Lindhe's Clinical Periodontology and Implant Dentistry -  - E-Book

Lindhe's Clinical Periodontology and Implant Dentistry E-Book

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Discover the latest edition of the cornerstone reference on periodontology and implant dentistry that combines scholarship and science with practical clinical instruction The Seventh Edition of Lindhe's Clinical Periodontology and Implant Dentistry brings together a distinguished team of periodontal specialists and academics who deliver another must-have resource for students, researchers, and practitioners specializing in periodontal care and implant dentistry. Seamlessly integrating the foundational science behind periodontology with practical clinical protocols in two comprehensive volumes, the chapters cover anatomy, microbiology, occlusion trauma, pathology, tissue regeneration, treatment planning protocols, infection control, reconstructive therapy, occlusal and prosthetic therapy, and more. The Seventh Edition of Lindhe's Clinical Periodontology and Implant Dentistry: * Provides an introduction to anatomy, including periodontal tissues, the edentulous ridge, the mucosa at teeth and implants, and osseointegration * Discusses the epidemiology of periodontal and peri-implant diseases * Explores the microbiology, including dental biofilms and calculus, periodontal infections, peri-implant infections, the pathogenesis of gingivitis and periodontitis, and the genetic susceptibility to periodontal disease * Includes the latest perio- and peri-implant disease classifications * Contains updated evidence-based preventive and treatment modalities for the treatment of periodontal and peri-implant diseases * Features the latest evidence-based therapeutic alternatives on the use of dental implants to rehabilitate the lost dentition Perfect for postgraduate dental students, researchers, and practitioners specializing in periodontal care and implant dentistry, Lindhe's Clinical Periodontology and Implant Dentistry continues to be the cornerstone reference work on periodontology.

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Table of Contents

Cover

Volume 1: BASIC CONCEPTS

Title Page

Copyright Page

Contributors

Preface

Part 1: Anatomy

Chapter 1: Anatomy and Histology of Periodontal Tissues

Introduction

Gingiva

Periodontal ligament

Root cementum

Bone of the alveolar process

Blood supply of the periodontium

Lymphatic system of the periodontium

Nerves of the periodontium

Acknowledgment

References and further reading

Chapter 2: Bone as a Living Organ

Introduction

Development

Structure

Function

Skeletal homeostasis

Conclusion

Acknowledgments

References

Chapter 3: The Edentulous Ridge

Clinical considerations

Topography of the alveolar process

From an alveolar process to an edentulous ridge

Topography of the edentulous ridge: summary

References

Chapter 4: The Mucosa at Teeth and Implants

Gingiva

Peri-implant mucosa

Probing gingiva and peri-implant mucosa

Dimensions of the buccal soft tissue at implants

Dimensions of the papilla between teeth and implants

Dimensions of the “papilla” between adjacent implants

References

Chapter 5: Osseointegration

Introduction

Implant installation

Process of osseointegration

Morphogenesis of osseointegration

References

Part 2: Epidemiology

Chapter 6: Epidemiology of Periodontitis

Introduction

Methodological issues

Prevalence of periodontitis

Risk factors for periodontitis

Concluding remarks

References

Chapter 7: Epidemiology of Peri-Implant Diseases

Introduction

Disease definition

Case definition

Examination methods

Prevalence of peri-implant diseases

Etiology of peri-implant diseases

Risk factors for peri-implant diseases

Concluding remarks

References

Part 3: Microbiology

Chapter 8: Dental Biofilms and Calculus

Introduction

The human microbiome

The oral microbiome

The mouth as a microbial habitat

Methods to determine the composition and function of the oral microbiome

The development and composition of the oral microbiome

Dental biofilm formation

The significance of a biofilm and community lifestyle for microorganisms

Benefits to the host of a resident oral microbiota.

Biofilms on implant surfaces

Dental calculus

Conclusions

References

Chapter 9: Periodontal and Peri-Implant Infections

Periodontal infections

Peri-implant infections

Acknowledgment

References

Part 4: Host–Parasite Interactions

Chapter 10: Pathogenesis of Gingivitis and Periodontitis

Introduction

Gingivitis

Factors influencing the pathogenesis of gingivitis

Periodontitis

Conversion of gingivitis to periodontitis

Control of the Th1/Th2 balance

Autoimmunity

Connective tissue matrix destruction

Bone loss

Conclusion

References

Chapter 11: Systemic and Environmental Modifying Factors

Introduction

Diabetes mellitus

Tobacco smoking

Obesity and nutrition

Osteoporosis

Stress

References

Chapter 12: Genetic Susceptibility to Periodontal Disease

Introduction

Evidence for the role of genetics in periodontitis

Heritability

Gene mutation of major effect on human disease and its association with periodontitis

Identification of genetic risk factors of periodontitis

Epigenetic signatures

From genetic disease susceptibility to improved oral care

References

Part 5: Trauma from Occlusion

Chapter 13: Effect of Load on Periodontal and Peri-Implant Tissues

INTRODUCTION

PART I: PERIODONTAL TISSUES

Definition and terminology

Occlusal trauma and plaque-associated periodontal disease

Conclusion

PART II: PERI-IMPLANT TISSUES

Orthodontic loading and alveolar bone

Bone reactions to functional loading

Excessive occlusal load on implants

Static and cyclic loads on implants

Load and loss of osseointegration

Masticatory occlusal forces on implants

Tooth–implant supported reconstructions

References

Part 6: Periodontal Pathology

Chapter 14: Non-Plaque-Induced Gingival Diseases

Introduction

Genetic/developmental disorders

Specific infections

Inflammatory and immune conditions

Reactive processes

Neoplasms

Endocrine, nutritional, and metabolic diseases

Traumatic lesions

Gingival pigmentation

References

Chapter 15: Plaque-Induced Gingivitis

Clinical features of plaque-induced gingivitis

Diagnostic criteria to assess a gingivitis lesion

Diagnostic criteria to define and grade a gingivitis case

Epidemiology of gingivitis

Impact of gingivitis on patient-reported quality of life

Impact of gingivitis on systemic inflammation

Prognostic value of gingivitis

Potential modifying factors of plaque-induced gingivitis

Prevention and management of plaque-induced gingivitis

References

Chapter 16: Current Classification of Periodontitis

Introduction

A brief historical perspective: recently used periodontitis classification systems

Need for the new classification

Key concepts and ground rules of the new classification of periodontitis

Implementation of the current classification: clinical examples

Interpretational challenges and “gray zones”

The value of the 2018 periodontitis classification

Acknowledgment

References

Chapter 17: Effect of Periodontal Diseases on General Health: Periodontal Medicine

Introduction

Atherosclerotic vascular disease

Diabetes mellitus

Adverse pregnancy outcomes

Chronic renal disease

Cognitive decline/dementia

Cancer

Conclusion

References

Chapter 18: Periodontitis and Systemic Diseases (Cardiovascular Disease and Diabetes): Biological Perspectives for Oral/Periodontal Implications

Introduction

Plausibility of periodontal disease as a risk factor for diseases at distant tissues

Biological plausibility of a link between periodontal diseases and cardiovascular diseases

Biological plausibility of a link between periodontal diseases and diabetes

Conclusion

References

Chapter 19: Abscesses, Necrotizing Lesions of the Periodontium, and Endo-Periodontal Lesions

Introduction

Abscesses in the periodontium

Necrotizing periodontal diseases

Endo-periodontal lesions

Summary

References

Part 7: Peri-implant Pathology

Chapter 20: Peri-Implant Mucositis and Peri-Implantitis

Introduction

Healthy peri-implant mucosa

Peri-implant mucositis

Peri-implantitis

Conclusion

References

Part 8: Tissue Regeneration

Chapter 21: Periodontal Wound Healing and Regeneration

Introduction

Wound healing: Outcomes and definitions

Wound healing biology

Periodontal wound healing

Advanced regenerative approaches to periodontal tissue reconstruction

Conclusion

Acknowledgments

References

Volume 2: CLINICAL CONCEPTS

Title Page

Copyright Page

Contributors

Part 9: Examination Protocols

Chapter 22: Examination of Patients

Patient’s history

Genetic testing before periodontal and implant therapy

Signs and symptoms of periodontal diseases and their assessment

Diagnosis and classification of periodontitis

Oral hygiene status

Additional dental examinations

Conclusion

References

Chapter 23: Diagnostic Imaging of the Periodontal and Implant Patient

Introduction

Basic principles of diagnostic imaging in dental medicine

Diagnostic imaging in periodontology

Diagnostic imaging in oral implantology

Conclusions and future outlook

References

Chapter 24: Patient-Specific Risk Assessment for Implant Therapy

Introduction

Systemic factors

Untreated periodontitis and oral hygiene habits

History of treated periodontitis

Compliance with supportive therapy

Tobacco use history

Genetic susceptibility traits

Conclusion

References

Part 10: Treatment Planning Protocols

Chapter 25: Treatment Planning of Patients with Periodontal Diseases

Introduction

Treatment goals

Screening for periodontal disease

Diagnosis

Treatment planning

Case presentations

Conclusion

References

Chapter 26: Systemic Phase of Therapy

Introduction

Protection of the dental team and their patients against infectious diseases

Protection of the patient’s health

Prevention of complications

Systemic diseases, disorders, or conditions influencing pathogenesis and healing potential

Specific medications: bisphosphonates as a threat to implant therapy

Control of anxiety and pain

Conclusion

References

Part 11: Initial Periodontal Therapy (Infection Control)

