Osseous Surgery: Opportunities Missed?

Tuesday Session, 8–10 a.m.
Program Track: Treatment of Inflammatory Periodontal Diseases

Moderator: Donald S. Clem, III
Speakers: Paul A. Fugazzotto, Paul Ricchetti and Frank Schwarz

Pocket reduction via osseous surgery as a component of comprehensive care in well-maintained uncompromised patients has demonstrated an extremely high degree of long term predictability. Periodontal diseases can be controlled, health is restored, and patients are provided with a milieu conductive to appropriate plaque control efforts and sustained periodontal and oral health. As this therapeutic option has developed, additional applications other than periodontal disease treatment have emerged. A solid understanding of the treatment and rationale for functional crown lengthening is a critical ingredient in perio-restorative management that can enhance, maintain, and help build a periodontal practice. It has multiple indications that can significantly affect the quality and long-term management of both the periodontal and restorative result. While dental implants have gained increasing presence in the periodontists’ treatment options, inflammatory bone loss, termed “peri-implantitis,” has raised increasing concerns. Reduction of these osseous defects also requires the periodontal surgeon to have an in depth understanding of the anatomy and surgical technique for new applications of this well-established surgical therapy. Unfortunately, the advent and continued growth of implant therapy have shifted focus to such a point where pocket elimination surgery is often either relegated to secondary importance, or completely ignored. An equilibrium of therapeutic prominence must be reestablished in the best interests of our patients and our practices. This session will explore the unique options osseous surgery brings to the periodontist in treating disease around teeth, implants, and enhancing restorative results.

Educational Objectives:
• Identify the surgical principles necessary for hard tissue management in accomplishing osseous reduction/re-contouring surgery.
• Assess the long term efficacy of pocket reduction surgery in controlling periodontal diseases.
• Discuss the contraindications of osseous surgery in disease management as well as in perio-restorative crown lengthening.
• Explore the surgical technique known as preparation of the restorative alveolar interface, surgical tooth preparation, or biologic shaping.
• Discuss the expanded role of osseous surgery in managing peri-implantitis.