maintenance of Health and Prevention of Disease | |
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| Definition: Prevention-Prophylaxis | |
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| Prevention of Gingivitis and Periodontitis | |
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| Therapy | |
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| Treatment of Inflammatory Periodontal Diseases | |
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| Therapeutic Concepts and Techniques | |
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| Therapy-Problems | |
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| Periodontitis-Therapeutic Goals, Therapeutic Outcomes | |
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| Periodontal Wound Healing | |
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| Wound Healing and Regeneration-Possibilities | |
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| Treatment Planning-Sequence of Treatment | |
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| Pre-phase-Systemic Health, Oral Hygiene | |
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| Causal, Antimicrobial, Anti-infectious | |
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| Surgical, Corrective | |
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| Preventive, Anti-infectious, "Life Long" | |
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| General Course of Therapy-Individual Planning | |
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| Systemic Pre-phase | |
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| Evaluation-Can the Patient be Safely Treated? | |
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| Bacteremia-Endocarditis Prophylaxis | |
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| Dental Procedures Carrying the Risk of Bacteremia | |
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| Diabetes mellitus (DM)-Risk Factor for Periodontitis | |
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| Smoking-An Alterable Risk Factor | |
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| Emergency Treatment | |
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| Phase 1 Therapy | |
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| Case presentation-Motivation-Information | |
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| Initial Treatment 1-Oral Hygiene by the Patient | |
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| Motivation-Gingival Bleeding | |
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| Plaque Disclosing Agents | |
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| Toothbrushes | |
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| Toothbrushing Technique | |
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| The Solo Technique-A Different Way to Brush Your Teeth | |
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| Electric Toothbrushes | |
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| Interdental Hygiene | |
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| Dentifrice | |
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| Chemical Plaque Control-"Soft Chemo" Prevention | |
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| Irrigators | |
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| Oral Hygiene for Halitosis-Tongue Cleansing | |
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| Possibilities, Successes and Limitations of Oral Hygiene | |
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| Initial Treatment 1-Creating Conditions that Enhance Oral Hygiene | |
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| Supragingival Tooth Cleaning-Power-driven Instruments... | |
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| ...and their Use | |
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| Supragingival Tooth Cleaning-Hand Instruments, Prophy Pastes... | |
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| ...and their Use | |
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| Creation of Conditions that Enhance Oral Hygiene-Removal of Iatrogenic Irritants | |
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| Correction of Iatrogenic Irritants-Bridge Pontics | |
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| Removal of Natural Plaque-retentive Areas-Odontoplasty of Grooves, Depressions, Irregularities | |
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| Reduction of Natural Plaque-retentive Areas-Crowding: Morphologic Odontoplasty | |
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| Treatment of Plaque-elicited Gingivitis | |
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| Gingivitis Treatment | |
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| Initial Treatment 2 "Closed", Subgingival Therapy | |
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| Definitions | |
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| Non-Surgical, Anti-Infectious Therapy-Goals of Treatment | |
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| Antimicrobial Therapy-Combating the Reservoir | |
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| Root Planing-With or without Curettage? | |
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| Closed Therapy-Indication, Instrumentation | |
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| Hand Instruments for Scaling and Root Planing-Curettes | |
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| Powered Instruments for Debridement | |
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| Gracey Curettes-Areas of Use | |
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| Hand Instruments for Special Problems-Curettes | |
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| Practical Scaling Technique with Gracey Curettes-Systematic Approach | |
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| Instrument Sharpening | |
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| Manual Sharpening of Hand Instruments | |
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| Automated Sharpening | |
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| Subgingival Debridement-Closed Root Cleaning | |
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| Closed Therapy in Quadrant 1... | |
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| ...and in the Rest of the Dentition | |
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| Limitations of Closed Therapy | |
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| Possibilities and Limitations of Closed Therapy | |
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| FMT-"Full Mouth Therapy" | |
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| FMT-Instrumental/Mechanical and... | |
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| ...Pharmacologic Therapy | |
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| FMT-Radiographic Results | |
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| FMT-Statistical/Numerical Results | |
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| Medications | |
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| Anti-Infectious Supportive Therapy-Antibiotics in Periodontitis Therapy | |
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| Decision-Making Criteria-When to Use Antibiotics? | |
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| Antibiotics-Bacterial Sensitivity and Resistance | |
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| Systemic Versus Local (Topical) Antimicrobial Therapy | |
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| Local (Topical) Antimicrobial Therapy-"Controlled Release Drugs" (CRD) | |
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| Host Response/Reaction-Modulating Substances | |
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| Phase 2 Therapy-Corrective Phase: Summary-Periodontal and Mucogingival Surgery | |
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| Purposes and Goals of Periodontal Surgery | |
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| Patient Selection | |
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| Factors that Influence the Treatment Result | |
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| Methods of Periodontal Surgery and their Indications | |
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| Principles of Various Treatment Modalities-Advantages and Disadvantages | |
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| Pre-operative Treatment-Post-operative Care | |
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| Furcation Involvement-Furcation Treatment | |
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| Therapeutic Possibilities for Various Cases | |
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| Furcation Involvement-Classifications | |
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| Furcation Involvement, F2, in the Maxilla-Furcationplasty | |
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| Phase 3 Therapy Periodontal Maintenance Therapy-Recall | |
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| Recall in the Dental Practice-Recall Effect | |
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| Recall-Continuous Risk Management | |
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| The "Recall Hour"-Practical Periodontal Maintenance Therapy | |
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| Dental Hygienist and Dentist-The "Preventive Team" | |
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| Auxiliary Personnel and Treatment Needs | |
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| Failures-Lack of Periodontal Maintenance Therapy | |
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| Negative Results of Therapy | |
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| Hypersensitive Dentin | |
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| Dental Implants-Implant Therapy | |
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| Determinative Diagnostic Criteria | |
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| Therapeutic Concepts-Therapeutic Results | |
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| Recall-Management of Implant Problems | |
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| Geriatric Periodontology?: The Periodontium in the Elderly | |
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| Age-related Changes-Influence Upon Treatment Planning | |
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| Classification of Periodontal Diseases | |
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| Most Recent Re-Classification of Periodontal Diseases (1999) | |
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| Acknowledgments for Figures | |
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| References | |
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| Index | |