Chapter 27: Oral Hygiene Motivation

Health behavior change counseling in periodontal care

Evidence for health behavior change counseling

Understanding health behavior change counseling

The patient activation fabric

Case examples

Conclusion

References

Chapter 28: Mechanical Supragingival Plaque Control

Importance of supragingival plaque removal

Self-performed plaque control

Toothbrushing

Interdental cleaning

Dentifrices

Side effects

Importance of instruction and motivation in mechanical plaque control

Conclusion

Acknowledgments

References

Chapter 29: Chemical Dental Biofilm Control

Rationale for supragingival biofilm control

Oral hygiene products

Mechanical biofilm control

Limitations of mechanical biofilm control

Chemical biofilm control

Mechanism of action

Evaluation of activity of agents for chemical biofilm control

Active agents

Delivery formats

Clinical indications for chemical plaque control: selection of agents

Conclusion

References

Chapter 30: Non-Surgical Therapy

Introduction

Goal of non-surgical pocket/root instrumentation

Debridement, scaling, and root planing

Instruments used for non-surgical pocket/root debridement

Approaches to subgingival debridement

Clinical outcomes following various approaches to pocket/root instrumentation

Microbiologic outcomes following various approaches to pocket/root instrumentation

Considerations in relation to selection of instruments and treatment approach

Re-evaluation following initial non-surgical periodontal treatment

Efficacy of repeated non-surgical pocket/root instrumentation

References

Chapter 31: Treatment of Acute Periodontal and Endo-Periodontal Lesions

Introduction

Treatment of periodontal abscesses

Treatment of necrotizing periodontal diseases

Treatment of endo-periodontal lesions

References

Part 12: Additional Therapy

Chapter 32: Periodontal Surgery

Introduction

Techniques in periodontal surgery (historical perspective)

Techniques in periodontal surgery (current perspective)

Specific surgical interventions for papilla management

Outcomes of surgical periodontal therapy

Conclusion

References

Chapter 33: Treatment of Furcation-Involved Teeth

Anatomy

Diagnosis of furcation involvement

Furcations and risk of tooth loss

Treatment options

Long-term maintenance of teeth with furcation involvement

References

Chapter 34: Non-Surgical Therapy of Peri-Implant Mucositis and Peri-Implantitis

Introduction

Non-surgical therapy of peri-implant mucositis

Non-surgical therapy of peri-implantitis

References

Chapter 35: Surgical Treatment of Peri-Implantitis

Introduction and goals of surgical therapy

Implant surface decontamination

Pocket elimination/reduction procedures

Reconstructive procedures

Conclusion

References

Chapter 36: Systemic Antibiotics in Periodontal Therapy

Introduction

Microbiological basis for periodontal treatment

Rationale for the use of adjunctive systemic antibiotics in periodontal treatment

Systemic antibiotics in periodontal therapy

Which antimicrobial(s) would provide the most predictable results? A historical perspective

Use of systemic antimicrobials: associated risks

Emergence of resistant strains/global increase in antibiotic resistance

Concluding remarks and recommendations for clinical practice

References

Chapter 37: Local Antimicrobial Delivery for the Treatment of Periodontitis and Peri-Implant Diseases

General principles of local drug delivery

Local antimicrobial delivery for the treatment of periodontitis

Local antimicrobial delivery for the treatment of peri-implant diseases

References

Part 13: Reconstructive Therapy

Chapter 38: Regenerative Periodontal Therapy

Introduction

Classification and diagnosis of periodontal osseous defects

Clinical indications

Long-term effects and benefits of regeneration

Evidence for clinical efficacy and effectiveness

Patient, defect, and tooth prognostic factors

Factors affecting the clinical outcomes in furcations

Relevance of the surgical approach

Surgical approach to intrabony defects

Barrier materials for regenerative surgery

Bone replacement grafts

Biologically active regenerative materials

Combination therapy

Clinical potential and limits for regeneration

Clinical strategies

Clinical flowcharts

Conclusion

References

Chapter 39: Mucogingival Therapy: Periodontal Plastic Surgery

Introduction

Mucogingival conditions

Mucogingival condition without gingival recession

Mucogingival condition with gingival recessions

Root coverage procedures

Interdental papilla reconstruction

Crown-lengthening procedures

References

Part 14: Surgery for Implant Installation

Chapter 40: Timing of Implant Placement

Introduction

Type 1 placement as part of the same surgical procedure as and immediately following tooth extraction

Type 2 placement: completed soft tissue coverage of the tooth socket

Type 3 placement: substantial bone fill has occurred in the extraction socket

Type 4 placement: alveolar process is healed following tooth loss

Clinical concepts

Conclusion

References

Part 15: Reconstructive Ridge Therapy

Chapter 41: Ridge Augmentation Procedures

Introduction: principles of alveolar bone regeneration

Treatment objectives

Diagnosis and treatment planning

Biologic principles of guided bone regeneration

Regenerative materials

Evidence‐based results for ridge augmentation procedures

Emerging technologies

Conclusion

Acknowledgments

References

Chapter 42: Maxillary Sinus Floor Augmentation

The maxillary sinus

Options for the rehabilitation of the posterior edentulous maxilla

Maxillary sinus floor augmentation techniques

Summary

References

Part 16: Occlusal and Prosthetic Therapy

Chapter 43: Tooth-Supported Fixed Dental Prostheses

Clinical symptoms of trauma from occlusion

Treatment of increased tooth mobility

References

Chapter 44: Implant-Supported Fixed Dental Prostheses

Introduction

Indications for implants in the posterior dentition

Diagnostics

General considerations and decision-making for implants in the posterior dentition

Applied clinical concepts

Acknowledgment

References

Chapter 45: Implants in the Zone of Esthetic Priority

Introduction

Patient safety first: how to protect patients from avoidable harm?

Preoperative diagnostics

Preoperative risk assessment

Provisional restorations and timing of the treatment sequences

Surgical considerations when dealing with implants in the zone of esthetic priority

Clinical concepts for replacement of a single missing tooth

Clinical concepts for replacement of multiple missing teeth

Prosthetic reconstruction in the zone of esthetic priority

Adverse esthetic outcomes

Concluding remarks and perspectives

Acknowledgments

References

Chapter 46: Technical Complications in Implant Dentistry

Introduction

Implant fractures

Implant complications

Abutment and abutment screw complications

Residual cement as a technical problem

Prosthesis attrition and fracture

Prevention of technical complications

Conclusion

References

Part 17: Orthodontics and Periodontics

Chapter 47: Tooth Movement in the Periodontally Compromised Patient

Introduction: biologic principles of orthodontic tooth movement

Periodontal and orthodontic diagnosis

Treatment planning

Orthodontic treatment

Specific orthodontic tooth movements

Orthodontic tooth movements and periodontal regeneration

Pathologic tooth migration

Multidisciplinary treatment of esthetic problems

References

Part 18: Supportive Care

Chapter 48: Supportive Periodontal Therapy

Introduction

Definition

Basic paradigms for the prevention of periodontal disease

Patients at risk for periodontitis without regular supportive periodontal therapy

Supportive periodontal therapy for patients with gingivitis

Supportive periodontal therapy for patients with periodontitis

Continuous multilevel risk assessment

Objectives for supportive periodontal therapy

Supportive periodontal therapy in daily practice

References

Index

End User License Agreement

List of Tables

Chapter 3

Table 3-1 Average amount of resorption of tooth extraction in different tooth ar...

Chapter 6

Table 6-1 Selected population-representative studies of periodontitis prevale...

Table 6-2 Selected prevalence studies of periodontitis in elderly subjects. (...

Table 6-3 Selected prevalence studies of periodontitis in adolescents and you...

Table 6-4 Genes mapping to single nucleotide polymorphisms reported to have a...

Table 6-5 Genes mapping to single nucleotide polymorphisms reported to have a...

Chapter 7

Table 7-1 Case definitions of peri-implant diseases suggested by the 2017 Wor...

Table 7-2 Selection of studies on the prevalence of peri-implant diseases and...

Table 7-3 Selection of studies on potential risk factors for peri-implant muc...

Table 7-4 Selection of studies on potential risk factors for peri-implantitis...

Table 7-5 Selection of studies on potential risk factors for peri-implantitis...

Chapter 11

Table 11-1 Potential modifiers of periodontal health.

Chapter 12

Table 12-1 Concordance rates for early-onset periodontitis in twins.

Table 12-2 Heritability estimates for clinical parameters of periodontitis.

Table 12-3 Number of identified risk gene variants for a selection of inflamm...

Chapter 13

Table 13-1 Buccal and lingual percentages of the level of osseointegration (b...

Table 13-2 Buccal and lingual percentages of alveolar bone height in relation...

Chapter 15

Table 15-1 Common clinical changes from gingival health to gingivitis.

Table 15-2 Gingival indices.

Table 15-3 Diagnostic look-up table for gingival health or plaque-induced gin...

Table 15-4 Prevalence of gingivitis as derived from national, large-scale epi...

Chapter 16

Table 16-1 Evolution of the classification systems of periodontal diseases ov...

Table 16-2 Classification of periodontitis based on Stages defined by Severit...

Table 16-3 Classification of periodontitis based on Grades that reflect biolo...

Chapter 17

Table 17-1 Selected epidemiologic studies with sample size >1000, associating...

Table 17-2 Selected epidemiologic studies with sample size >1000, associating...

Table 17-3 Selected epidemiologic studies with sample size >1000, associating...

Table 17-4 Summary of the evidence on the effect of periodontal therapy on su...

Chapter 18

Table 18-1 Studies reporting reduced diversity in the periodontal microbiome ...

Chapter 19

Table 19-1 Classification of periodontal abscesses, based on the etiological ...

Table 19-2 Microbiological features of periodontal abscesses: frequency of de...

Table 19-3 Differential diagnosis of periodontal abscesses, as shown in diffe...

Table 19-4 Systemic complications of periodontal abscesses.

Table 19-5 Classification of necrotizing periodontal diseases, based on the p...

Table 19-6 Differential diagnosis of necrotizing periodontal diseases in case...

