www.metdental.com
Author Acknowledgements
Thomas G. Wilson Jr., DDS
Dr. Wilson is a Board Certified periodontist with
a private practice in Dallas, Texas.
Dr. Wilson has no relevant relationships
to disclose.
The following commentary highlights
fundamental and commonly accepted practices
on the subject matter. The information is
intended as a general overview and is for
educational purposes only. This information
does not constitute legal advice, which can only
be provided by an attorney.
© Metropolitan Life Insurance Company,
New York, NY. All materials subject to
this copyright may be photocopied for the
noncommercial purpose of scientific or
educational advancement.
Originally published August 2010.
Updated
and revised December 2013 and December
2016.
Expiration date:
December 2019.
The
content of this Guide is subject to change as
new scientific information becomes available.
MetLife is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental
Association to assist dental professionals in
identifying quality providers of continuing dental
education. ADA CERP does not approve or
endorse individual courses or instructors, nor
does it imply acceptance of credit hours by
boards of dentistry.
Concerns or complaints about a CE provider
may be directed to the provider or to ADA
CERP at www.ada.org/goto/cerp.
Accepted Program Provider FAGD/MAGD
Credit 11/01/16 - 12/31/20.
Address comments to:
dentalquality@MetLife.com
MetLife Dental
Quality Initiatives Program
501 US Highway 22
Bridgewater, NJ 08807
Educational Objectives
Following this unit of instruction, the practitioner should be able to:
1.
Understand the rationale for Periodontal Osseous Surgery;
a.
to treat moderate and severe periodontitis.
b.
to lengthen clinical crowns prior to restoration of a tooth.
2.
Delineate the advantages and disadvantages of closed subgingival scaling and root
planing compared to periodontal surgery.
3.
Understand the relationship of disease severity to the decision to recommend Periodontal
Osseous Surgery.
4.
Identify patients who would benefit from Periodontal Osseous Surgery.
5.
Understand the concept of biologic width and how it relates to crown lengthening.
6.
Understand the role of maintenance care and personal oral hygiene following Periodontal
Osseous Surgery.
Introduction
Periodontal Osseous Surgery can be defined as
the removal of bone surrounding the teeth in order
to reestablish normal bony contours at a more
apical level. The two primary applications for this
type
of
surgery
are
treating
periodontitis
and lengthening the clinical crown of a tooth
(crown lengthening) prior to restoring that tooth.
Other forms of periodontal therapy, including
closed
subgingival
scaling
and
root
planing,
and
surgical
therapy
designed
to
achieve
regeneration of the periodontium for patients with
periodontitis, have been covered in other Quality
Resource Guides.
1,2
This Guide will focus on
the intentional removal of bone supporting the
tooth (ostectomy) and contouring of non-supporting
alveolar bone (osteoplasty), together known as
“Periodontal Osseous Surgery”, as part of therapy
for periodontitis and for lengthening clinical crowns.
Quality Resource Guide
Periodontal Osseous Surgery
MetLife designates this activity for
1.0 continuing education credit
for the review of this Quality Resource Guide
and successful completion of the post test.
THIRD EDITION
Figure 1
Moderate periodontitis is usually seen first in the molar
regions and causes bone loss under the contact area. This
figure demonstrates a typical two wall (one to the lingual,
one to the facial) bony crater. Two to three millimeters
deep interdental bony defects are optimal candidates for
definitive osseous surgery. This is seen clinically as an
increased interproximal probing depth and may or may not
be visible on radiographs. The configuration of this defect
reduces the efficacy of interproximal personal oral hygiene
measures such as the use of dental floss.