Success in periodontology: An evolutive concept

Abstract

Aim The purpose of this editorial was to discuss a definition of success after periodontal therapy based on the retention of natural dentition. Materials and Methods Based on topic and relevance, references were collected and then divided into four categories: (a) the influence of available therapeutic techniques on the definition of hopeless teeth, (b) the long‐term rate of tooth loss during supportive periodontal therapy, (c) the duration of time that the treatment outcomes may be considered stable and (d) patients’ perception and satisfaction of periodontal therapy. Results Periodontal therapy can change the prognosis of hopeless teeth, making them maintainable in the long term. The rate of tooth loss can be minimized in a way that a period of 10 years or more is needed to evaluate further periodontal breakdown. In addition, patients’ perception and satisfaction of the treatment should be considered as the main therapeutic endpoints of the provided periodontal therapy. Conclusions Definition of success is linked to the available therapeutic tools. Due to the recent advancement of treatment modalities, periodontally hopeless teeth can now be treated and maintained for a long period of time with health, function and patient satisfaction.

Efficacy of access flap procedures compared to subgingival debridement in the treatment of periodontitis. A systematic review and meta‐analysis

“…This is achieved in part by reducing the severity and the number of pockets, creating an accessible environment for oral hygiene. These goals should be maintained over time to warrant periodontal stability (Pini Prato, Di Gianfilippo, & Wang, ). Interestingly, AF was more successful increasing the number of shallow sites (11.6%).…”

Diagnosis of Stage III Periodontitis and Ambiguities of the “Gray Zones” in Between Stage III and Stage IV

“…The primary goal of periodontal treatment is the preservation of natural dentition in health, comfort, function, and esthetics, 5 and is best achieved through an accurate diagnosis, treatment planning, regular maintenance, and long‐term follow‐up. The staging and grading system offers a guide for clinicians to highlight the important differentiating features of severe periodontitis cases that may have a major impact on treatment, monitoring, and efforts to identify systemic factors that may influence the patient's response to therapy.…”

“…The periodontal community is undergoing the process of adaptation to the new system and exploration of “gray zone” cases that may produce uncertain clinical scenarios in need of thoughtful clinical judgement 3 . A call for sharing experience and rationale on how to interpret the “gray zone” is needed and narratives have been published to guide clinicians on their interpretation and dissemination of the new classification 4,5 . Therefore, the aim of this article is to present two “gray‐zone” cases that fall within Stage III and IV, and illustrates the decision‐making process and the clinical judgment that was used to differentiate Stage III and Stage IV cases.…”

On the value of the 2017 classification of phenotype and gingival recessions

“…Over the years, the classification of periodontal disease has evolved to reflect our knowledge and understanding of the disease and its progression 2 . The 2017 World Workshop on the classification of periodontal and peri‐implant diseases and conditions completely restructured knowledge in periodontology.…”