Table 19-7 Endo-periodontal lesions classification. (Source: Herrera

et al

. 20...

Table 19-8 Main characteristics of the endo-periodontal lesions, stratified b...

Table 19-9 Risk factors reported in clinical studies that evaluated endo-peri...

Table 19-10 Studies that evaluated the microbiota of endo-periodontal lesions...

Chapter 21

Table 21-1 Healing patterns in the periodontal tissues.

Table 21-2 Outcomes of periodontal wound healing.

Table 21-3 Applications of cell therapies for periodontal tissue engineering.

Chapter 22

Table 22-1 Periodontitis stages I–IV according to Tonetti

et al

. (2018).

Table 22-2 Periodontitis grades A to C according to Tonetti

et al

. (2018).

Chapter 26

Table 26-1 Absolute risk following dental interventions. (Source: Adapted fro...

Table 26-2 Consensus of The American Heart Association, the European Society ...

Table 26-3 The use of antibacterial prophylaxis in high-risk cases should be ...

Chapter 28

Table 28-1 Interdental cleaning methods recommended for particular situations...

Chapter 29

Table 29-1 Summary of meta-analyses of 6-month, home-use, randomized clinical...

Table 29-2 Summary of meta-analyses of 6-month home-use randomized clinical t...

Chapter 30

Table 30-1 Predicted probability of pocket closure (probing pocket depth ≤4 m...

Chapter 31

Table 31-1 Treatment protocols for endo-periodontal lesions reported in publi...

Chapter 33

Table 33-1 Recommended classification of furcation involvement (Sources: Hamp

Table 33-2 Furcation closure/conversion (class II to class I) after 12 months...

Chapter 34

Table 34-1 Studies reporting disease resolution (absence of bleeding on probi...

Table 34-2 Studies reporting disease resolution following non-surgical treatm...

Chapter 35

Table 35-1 Clinical studies evaluating surgical therapy of peri-implantitis: ...

Table 35-2 Clinical studies evaluating surgical therapy of peri-implantitis: ...

Chapter 37

Table 37-1 Randomized clinical trials of at least 6-month duration, evaluatin...

Table 37-2 Brand names and product description of the tested products, in alp...

Chapter 38

Table 38-1 Survival analysis of regenerated periodontal attachment over a 16-...

Table 38-2 Outcomes of regression analyses performed to explain variability i...

Table 38-3 Comparison between clinical studies of conventional versus those o...

Table 38-4 Clinical outcomes of guided tissue regeneration (GTR) treatment of...

Table 38-5 Controlled clinical trials comparing clinical outcomes of guided t...

Table 38-6 Clinical outcomes and weighted mean of guided tissue regeneration ...

Table 38-7 Controlled clinical trials comparing clinical outcomes of guided t...

Table 38-8 Controlled clinical trials comparing clinical outcomes of guided t...

Table 38-9 Controlled clinical trials evaluating the combined effects of deca...

Chapter 39

Table 39-1 Mucogingival deformities and conditions around teeth. (Source: Cor...

Table 39-2 Diagnostic table for treatment support of gingival recessions.

Chapter 40

Table 40-1 Classification of types 1–4 implant placements, and advantages and...

Chapter 41

Table 41-1 Clinical studies of growth factors for periodontal, peri-implant a...

Chapter 44

Table 44.1 Implant loading protocols. (Sources: Gallucci

et al

. 2018; Morton

e

...

Chapter 45

Table 45-1 Therapeutic modalities for tooth replacement in the zone of esthet...

Table 45-2 Risk factors for implant placement in the zone of esthetic importa...

Chapter 48

Table 48-1 Percentage of sites showing various changes in probing attachment ...

Table 48-2 Percentage of various probing depths in supportive periodontal thera...

Table 48-3 Results from multilevel logistic regression models for the associa...

List of Illustrations

Chapter 1

Fig. 1-1 A tooth and its periodontal tissues consisting of gingiva (G), peri...

Fig. 1-2 Light micrograph of a tooth germ at the cap stage with the dental o...

Fig. 1-3 Light micrograph illustrating the edge of a developing tooth root w...

Fig. 1-4 Transmission electron micrograph illustrating the attachment of the...

Fig. 1-5 Frontal view of the masticatory and lining mucosa. The arrows indic...

Fig. 1-6 Masticatory mucosa lining the hard palate. There is no mucogingival...

Fig. 1-7 Three parts of the gingiva can be identified: the free gingiva (FG)...

Fig. 1-8 A periodontal probe has been inserted into a clinically healthy too...

Fig. 1-9 Frontal view showing the shape of the interdental papillae in the a...

Fig. 1-10 (a) Premolar/molar regions of the dentition exhibit an approximal ...

Fig. 1-11 Clinical view on the mucosal tissues. The mucogingival junction (a...

Fig. 1-12 Widths of the vestibular maxillary and mandibular gingivae (a) as ...

Fig. 1-13 Minimal width of the vestibular gingiva in the premolar region of ...

Fig. 1-14 Width of attached gingiva in two age cohorts of 20–30 years and 40...

Fig. 1-15 (a) The dentogingival unit. The gingiva consists of three epitheli...

Fig. 1-16 Wax model illustrating the surface of the oral gingival epithelium...

Fig. 1-17 Wax model of the connective tissue subjacent to the oral gingival ...

Fig. 1-18 (a) Conspicuous stippling of the masticatory mucosa of the gingiva...

Fig. 1-19 The four layers of the oral gingival epithelium: (1) stratum basal...

Fig. 1-20 “Clear cells” (arrows) located in or near the stratum basale of th...

Fig. 1-21 The cells in the basal layer of the oral gingival epithelium are a...

Fig. 1-22 Cell proliferation in the basal layer of the oral gingival epithel...

Fig. 1-23 A basement membrane (arrows), positive for periodic acid-Schiff (P...

Fig. 1-24 Transmission electron micrograph (magnification ×70 000) illustrat...

Fig. 1-25 Light micrograph depicting an area of the stratum spinosum in the ...

Fig. 1-26 Transmission electron micrograph of stratum spinosum highlighting ...

Fig. 1-27 The composition of a desmosome. AP, attachment plaque; GM, granula...

Fig. 1-28 Transmission electron micrograph illustrating a melanocyte (MC) su...

Fig. 1-29 The frontal view of the gingiva and alveolar mucosa. Distinct pigm...

Fig. 1-30 A keratinized stratified squamous epithelium. From the basal layer...

Fig. 1-31 Photomicrograph of the stratum granulosum and stratum corneum (SC)...

Fig. 1-32 Photomicrograph illustrating a portion of the epithelium of the al...

Fig. 1-33 The development of the dentogingival junction during tooth eruptio...

Fig. 1-34 Histologic section through the border area between the tooth and t...

Fig. 1-35 Histologic section showing the junctional epithelium (JE) at the b...

Fig. 1-36 Light (a) and transmission electron (b-d) micrographs illustrating...

Fig. 1-37 The most apically positioned cell in the junctional epithelium. Th...

Fig. 1-38 A fibroblast (F) residing in a network of connective tissue fibril...

Fig. 1-39 Transmission electron micrograph illustrating a part of a fibrobla...

Fig. 1-40 Transmission electron micrograph showing a mast cell. The cytoplas...

Fig. 1-41 Transmission electron micrograph demonstrating a macrophage. E, ro...

Fig. 1-42 Transmission electron micrographs showing a polymorphonuclear leuk...

Fig. 1-43 Transmission electron micrograph demonstrating cross-sections and ...

Fig. 1-44 Some important features of the synthesis and composition of collag...

Fig. 1-45 Light micrograph showing reticulin fibers adjacent to the basement...

Fig. 1-46 Light micrograph demonstrating oxytalan fibers (arrows) in the per...

Fig. 1-47 Light micrograph illustrating elastic fibers (arrows) in the lamin...

Fig. 1-48 The arrangement of collagen fiber bundles in the gingiva in a bucc...

Fig. 1-49 Histologic section illustrating the orientation of the trans-septa...

Fig. 1-50 A buccal site in a monkey where the gingiva (G) and the alveolar m...

Fig. 1-51 The same area as seen in Fig. 1-50, but 4 months later. The transp...

Fig. 1-52 Histologic section through the transplanted gingiva (G) seen in Fi...

Fig. 1-53 Histologic section through the coronal portion of the area of tran...

Fig. 1-54 The development of the new, narrow zone of keratinized gingiva see...

Fig. 1-55 A portion of gingival connective tissue (G) and alveolar mucosal c...

Fig. 1-56 The transplanted gingival connective tissue (G) after re-epithelia...

Fig. 1-57 Two histologic sections through the area of the transplanted gingi...

Fig. 1-58 Radiograph of a mandibular premolar region. Two types of alveolar ...

Fig. 1-59 This schematic drawing illustrates how the periodontal ligament is...

Fig. 1-60 The various stages in the organization of the periodontal ligament...

Fig. 1-61 The development of the principal periodontal ligament fibers. (a) ...

Fig. 1-62 Histologic sections viewed under transmitted (a) and polarized (b)...

Fig. 1-63 (a) Light micrograph showing three clusters of epithelial cells, c...

Fig. 1-64 Transmission electron micrograph illustrating epithelial cell rest...

Fig. 1-65 Photomicrograph of a periodontal ligament removed from an extracte...

Fig. 1-66 Photomicrographs illustrating the tooth attachment apparatus. (a) ...

Fig. 1-67 Light (a) and transmission electron (b) micrographs illustrating t...

Fig. 1-68 These photomicrographs illustrate the developmental stages of the ...

Fig. 1-69 Scanning (a) and transmission (b) electron micrographs illustratin...

Fig. 1-70 Transmission electron micrographs of acellular extrinsic fiber cem...

