Classic Periodontal Prosthesis vs. Current Treatment Modalities

Having received my dental education at Boston University Goldman School of Dentistry in the early 1980's from some of the finest academicians and clinicians, the foundation of my periodontal specialty training centered around a comprehensive treatment planning approach which I continue to employ every day in clinical practice. Along with disease elimination and control of the etiologic factors, attainment of the classic "periodontal prosthesis" was the mainstay and goal of treatment for the most challenging cases. With the advent of predictable bone regeneration and osseointegration of dental implants, contemporary treatment plans no longer include the more "heroic" aspects of the classic approach such as hemisections and root resections. Yet, many of our patients whom were treated with the classic periodontal prosthesis protocol still enjoy successful outcomes today, decades later. Check out an interesting case report by Dr. Myron Nevins and Dr. David Kim to be published in the Journal of Periodontology. The treatment approach and outcome from 1969 is compared to a hypothetical approach in 2009 based upon contemporary options. Kudos to the authors for this perspective and their continued contributions to the dental profession.

Alot of the move to an implant treatment plan and sacrificing periodontally involved teeth, today is BS. In my practice environment patients still want to hold on to their own teeth, in "health" for as long as possible by whatever treatment modes we can maintain "health", before having to go on to implants !! Also. all this pappilae "ideal" aesthetics nonsense we want to achieve in implants, is low on their priority list - most patients have held on to their own teeth for as long as possible, mostly in an awful aestehtic state, main reason in most of my patients is because they dread losing their teeth and moving on to the "removable paltes" phase!!. That's where implants primarily prove their worth - avoiding "plates". Get real !! Alot of implantology is over hyped over priced stuff. HdeW

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Henk de Waal February 6, 2010 at 3:29pm

Alot of the move to an implant treatment plan and sacrificing periodontally involved teeth, today is BS. In my practice environment patients still want to hold on to their own teeth, in "health" for as long as possible by whatever treatment modes we can maintain "health", before having to go on to implants !! Also. all this pappilae "ideal" aesthetics nonsense we want to achieve in implants, is low on their priority list - most patients have held on to their own teeth for as long as possible, mostly in an awful aestehtic state, main reason in most of my patients is because they dread losing their teeth and moving on to the "removable paltes" phase!!. That's where implants primarily prove their worth - avoiding "plates". Get real !! Alot of implantology is over hyped over priced stuff. HdeW

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