Fig. 1-71 Ground sections viewed under polarized light illustrating (a) cell...

Fig. 1-72 Transmission electron micrographs illustrating (a) the surface of ...

Fig. 1-73 Cross-section through the alveolar process (pars alveolaris) of th...

Fig. 1-74 Cross-sections through the mandibular alveolar process at levels c...

Fig. 1-75 Buccal aspect of the jaws. The bone coverage of the roots is occas...

Fig. 1-76 Vertical sections through various regions of the mandibular dentit...

Fig. 1-77 Histologic section illustrating the bone of the interproximal sept...

Fig. 1-78 Histologic section showing the bone tissue within the furcation ar...

Fig. 1-79 Histologic section through the furcation area showing the alveolar...

Fig. 1-80 The composition of the hard tissue of the furcation area in Fig. 1...

Fig. 1-81 Histologic section showing a portion of lamellar bone that contain...

Fig. 1-82 Micrograph showing the borderline between the alveolar bone proper...

Fig. 1-83 Histologic sections showing numerous osteocytes (OC) that reside i...

Fig. 1-84 How osteocytes (OC), present in lacunae in the mineralized bone ma...

Fig. 1-85 Transmission electron micrograph showing an osteocyte residing in ...

Fig. 1-86 How neighboring osteocytes (OC) communicate with each other via th...

Fig. 1-87 Histologic section illustrating bone. Osteoblasts (arrows) are san...

Fig. 1-88 Micrograph of a horizontal section illustrating the tooth attachme...

Fig. 1-89 Micrograph illustrating three resorption sites lined with osteocla...

Fig. 1-90 Histologic section of compact bone illustrating a bone multicellul...

Fig. 1-91 Histologic sections illustrating the sequence of bone remodeling w...

Fig. 1-92 Micrograph illustrating the insertion of periodontal ligament (PDL...

Fig. 1-93 The blood supply to the teeth and the periodontal tissues. a.a.i.,...

Fig. 1-94 The blood supply to the gingivae. a.ap., posterior superior dental...

Fig. 1-95 The course of the greater palatine artery (a.p.) in a monkey speci...

Fig. 1-96 An anastomosis (arrow) between the facial artery (a.f.) and the bl...

Fig. 1-97 Illustration of a vestibular segment of the maxilla and mandible f...

Fig. 1-98 Blood vessels (arrows) originating from vessels in the periodontal...

Fig. 1-99 Blood vessels in the gingiva in a specimen from a monkey perfused ...

Fig. 1-100 Higher magnification of a cleared specimen illustrating how the s...

Fig. 1-101 Higher magnification of a cleared specimen illustrating the dento...

Fig. 1-102 The blood supply to the free gingiva. The main blood supply to th...

Fig. 1-103 Cleared specimen through a tooth (T) with its periodontium. Blood...

Fig. 1-104 Cleared specimen illustrating the blood vessels in the periodonta...

Fig. 1-105 The blood supply of the periodontium. The blood vessels in the pe...

Fig. 1-106 The so-called extravascular circulation (small arrows) through wh...

Fig. 1-107 The lymph system in the periodontium. cp, deep cervical lymph nod...

Fig. 1-108 The various regions of the gingiva that are innervated by end bra...

Fig. 1-109 Photomicrograph showing small nerves (arrows) that have emerged f...

Chapter 2

Fig. 2-1 Bone as an organ. The bone organ encompasses a number of complex ti...

Fig. 2-2 Bone development. There are two types of process involved in bone d...

Fig. 2-3 Osseous matrix. The extracellular matrix in bone is particularly ab...

Fig. 2-4 Osteoblast. Osteoblasts are derived from bone marrow osteoprogenito...

Fig. 2-5 Osteocytes. The osteocyte can be defined as the orchestrator of the...

Fig. 2-6 Osteocytes: lacunocanalicular system in disease. (a) In healthy bon...

Fig. 2-7 Osteoclasts. (a) Histologically, osteoclasts can be depicted morpho...

Fig. 2-8 Bone formation/resorption coupling. Bone formation and resorption p...

Fig. 2-9 Bone remodeling. The bone remodeling cycle involves a complex serie...

Fig. 2-10 Calcium and bone metabolism. Calcium homeostasis is of major impor...

Fig. 2-11 Bone multicellular units (BMU). Bone remodeling occurs in local gr...

Fig. 2-12 Alveolar socket healing sites over time. (a) Rodent extraction mod...

Fig. 2-13 Gene expression pattern of tooth extraction healing sites. Laser c...

Fig. 2-14 Osteoporosis. In osteoporosis, there is decreased cortical thickne...

Fig. 2-15 Bone mineral density (BMD). Dual-energy X-ray absorptiometry (DEXA...

Fig. 2-16 Osteopetrosis. Increased density and deposits of mineralized bone ...

Fig. 2-17 Osteomalacia. (a, c) Normal matrix mineralization and maturation. ...

Chapter 3

Fig. 3-1 Buccal aspect of adult skull preparations illustrating a dentate ma...

Fig. 3-2 Buccolingual histologic section of the alveolar process. (a) Tooth ...

Fig. 3-3 (a) Clinical view of a partially edentulous maxilla. Note that the ...

Fig. 3-4 Buccal aspect of a skull preparation illustrating a fully edentulou...

Fig. 3-5 Profile of the mandibular bone following tooth extraction at 2 days...

Fig. 3-6 Clinical view of an edentulous ridge in the maxillary premolar regi...

Fig. 3-7 Radiographic (subtraction radiography) images of an extraction site...

Fig. 3-8 Histologic sections of an edentulous site obtained from the maxilla...

Fig. 3-9 (a) A classification of residual jaw shape and (b) jaw bone quality...

Fig. 3-10 (a) Cone-beam tomogram of the premolar region of the maxilla. The ...

Fig. 3-11 (a) A mandibular premolar site (from a dog model) from which the d...

Fig. 3-12 Histologic section showing the mesiodistal aspect of a fresh extra...

Fig. 3-13 (a–h) Overall pattern of bone formation in an extraction socket. F...

Fig. 3-14 Histologic section (mesiodistal aspect) representing 1 day of heal...

Fig. 3-15 (a) Histologic section (mesiodistal aspect) representing 3 days of...

Fig. 3-16 (a) Histologic section (mesiodistal aspect) representing 7 days of...

Fig. 3-17 (a) Histologic section (mesiodistal aspect) representing 14 days o...

Fig. 3-18 (a) Histologic section (mesiodistal aspect) representing 30 days o...

Fig. 3-19 (a) Histologic section (mesiodistal aspect) representing 60 days o...

Fig. 3-20 Woven bone is replaced by lamellar bone. Woven bone with primary o...

Fig. 3-21 Histologic sections (mesiodistal aspect) describing the hard tissu...

Fig. 3-22 (a) Histologic section (buccolingual aspect) of the socket after 1...

Fig. 3-23 (a) Histologic section (buccolingual aspect) of the socket after 2...

Fig. 3-24 Histologic section (buccolingual aspect) of the socket after 4 wee...

Fig. 3-25 Histologic section (buccolingual aspect) of the socket after 8 wee...

Fig. 3-26 Histologic sections (buccolingual aspects) showing the profile of ...

Fig. 3-27 Cone-beam computed tomograms that illustrate edentulous incisor si...

Fig. 3-28 Cone-beam computed tomograms illustrating edentulous regions of th...

Fig. 3-29 Histologic section representing an edentulous maxilla. The biopsy ...

Chapter 4

Fig. 4-1 Histological section describing the dimensions of the various compo...

Fig. 4-2 A subject who belongs to the “pronounced scalloped” gingival phenot...

Fig. 4-3 A subject who belongs to the “flat” gingival phenotype. The crowns ...

Fig. 4-4 Tarnow

et al

. (1992) measured the distance between the contact poin...

Fig. 4-5 Mesiodistal section of the interproximal area between the two centr...

Fig. 4-6 Three titanium implants (Brånemark System®) were installed.

Fig. 4-7 At the end of the study, the gingiva (a) and the peri-implant mucos...

Fig. 4-8 Radiograph of the premolars in the left side of the mandible.

Fig. 4-9 Radiograph of the implants in the right side of the mandible.

Fig. 4-10 Microphotograph of a cross-section of the buccal and coronal part ...

Fig. 4-11 Higher magnification of the supracrestal connective tissue portion...

Fig. 4-12 Microphotographs of buccolingual sections of the peri-implant muco...

Fig. 4-13 Higher magnification of the apical portion of the junctional epith...

Fig. 4-14 Implants with abutments made of titanium (Ti), zirconium dioxide (...

Fig. 4-15 Microphotographs illustrating bucco-lingual sections of the peri-i...

Fig. 4-16 The mucosa at the test site was reduced to about 2 mm.

Fig. 4-17 The peri-implant mucosa at both control and test sites contained a...

Fig. 4-18 Microphotograph illustrating a buccolingual section of the peri-im...

Fig. 4-19 Microphotograph illustrating a buccolingual ground section of the ...

Fig. 4-20 Microphotograph illustrating a section of a human peri-implant muc...

Fig. 4-21 Microphotograph of the implant–connective tissue interface of the ...

Fig. 4-22 Electron micrograph of the implant–connective tissue interface. El...

Fig. 4-23 Buccolingual cleared section of the marginal portion of a tooth. T...

Fig. 4-24 (a) Buccolingual cleared section of the marginal portion of peri-i...

Fig. 4-25 Acrylic strip with a blue zone located 2 mm from the strip margin ...

Fig. 4-26 Buccolingual ground section from a tooth site illustrating the pro...

Fig. 4-27 Buccolingual ground section from an implant site illustrating the ...

Fig. 4-28 (a) An implant-supported single-tooth replacement in position 12 a...

Fig. 4-29 Comparison of mucosa thickness and probing depth at the facial asp...

Fig. 4-30 Soft tissue height adjacent to single-tooth dental implants in rel...

Fig. 4-31 Comparison of papilla height and papilla fill adjacent to single-i...

Fig. 4-32 Single implant in a mandibular premolar region. (a) Papilla fill b...

Fig. 4-33 See text for details. Arrows indicate the position of the soft tis...

Fig. 4-34 See text for details.

Chapter 5

Fig. 5-1 Ground section of a “non-cutting” implant and surrounding tissues o...

Fig. 5-2 Detail from the apical region of the implant described in Fig. 5-1....

Fig. 5-3 (a) Ground section showing a “non-cutting” implant and surrounding ...

Fig. 5-4 (a) Ground section of a self-tapping implant site from a biopsy sam...

Fig. 5-5 Ground section of an implant site with a self-tapping implant from ...

Fig. 5-6 Ground section of a self-tapping implant representing 16 months of ...

Fig. 5-7 Device used in the dog experiment. The implant is a modification of...

Fig. 5-8 The dimensions of the “wound chamber” in the implant device.

Fig. 5-9 Ground section showing the implant and adjacent tissues immediately...

Fig. 5-10 Detail of Fig. 5-9. The wound chamber was filled with blood and a ...

Fig. 5-11 Wound chamber 2 hours after implant installation. Decalcified sect...

Fig. 5-12 Wound chamber after 4 days of healing. Decalcified section. (a) Mo...

Fig. 5-13 (a) Ground section representing 1 week of healing. Note the presen...

Fig. 5-14 Ground sections showing, in various magnifications, the tissues in...

Fig. 5-15 Ground section representing 4 weeks of healing. (a) Newly formed b...

Fig. 5-16 Ground section representing 12 weeks of healing. The woven bone is...

Fig. 5-17 The percentages of new bone, old bone, bone debris, and soft tissu...

Fig. 5-18 Longitudinal ground section through a biopsy including a solid scr...

Fig. 5-19 Compact bone in direct contact with the implant surface in the cor...

Fig. 5-20 Initial stage of bone apposition onto the surface of old bone occu...

Fig. 5-21 After 1 week of healing, a considerable amount of bone debris (BD)...

Fig. 5-22 After a healing period of 1 week, old bone (OB) is still in contac...

Fig. 5-23 Area of compact old bone in contact with the most coronal portion ...

Fig. 5-24 Site characterized by active tissue modeling, in other words woven...

Fig. 5-25 Micrograph showing the implant–tissue interface of an implant site...

Fig. 5-26 Micrograph showing the implant–tissue interface and the peri-impla...

Fig. 5-27 Micrograph showing the implant–tissue interface after 6 weeks of h...

Chapter 6

Fig. 6-1 Attachment loss in a group of Japanese subjects aged 50–59 years. T...

Fig. 6-2 Cumulative distribution of individuals aged ≥50 years according to ...

Fig. 6-3 Contingency tables describing the association between a particular ...

Fig. 6-4 Hypothetical sufficient component causal model for the development ...

Fig. 6-5 Hypothetical sufficient component causal model for the development ...

Fig. 6-6 Frequency distribution of subjects with healthy periodontal conditi...

Fig. 6-7 Mean number of teeth present (range in parenthesis) in subjects wit...

Chapter 7

Fig. 7-1 (a) Bleeding on probing at an implant installed 11 years earlier. (...

Chapter 8

Fig. 8-1 Host factors that influence the microbial composition, activity and...

Fig. 8-2 Predominant groups of bacteria found at, and the key features of, d...

Fig. 8-3 The different stages in the formation of dental biofilms. (a) A con...

Fig. 8-4 Semi-thin section of a supragingival biofilm on enamel (E) which ha...

Fig. 8-5 “Corn-cob” formations seen at the biofilm surface in Fig. 8-4. Magn...

Fig. 8-6 Beneficial functions of the resident oral microbiota.

Fig. 8-7

In vitro

biofilm system consisting of a bio-generator, gas pumps, a...

Fig. 8-8 (a) SEM image depicting biofilm deposition on the implant surface. ...

Fig. 8.9 (a) SEM images depicting biofilm deposition on the implant surface ...

Fig. 8-10 (a) Supragingival calculus adhering to enamel and the root surface...

Fig. 8-11 Abundance of supragingival calculus deposits. (a) Gross deposits a...

Fig. 8-12 Subgingival calculus may be visible (arrows) on radiographs if abu...

Fig. 8-13 (a) Subgingival calculus presents as a black–brownish hard mass if...

Fig. 8-14 Biofilm- and calculus-free zone coronal to the epithelial attachme...

Fig. 8-15 Seven-day-old calcified biofilm. Observe the isolated calcificatio...

Fig. 8-16 Thin section of old biofilm. A degenerating organism is surrounded...

Fig. 8-17 Thin section of old mineralizing biofilm. The intermicrobial matri...

Fig. 8-18 Immunolabeling of calculus on a human tooth root with an antibody ...

Fig. 8-19 Thin section of enamel surface (E) with overlying calculus. The en...

Fig. 8-20 Thin section of cementum surface (C) with overlying calculus. The ...

Fig. 8-21 Thin section of dentin (D) surface with overlying calculus. The in...

Fig. 8-22 Calculus deposit on an oral implant in a patient without regular m...

Fig. 8-23 Excess cement at the abutment–crown interface provides an ideal su...

Fig. 8-24 Hemidesmosomal attachment of junctional epithelium on dental calcu...

Chapter 9

Fig. 9-1 The relative abundances of the six dominant bacterial phyla in each...

Fig. 9-2 Technological advances linked to increased understanding of the ora...

Fig. 9-3 The vertical lanes are the plaque samples numbered 11–47 and two la...

Fig. 9-4 The association among subgingival species. The different colors in ...

Fig. 9-5 The mean percentage DNA probe count of microbial groups in supragin...

Fig. 9-6 Bacterial profiles of 461 bacterial taxa (representing approximatel...

Fig. 9-7 Correspondence analysis of subgingival plaque bacterial communities...

Fig. 9-8 TM7x represents the first Candidate Phylum Radiation (CPR) bacteria...

Fig. 9-9 Health-associated, periodontitis-associated, and core species of th...

Fig. 9-10 Essential components of the parasite life cycle. Successful coloni...

Fig. 9-11 Intracellular bacteria in buccal epithelial cells. A three-dimensi...

Fig. 9-12 The bidirectional relationship between the subgingival microbiome ...

Fig. 9-13 Clinical appearance of a peri-implant infection. (a) Bleeding and ...

Fig. 9-14 Simplified schematic representation of the microbial succession th...

Fig. 9-15 Scanning electron micrograph depicting the characteristic biofilm ...

Fig. 9-16 (a, b) Biofilms on a minimal-roughness implant surface. Spindle-sh...

Fig. 9-17 Confocal laser scanning microscopy images depicting biofilm format...

Fig. 9-18 Supramucosal peri-implant biofilm accumulation and associated peri...

Fig. 9-19 (a) An implant-supported prosthesis where there is inadequate acce...

Fig. 9-20 Mean counts (×10

5

) of 40 species in samples from 48 implants and 4...

Fig. 9-21 Mean counts (×10

5

) of 40 species at 2, 4, and 26 weeks after impla...

Fig. 9-22 Stacked bar charts of the frequency of detection of

Porphyromonas

...

Fig. 9-23 (a) Scanning electron micrograph showing biofilm on an implant sur...

Fig. 9-24 The mean percentage of different morphotypes in the microbiota of ...

Fig. 9-25 The mean percentage DNA probe count of subgingival microbial compl...

Fig. 9-26 The mean percentage DNA probe count of microbial complexes (Socran...

Fig. 9-27 (a) Inverted light microscopy of a subgingival biofilm obtained fr...

Chapter 10

Fig. 10-1 Experimentally induced gingivitis lesion (Trombelli

et al

. 2004). ...

Fig. 10-2 Descriptive statistics (box and whisker plot) for (a) plaque index...

Fig. 10-3 Individuality of disease expression is due to the interaction of t...

Fig. 10-4 Polymorphonuclear neutrophil (PMN) infiltration with destruction o...

Fig. 10-5 Perivascular lymphocyte/macrophage infiltrate seen in a 21-day exp...

Fig. 10-6 21-Day experimental gingivitis lesion showing the predominance of ...

Fig. 10-7 21-Day experimental gingivitis lesion showing a (a) CD4 to (b) CD8...

Fig. 10-8 21-Day experimental gingivitis lesion showing HLA-DR-positive acti...

Fig. 10-9 21-Day experimental gingivitis lesion showing (a) increased CD1a-p...

Fig. 10-10 Chronic gingivitis lesion showing (a) increased CD1a-positive Lan...

Fig. 10-11 Markov chain analysis of the effect of smoking on the initiation ...

Fig. 10-12 Distribution of cells in periodontitis lesions.

Fig. 10-13 Autopsy specimen showing a human periodontitis lesion. Calculus a...

Fig. 10-14 Detail of Fig. 10.13. Note the ulcerated pocket epithelium with r...

Fig. 10-15 A band of non-infiltrated connective tissue is interposed between...

Fig. 10-16 Autopsy specimen showing a human periodontitis lesion. The overt ...

Fig. 10-17 Detail of Fig. 10.16. Pocket epithelium walling off calculus and ...

Fig. 10-18 Detail of Fig. 10.16. Note the non-infiltrated fibrous band betwe...

Fig. 10-19 Immunoglobulin-bearing B cells in a periodontitis lesion.

Fig. 10-20 Representation of the CD68-positive macrophage distribution in gi...

Fig. 10-21 CD83-positive endothelial cells (arrow) in periodontitis.

Fig. 10-22 Double labeling immunofluorescence for (a) CD4/Foxp3 and (b) CD8/...

Fig. 10-23 Double labeling immunohistochemistry for Foxp3-positive (DAB-brow...

Fig. 10-24 Double labeling immunofluorescence for CD4/IL-17 showing IL-17-po...

Fig. 10-25 Double labeling immunofluorescence for CD8/IL-17 showing IL-17-po...

Fig. 10-26 Double labeling immunofluorescence for IL-17/tryptase showing IL-...

Fig. 10-27 T cell plasticity where the cellular microenvironment and the pre...

Chapter 11

Fig. 11-1 Potential mechanisms in the pathogenesis of diabetes-associated pe...

Fig. 11-2 (a–c) Clinical and (d) radiographic presentation of a 38-year-old ...

Fig. 11-3 Clinical presentation of a 50-year-old male patient with type 2 di...

Fig. 11-4 Periapical radiographs of the patient shown in Fig. 11-3 reveal ar...

Fig. 11-5 (a–c) Clinical and (d) radiographic presentation of a 41-year-old ...

Fig. 11-6 Same patient as in Fig. 11-5. Posterior periapical radiographs at ...

Fig. 11-7 Panoramic radiographs of a female patient with type 1 diabetes (a)...

Fig. 11-8 Clinical appearance of a 53-year-old male patient who reports smok...

Fig. 11-9 Same patient as in Fig. 11-8. (a, b) Maxillary left buccal and pal...

Chapter 12

Fig. 12-1 Variations in the antimicrobial response of the host may be import...

Fig 12-2 Structure of a gene. This gene has four exons (yellow bands), but i...

Fig 12-3 Single nucleotide polymorphisms (SNPs) in a randomly selected segme...

Fig 12-4 Case–control studies compare the frequency of single nucleotide pol...

Fig 12-5 Statistical power in relation to the sample size, allele frequency,...

Fig 12-6 It is hypothesized that common variants influence the expression an...

Fig 12-7 (a, b) Relationship between the heritability, genetic complexity, a...

Chapter 13

Fig. 13-1 (a) If the crown of a tooth is exposed to excessive, horizontally ...

Fig. 13-2 When a tooth is exposed to forces which produce “bodily tooth move...

Fig. 13-3 Two mandibular premolars with normal periodontal tissues (a) are e...

Fig. 13-4 (a) Two mandibular premolars are surrounded by a healthy periodont...

Fig. 13-5 (a) A composite photomicrograph illustrating the interdental space...

Fig. 13-6 (a) Two mandibular premolars with supra- and subgingival plaque, a...

Fig. 13-7 Radiographic appearance of one test tooth (T) and one control toot...

Fig. 13-8 Microphotographs from one control (C) and one test (T) tooth after...

Fig. 13-9 (a) A tooth where subgingival plaque has mediated the development ...

Fig. 13-10 Nickel–titanium coil springs applied for a continuous loading thr...

Fig. 13-11 Horizontal section of the implant with the projected grid used fo...

Fig. 13-12 Horizontal section of the implant onto which a grid with 32 radia...

Fig. 13-13 The fixed dental prosthesis (FDP) supported by maxillary canines ...

Fig. 13-14 Fixed dental prostheses fabricated of gold and installed on impla...

Fig. 13-15 Radiographs obtained from implants on the left and right side imm...

Fig. 13-16 (a) Non-loaded control implant (AstraTech®) after 10 months (whit...

Fig. 13-17 (a) Four implants at the time of placement in one side of the man...

Fig. 13-18 (a) Histologic and (b) schematic representation of the histomorph...

Fig. 13-19 Osseointegrated implants (a) not in occlusal contact and (b) in o...

Fig. 13-20 Histological micrograph representing SC (single crown, normally o...

Fig. 13-21 (a) Osseointegrated implant with plaque accumulation. The margina...

Fig. 13-22 (a) Eight strain gauge transducers placed into a maxillary comple...

Fig. 13-23 Chewing force patterns in implant-supported fixed dental prosthes...

Fig. 13-24 Reconstruction of function in the left side of the mandible using...

Fig. 13-25 Ten-year randomized controlled clinical trial of three-unit fixed...

Chapter 14

Fig. 14-1 Hereditary gingival fibromatosis. Facial aspect with partial cover...

Fig. 14-2 Same patient as shown in Fig. 14-1. The maxillary gingival fibroma...

Fig. 14-3 Hand-foot-and-mouth disease. Gingival lesions (a) are rare but com...

Fig. 14-4 Herpetic gingivostomatitis in a 3-year-old child. Erythematous swe...

Fig. 14-5 Herpetic gingivostomatitis affecting palatal gingivae. Numerous ve...

Fig. 14-6 Herpetic gingivostomatitis in a 38-year-old woman. Widespread ulce...

Fig. 14-7 Recurrent intraoral herpes infection. Ruptured vesicles of right p...

Fig. 14-8 Herpes zoster of left palatal gingiva and mucosa. Irregular fibrin...

Fig. 14-9 Squamous cell papilloma of palatal gingiva.

Fig. 14-10 Gingival condyloma acuminatum.

Fig. 14-11 Pseudomembranous candidosis of maxillary gingiva and mucosa in an...

Fig. 14-12 Erythematous candidosis of attached mandibular gingiva in an HIV-...

Fig. 14-13 Chronic erythematous candidosis of maxillary attached gingiva of ...

Fig. 14-14 Candidal infection of maxillary gingiva, sometimes denoted linear...

Fig. 14-15 Gingival histoplasmosis with loss of periodontal tissue around th...

Fig. 14-16 Same patient as shown in Fig. 14-15. Lingual aspect with ulcerati...

Fig. 14-17 Drug-induced erythema multiforme sometimes involves the gingiva. ...

Fig. 14-18 Lichenoid contact lesion of the left buccal mucosa due to type IV...

Fig. 14-19 Diffuse gingivitis and cheilitis due to contact allergy to a flav...

Fig. 14-20 Plasma cell gingivitis.

Fig. 14-21 Erythema multiforme with crust formation of the vermilion border ...

Fig. 14-22 Erythema multiforme with ulceration covered by heavy fibrin exuda...

Fig. 14-23 Erythema multiforme. Skin lesion with characteristic iris appeara...

Fig. 14-24 Pemphigus vulgaris. Initial lesion resembling recurrent aphthous ...

Fig. 14-25 Pemphigus vulgaris. Erosions of soft palatal mucosa. The erosive ...

Fig. 14-26 Mucous membrane pemphigoid affecting the attached gingiva of both...

Fig. 14-27 Mucous membrane pemphigoid with intact and ruptured gingival bull...

Fig. 14-28 Mucous membrane pemphigoid with hemorrhagic gingival bulla. The p...

Fig. 14-29 Mucous membrane pemphigoid. Eye lesion with scar formation due to...

Fig. 14-30 Skin lesions of lichen planus. Papules with delicate white striat...

Fig. 14-31 Oral lichen planus. Papular lesion of right buccal mucosa.

Fig. 14-32 Oral lichen planus. Reticular lesion of lower lip mucosa. The whi...

Fig. 14-33 Oral lichen planus. Reticular lesions of gingivae in the lower le...

Fig. 14-34 Oral lichen planus. Plaque-type lesion of maxillary gingivae.

Fig. 14-35 Oral lichen planus. Erythematous lesions of facial maxillary and ...

Fig. 14-36 Oral lichen planus. Erythematous and ulcerative lesion of the max...

Fig. 14-37 Oral lichen planus. Erythematous and reticular lesion of maxillar...

Fig. 14-38 Oral lichen planus. Erythematous and reticular lesion of the lowe...

Fig. 14-39 Oral lichen planus. Erythematous and reticular lesion of right ma...

Fig. 14-40 Same patient as shown in Fig. 14-39 after modified toothbrushing ...

Fig. 14-41 Oral lichen planus. Erythematous and ulcerative/reticular lesions...

Fig. 14-42 Same patient as shown in Fig. 14-41 after periodontal treatment a...

Fig. 14-43 Oral lichen planus. Bullous/reticular lesion of the left palatal ...

Fig. 14-44 Gingival discoid lupus erythematosus lesion. A central erythemato...

Fig. 14-45 Gingival plaque-type discoid lupus erythematosus lesion resemblin...

Fig. 14-46 Antimalarial drugs may result in brownish gingival discoloration....

Fig. 14-47 A frequent oral finding in patients with Crohn´s disease is mucos...

Fig. 14-48 Gingival lesion in a Crohn’s patient. Cobblestoning may be seen i...

Fig. 14-49 Gingival lesion in a Crohn’s patient. Erythema and swelling with ...

Fig. 14-50 Granulomatous gingival hyperplasia may be due to sarcoidosis, whi...

Fig. 14-51 Fibrous epulis.

Fig. 14-52 Calcifying fibroblastic granuloma of the lower right premolar reg...

Fig. 14-53 Pyogenic granuloma of upper incisor region before (a) and after t...

Fig. 14-54 Large pyogenic granuloma of the maxillary premolar/molar region....

Fig. 14-55 Peripheral giant cell granuloma of the mandibular canine/premolar...

Fig. 14-56 Homogenous leukoplakia of the sublingual area.

Fig. 14-57 (a) The combined red and white areas is characteristic of this no...

Fig. 14-58 Proliferative verrucous leukoplakia with exophytic growth and inv...

Fig. 14-59 Gingival erythroplakia of the lower left premolar/molar region.

Fig. 14-60 Gingival cancer characterized by a persisting ulcer.

Fig. 14-61 Early squamous cell carcinomas clinically demonstrating small nod...

Fig. 14-62 Gingival cancer characterized by proliferating small nodules on t...

Fig. 14-63 Verrucous carcinoma of the mandibular lingual gingivae.

Fig. 14-64 Acute myelogenous leukemia with extensive swelling of the gingiva...

Fig. 14-65 Acute lymphocytic leukemia with gingival ulceration in a child.

Fig. 14-66 Acute myelogenous leukemia with petechiae and swelling of the gin...

Fig. 14-67 Gingival non-Hodgkin’s lymphoma of the mandibular molar region.

Fig. 14-68 Frictional keratosis due to an aggressive tooth brushing habit. N...

Fig. 14-69 Gingival wounding due to improper toothbrushing. Note the charact...

Fig. 14-70 Gingival wounding due to improper toothbrushing. Note the charact...

Fig. 14-71 Severe gingival recession and wounding due to improper toothbrush...

Fig. 14-72 Healing of the lesion shown in Fig. 14-71. The damage to the peri...

Fig. 14-73 Lesions after dental flossing are common and sometimes result in ...

Fig. 14-74 (a) Self-inflicted gingival recession with an ulcerated margin in...

Fig. 14-75 Chlorhexidine-induced mucosal desquamation. This is a reversible ...

Fig. 14-76 Thermal burn with slight erosion and petechiae of palatal gingiva...

Fig. 14-77 Pigmentation in left buccal mucosa in a patient with Peutz-Jegher...

Fig. 14-78 Smoker’s melanosis of mandibular anterior gingiva.

Fig. 14-79 Amalgam tattoo of the attached gingiva.

Chapter 15

Fig. 15-1 Site-specific changes in gingival color and contour associated wit...

Fig. 15-2 Two subpopulations of individuals presenting a substantially diffe...

Fig. 15-3 Gingival inflammatory response to similar plaque deposits as measu...

Fig. 15-4 Gingival inflammatory response to plaque in periodontally healthy ...

Fig. 15-5 Plaque-induced gingivitis on an intact periodontium. Clinical atta...

Fig. 15-6 Plaque-induced gingivitis on a reduced periodontium in a patient w...

Fig. 15-7 Periodontal health in an intact periodontium. Clinical attachment ...

Chapter 16

Fig. 16-1 The initial assessment of Stage distinguishes between Stage I or I...

Fig. 16-2 Case 1. (a–d) Clinical and (e–g) radiographic images of a case dia...

Fig. 16-3 Case 2. (a–d) Clinical and (e, f) radiographic images of a case di...

Fig. 16-4 Case 3. (a–d) Clinical and radiographic images of a case diagnosed...

Fig. 16-5 Case 4. (a, b) Clinical (c, d) radiographic images of a case diagn...

Fig. 16-6 Case 5. (a, b) Clinical and (c) radiographic images of a case diag...

Fig. 16-7 Case 6. (a) Clinical and (b) radiographic images of a case diagnos...

Chapter 17

Fig. 17-1 An overview of “landmark studies” in periodontal medicine publishe...

Fig. 17-2 Oro-systemic inflammatory link. Several systemic diseases associat...

Fig. 17-3 Scatter plot with error horizonal lines of reported adjusted relat...

Fig. 17-4 Scatter plot with error horizonal lines of reported adjusted weigh...

Fig. 17-5 Scatter plot with error horizonal lines of reported adjusted relat...

Chapter 18

Fig. 18-1 Plausibility of the biological link between periodontal diseases a...

Fig. 18-2 The impact of experimental periodontitis in a rabbit model and how...

Fig. 18-3 The phases of atherosclerosis, atherothrombosis, and cardiovascula...

Fig. 18-4 Plausibility of the biological link through which diabetes impacts...

Fig. 18-5 Plausibility of the biological link through which periodontal dise...

Fig. 18-6 Diabetic control and the severity of periodontitis. CRP, C-reactiv...

Fig. 18-7 Stage III generalized periodontitis in a patient with type 2 diabe...

Fig. 18-8 Stage IV generalized periodontitis in a patient with type 2 diabet...

Fig. 18-9 Stage IV generalized periodontitis in a patient with type 2 diabet...

Fig. 18-10 Plausibility of the link between periodontal and systemic disease...

Chapter 19

Fig. 19-1 Histopathology of a periodontal abscess.

Fig. 19-2 Periodontal abscess associated with a lower right first molar. Not...

Fig. 19-3 Periodontal abscess associated with a mandibular second molar. Not...

Fig. 19-4 Periodontal abscess associated with a lower right first molar. Not...

Fig. 19-5 Periodontal abscess associated with an upper right third molar. No...

Fig. 19-6 (a) Periodontal abscess associated with a lower left canine. Note ...

Fig. 19-7 Necrotizing gingivitis in a 22-year-old woman: bleeding, necrosis,...

Fig. 19-8 Necrotizing periodontitis: presence of necrosis/ulcer of the inter...

Fig. 19-9 Healing of necrotizing gingivitis lesions in the upper anterior se...

Fig. 19-10 Diagnostic tree for endo-periodontal lesions (EPL).

Chapter 20

Fig. 20-1 Healthy peri-implant mucosa, peri-implant mucositis, and peri-impl...

Fig. 20-2 Clinical symptoms of peri-implant mucositis, including varying sig...

Fig. 20-3 Diagnosis of peri-implant mucositis indicated by the clinical find...

Fig. 20-4 (a) Healthy gingiva and peri-implant mucosa. (b) Same site followi...

Fig. 20-5 Five months of undisturbed plaque formation on three different typ...

Fig. 20-6 (a–c) Photomicrographs illustrating inflammatory cell infiltrates ...

Fig. 20-7 Diagnosis of peri-implantitis indicated by the clinical finding of...

Fig. 20-8 Clinical symptoms of peri-implantitis. Note the large amounts of p...

Fig. 20-9 An implant-supported crown in the premolar position in the right s...

Fig. 20-10 Clinical (a) and radiographic (b) characteristics of three implan...

Fig. 20-11 (a) Photomicrograph showing a human peri-implantitis lesion. Note...

Fig. 20-12 Photomicrographs showing human specimens obtained from sites with...

Fig. 20-13 Radiographs showing (a) experimental peri-implantitis and (b) per...

Fig. 20-14 (a) Photomicrograph of a buccolingual ground section showing a pe...

Fig. 20-15 (a) Photomicrograph of a buccolingual ground section showing a pe...

Chapter 21

Fig. 21-1 (a) The tooth-supporting apparatus (i.e. periodontium) includes th...

Fig. 21-2 Stages of periodontal wound healing. Optimal periodontal healing r...

Fig. 21-3 Periodontal wound following flap surgery: (1) gingival epithelium;...

Fig. 21-4 (a) Regular healing process following the periodontal flap adaptat...

Fig. 21-5 Advanced approaches for regenerating tooth-supporting structures. ...

Fig. 21-6 Cell- and gene-based technologies using scaffolding matrices for p...

Fig. 21-7 (a) Concept of additive manufacturing (3D printing) of a 3D scaffo...

Fig. 21-8 (a) Severe probing pocket depth (PPD) (7 mm), mesial to tooth 43 a...

Fig. 21-9 (a) A 32-year-old male patient with severe periodontitis. Tooth 13...

Fig. 21-10 (a) A 27-year-old patient at the re-evaluation visit after the in...

Chapter 22

Fig. 22-1 (a–g) Buccal/labial and palatal/lingual views of a 59-year-old mal...

Fig. 22-2 Buccal migration of tooth 13 as a sign of severe periodontitis.

Fig. 22-3 Periapical radiographs of the patient presented in Fig. 22-1.

Fig. 22-4 Schematic drawing (a) and histologic section (b) illustrating the ...

Fig. 22-5 Pocket probing depth in conjunction with bleeding on probing. A gr...

Fig. 22-6 Chart used to identify bleeding on probing-positive sites in a dic...

Fig. 22-7 Examples of graduated periodontal probes with a standardized tip d...

Fig. 22-8 Periodontal chart indicating pocket probing depth (PPD) <4 mm in b...

Fig. 22-9 Periodontal chart indicating periodontal attachment loss has occur...

Fig. 22-10 (a) In the presence of an inflammatory cell infiltrate (ICT) in t...

Fig. 22-11 Superficial (tooth 46) and deep (tooth 16) periodontal tissue des...

Fig. 22-12 (a, b) Anatomic locations for the assessment of furcation involve...

Fig. 22-13 (a) Furcation involvement is explored using a curved periodontal ...

Fig. 22-14 The furcation involvement (FI) shown on the periodontal chart. Op...

Fig. 22-15 The use of a Rinn filmholder and a long-cone paralleling techniqu...

Fig. 22-16 The presence of bacterial biofilms is marked in the appropriate f...

Chapter 23

Fig. 23-1 Representative periapical images of the upper and lower jaws. (a) ...

Fig. 23-2 This bitewing radiograph shows an impacted third molar with resorp...

Fig. 23-3 The width of the mandibular base can be estimated on an occlusal i...

Fig. 23-4 This panoramic view shows an overview of the dental and maxillofac...

Fig. 23-5 This panoramic view exhibits image distortion and superimposition ...

Fig. 23-6 (a) Lateral and (b) posteroanterior cephalometric projections can ...

Fig. 23-7 The superior soft tissue contrast resolution of MDCT scans enables...

Fig. 23-8 Representative cross-sectional CBCT images show a dentigerous cyst...

Fig. 23-9 Metal artifacts from a titanium dental implant and corresponding r...

Fig. 23-10 Representative ultrasound image shows superficial anatomical land...

Fig. 23-11 Representative magnetic resonance images exhibiting facial soft t...

Fig. 23-12 Axial magnetic resonance image shows multiple hyperintense rings ...

Fig. 23-13 This bitewing radiograph exhibits a radiolucency in the region of...

Fig. 23-14 An example of a full-mouth intraoral X-ray examination for period...

Fig. 23-15 Representative periapical images show periodontal bone loss in di...

Fig. 23-16 The periapical image shows a reduced interradicular alveolar cres...

Fig. 23-17 Representative examples of bony defects around teeth as depicted ...

Fig. 23-18 Various stages of furcation involvement as depicted on periapical...

Fig. 23-19 A periapical image demonstrating a radiolucent triangle superimpo...

Fig. 23-20 This periapical image shows an extended radiolucency from the alv...

Fig. 23-21 The cone beam computed tomography images show the extent of the i...

Fig. 23-22 The coronal cut of a magnetic resonance image shows the outline o...

Fig. 23-23 This periapical image shows a reduced bone level at the edentulou...

Fig. 23-24 This periapical image shows a wide fracture line on the root of t...

Fig. 23-25 The panoramic view enables an overview of all edentulous regions ...

Fig. 23-26 The sagittal cone beam computed tomography plane shows the residu...

Fig. 23-27 The sagittal cone beam computed tomography view taken between tee...

Fig. 23-28 The coronal cone beam computed tomography view shows a severely a...

Fig. 23-29 (a) Slight and severe mucosal thickening can be respectively seen...

Fig. 23-30 The bony canal for the superior alveolar artery (arrow) can be se...

Fig. 23-31 Different morphologies and anatomical landmarks of the mandibular...

Fig. 23-32 The cone beam computed tomography scan (coronal view) exhibits a ...

Fig. 23-33 This cone beam computed tomography scan (coronal view) shows exte...

Fig. 23-34 The periapical image shows insertion depth and also the position ...

Fig. 23-35 This periapical image highlights an incomplete seating of the hea...

Fig. 23-36 This periapical image shows the seating of the impression posts o...

Fig. 23-37 The periapical image shows complete seating of the final abutment...

Fig. 23-38 The bitewing radiograph shows complete seating of the prosthesis ...

Fig. 23-39 The cone beam computed tomography images show a fragment of the i...

Fig. 23-40 The cross-sectional cone beam computed tomography images show per...

Fig. 23-41 The periapical radiograph exhibits bone loss at the mesial and di...

Fig. 23-42 The periapical radiograph shows a uniform radiolucent lining arou...

Fig. 23-43 Representative example of a surgical navigation technique for the...

Fig. 23-44 Cross-sectional cone beam computed tomography images demonstratin...

Chapter 24

Fig. 24-1 Standard form used to collect health history data from the patient...

Chapter 25

Fig. 25-1 Basic periodontal examination system code. (a) Code 0. (b) Code 1....

Fig. 25-2 (a–d) Clinical extra- and intraoral photographs of a 27-year-old f...

Fig. 25-3 Periodontal chart of the patient presented in Fig. 25-2.

Fig. 25-4 Radiographs of the patient presented in Fig. 25-2.

Fig. 25-5 Pretherapeutic single tooth prognosis of the patient presented in ...

Fig. 25-6 (a–c) Intraoral photographs of the patient presented in Fig. 25-2 ...

Fig. 25-7 Periodontal chart of the patient presented in Fig. 25-2 at re-eval...

Figs. 25-8 (a–c) Clinical intrasurgical views of the mandibular and maxillar...

Figs. 25-9 (a, b) Clinical lateral views of the patient presented in Fig. 25...

Fig. 25-10 Periodontal chart of the patient presented in Fig. 25-2 at re-eva...

Figs. 25-11 (a–c) Intraoral photographs of the patient presented in Fig. 25-...

Figs. 25-12 (a–c) Intraoral photographs of the patient presented in Fig. 25-...

Fig. 25-13 Periodontal chart of the patient presented in Fig. 25-2 at the re...

Fig. 25-14 Periapical radiographs of the patient presented in Fig. 25-2 at t...

Figs. 25-15 (a, b) Periapical radiographs of tooth 36 of the patient present...

Fig. 25-16 Intraoral photographs of patient S.B. 20 years following completi...

Fig. 25-17 Periodontal chart of patient S.B. 20 years following completion o...

Fig. 25-18 Periapical radiographs of patient S.B. 20 years following complet...

Fig. 25-19 Intraoral photographs, periapical radiographs, and periodontal ch...

Fig. 25-20 Pretherapeutic single tooth prognosis of patient M.A.

Fig. 25-21 Intraoral photographs and periodontal chart of patient M.A. 3 mon...

Fig. 25-22 (a–l) Resective surgery and reconstructions in the first sextant ...

Fig. 25-23 Clinical and radiographic aspects (a, b) before and (c, d) after ...

Fig. 25-24 (a–j) Clinical and radiographic views of periodontal regeneration...

Fig. 25-25 Intraoral photographs, periapical radiographs, and periodontal ch...

Fig. 25-26 Periodontal risk assessment of patient M.A. at completion of acti...

Fig. 25-27 Intraoral photographs, periapical radiographs, and periodontal ch...

Chapter 27

Fig. 27-1 Following an individually tailored treatment program for improved ...

Fig. 27-2 Readiness to change.

Fig. 27-3 Motivation (importance) and self-efficacy (readiness) scale.

Fig. 27-4 Patient Activation Fabric for the Dental Visit (Implementation Mod...

Fig. 27-5 Appropriate position for a conversation: the clinician is facing t...

Fig. 27-6 Inappropriate position for a conversation: the clinician is wearin...

Chapter 28

Fig. 28-1 Illustration of a toothbrush and tongue scraper from a book by Cor...

Fig. 28-2 Flat-trim, multilevel and angled manual toothbrush bristle tuft de...

Fig. 28-3 Charters method of toothbrushing. (a) Note how the head of the too...

Fig. 28-4 Filament end-rounding.

Fig. 28-5 Tapered toothbrush filaments.

Fig. 28-6 (a) Overview of the development of electric toothbrushes, from bru...

Fig. 28-7 With interdental brushes, the diameter of the metal wire core is a...

Fig. 28-8 Dental water jet. Fluid flow can be either continuous or pulsated....

Fig. 28-9 (a) Soft tissue damage as a result of extensive toothbrushing. Not...

Fig. 28-10 (a) Disclosing solution is often used to identify plaque. (b) Not...

Fig. 28-11 Chart showing the teeth and tooth surfaces in the maxilla and man...

Chapter 29

Fig. 29-1 Mechanisms of effect of antiplaque agents on bacterial biofilms (i...

Fig. 29-2 Substantivity. (a, b) Two agents with different substantivity (mea...

Fig. 29-3 Three-dimensional assessment of cell vitality in a biofilm, with a...

Fig. 29-4 Chemical structure of delmopinol (prepared with Jmol; www.jmol.org...

Fig. 29-5 Chemical structure of essential oils: (a) Menthol. (b) Eucalyptol....

Fig. 29-6 Chemical structure of triclosan (prepared with Jmol).

Fig. 29-7 Chemical structure of chlorhexidine digluconate (prepared with Jmo...

Fig. 29-8 Tooth staining after chlorhexidine use. (a) Lingual aspect. (b) Bu...

Fig. 29-9 Chemical structure of cetylpyridinium chloride (prepared with Jmol...

Chapter 30

Fig. 30-1 Curette demonstrating the handle, shank, and blade.

Fig. 30-2 Working end of a sickle, which has a triangular cross-section and ...

Fig. 30-3 Examples of the working end of instruments and their design with c...

Fig. 30-4 Selection of instruments with varying shank configurations to faci...

Fig. 30-5 (a) Curette is inserted into the periodontal pocket. Note the near...

Fig. 30-6 A modified pen grasp and “third finger rest” in the premolar and m...

Fig. 30-7 Sharpening of a curette. The original geometry of the cutting edge...

Fig. 30-8 Inserts of different length and curvature for piezoelectric (left)...

Fig. 30-9 Control of wear of the piezoelectric ultrasonic tip. The red line ...

Fig. 30-10 (a) The specially designed subgingival nozzle applied for debride...

Fig. 30-11 (a) Using a laser in periodontal treatment: patient and operator ...

Fig. 30-12 Radiographs, clinical image, and probing pocket assessments of a ...

Fig. 30-13 Clinical image and probing pocket assessments of the same patient...

Fig. 30-14 A gingival unit (a) before and (b) after periodontal therapy. Pro...

Chapter 31

Fig. 31-1 Treatment of a periodontal abscess with systemic antibiotics (azit...

Fig. 31-2 Healing of necrotizing gingivitis lesions, after treatment, in the...

Fig. 31-3 Sequelae, namely absence of interdental papillae and gingival crat...

Fig. 31-4 Endo-periodontal lesion without root damage (grade 3) in a non-per...

Fig. 31-5 Steps in the management of an endo-periodontal lesion (EPL).

Fig. 31-6 Endo-periodontal lesion without root damage (grade 2) in a patient...

Fig. 31-7 Endo-periodontal lesion without root damage (grade 3) in non-perio...

Chapter 32

Fig. 32-1 Gingivectomy. Straight incision technique.

Fig. 32-2 Gingivectomy. Scalloped incision technique.

Fig. 32-3 Gingivectomy. Pocket marking. (a) An ordinary periodontal probe is...

Fig. 32-4 Gingivectomy. (a) Primary incision. (b) The incision is terminated...

Fig. 32-5 Gingivectomy. The secondary incision through the interdental area ...

Fig. 32-6 Gingivectomy. The detached gingiva is removed with a scaler.

Fig. 32-7 Gingivectomy. Probing for residual pockets. Gauze packs have been ...

Fig. 32-8 Gingivectomy. The periodontal dressing has been applied and proper...

Fig. 32-9 Original Widman flap. Two releasing incisions demarcate the area s...

Fig. 32-10 Original Widman flap. The collar of inflamed gingival tissue is r...

Fig. 32-11 Original Widman flap. By bone recontouring, a “physiologic” conto...