Dental Clinics of North America RSS feed: Current Issue. The Dental Clinics of North America updates you on the latest trends in patient management and the newest advances as well as provides a sound basis for choosing treatment options. Each issue focuses on a single topic in dentistry and is presented under the direction of an experienced guest editor.http://www.dental.theclinics.com/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Dental Clinics of North America0011-8532541January 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.dental.theclinics.com/article/PIIS0011853209001219/abstract?rss=yesContents10.1016/S0011-8532(09)00121-9Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-4viiixhttp://www.dental.theclinics.com/article/PIIS0011853209001220/abstract?rss=yesForthcoming Issues10.1016/S0011-8532(09)00122-0Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-4xxhttp://www.dental.theclinics.com/article/PIIS0011853209000974/abstract?rss=yesUntil the middle of the twentieth century, the treatment of periodontal diseases was based on inferences on the cause of the disease from the study of histologic material and expert opinion. Thus, at that time, such investigators as Shluger called for the need for the therapist to eliminate the periodontal pocket, create harmonious gingival form, and recontour the osseous architecture to prevent progression or recurrence of periodontal pocketing. Preservation of “physiologic architecture,” elimination of food traps, and maintenance of a wide zone of keratinized gingiva were all desired end points of periodontal therapy. Thus, much attention was paid to correction of anatomic deformities to enable the patient to adequately perform oral hygiene.PrefaceFrank A. Scannapieco10.1016/j.cden.2009.10.003Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-4xixiiihttp://www.dental.theclinics.com/article/PIIS0011853209000718/abstract?rss=yesThe comparison of the efficacy of surgical and nonsurgical procedures revealed that scaling and root planing alone or in combination with flap procedures are effective methods for the treatment of chronic periodontitis. Also, the consistent message is that in treating deep pockets, open-flap debridement results in greater probing pocket depth reduction and clinical attachment gain than nonsurgical modalities. Nonsurgical modalities in shallower pockets consistently involve less post-therapy recession and are clearly recognized as being more conservative. Research is still needed on the clinical benefit of the granulation tissue removal that is a feature of periodontal surgical therapy and, to a lesser extent, occurs through indirect trauma in nonsurgical therapy.Nonsurgical Mechanical Treatment Strategies for Periodontal DiseaseDanae A. Apatzidou, Denis F. Kinane10.1016/j.cden.2009.08.006Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-4112http://www.dental.theclinics.com/article/PIIS0011853209000755/abstract?rss=yesPeriodontal diseases are initiated by subgingival periodontal pathogens in susceptible periodontal sites. The host immune response toward periodontal pathogens helps to sustain periodontal disease and eventual alveolar bone loss. Numerous adjunctive therapeutic strategies have evolved to manage periodontal diseases. Systemic and local antibiotics, antiseptics, and past and future host immune modulatory agents are reviewed and discussed to facilitate the dental practitioner's appreciation of this ever-growing field in clinical periodontics.Non-Surgical Chemotherapeutic Treatment Strategies for the Management of Periodontal DiseasesJoe W. Krayer, Renata S. Leite, Keith L. Kirkwood10.1016/j.cden.2009.08.010Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-41333http://www.dental.theclinics.com/article/PIIS001185320900072X/abstract?rss=yesFor many intraoral soft-tissue surgical procedures the laser has become a desirable and dependable alternative to traditional scalpel surgery. However, the use of dental lasers in periodontal therapy is controversial. This article presents the current peer-reviewed evidence on the use of dental lasers for the treatment of chronic periodontitis.Lasers and the Treatment of Chronic PeriodontitisCharles M. Cobb, Samuel B. Low, Donald J. Coluzzi10.1016/j.cden.2009.08.007Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-43553http://www.dental.theclinics.com/article/PIIS0011853209000792/abstract?rss=yesBone replacement grafts are widely used to promote bone formation and periodontal regeneration. Conventional surgical approaches, such as open flap debridement, provide critical access to evaluate and detoxify root surfaces as well as establish improved periodontal form and architecture; however, these surgical techniques offer only limited potential in restoring or reconstituting component periodontal tissues. A wide range of bone grafting materials, including bone grafts and bone graft substitutes, have been applied and evaluated clinically, including autografts, allografts, xenografts, and alloplasts (synthetic/semisynthetic materials). This review provides an overview of the biologic function and clinical application of bone replacement grafts for periodontal regeneration. Emphasis is placed on the clinical and biologic goals of periodontal regeneration as well as evidence-based treatment outcomes.Regeneration of Periodontal Tissue: Bone Replacement GraftsMark A. Reynolds, Mary Elizabeth Aichelmann-Reidy, Grishondra L. Branch-Mays10.1016/j.cden.2009.09.003Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-45571http://www.dental.theclinics.com/article/PIIS0011853209000767/abstract?rss=yesThe concept that only fibroblasts from the periodontal ligament or undifferentiated mesenchymal cells have the potential to re-create the original periodontal attachment has been long recognized. Based on this concept, guided tissue regeneration has been applied with variable success to regenerate periodontal defects. Quantitative analysis of clinical outcomes after guided tissue regeneration suggests that this therapy is a successful and predictable procedure to treat narrow intrabony defects and class II mandibular furcations, but offers limited benefits in the treatment of other types of periodontal defects.Regeneration of Periodontal Tissues: Guided Tissue RegenerationCristina C. Villar, David L. Cochran10.1016/j.cden.2009.08.011Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-47392http://www.dental.theclinics.com/article/PIIS0011853209000779/abstract?rss=yesSeveral growth and differentiation factors have shown potential as therapeutic agents to support periodontal wound healing/regeneration, although optimal dosage, release kinetics, and suitable delivery systems are still unknown. Experimental variables, including delivery systems, dose, and the common use of poorly characterized preclinical models, make it difficult to discern the genuine efficacy of each of these factors. Only a few growth and differentiation factors have reached clinical evaluation. It appears that well-defined discriminating preclinical models followed by well-designed clinical trials are needed to further investigate the true potential of these and other candidate factors. Thus, current research is focused on finding relevant growth and differentiation factors, optimal dosages, and the best approaches for delivery to develop clinically meaningful therapies in patient-centered settings.Periodontal Regeneration: Focus on Growth and Differentiation FactorsJaebum Lee, Andreas Stavropoulos, Cristiano Susin, Ulf M.E. Wikesjö10.1016/j.cden.2009.09.001Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-493111http://www.dental.theclinics.com/article/PIIS0011853209000731/abstract?rss=yesThe principal reason for providing periodontal therapy is to achieve periodontal health and retain the dentition. Patients with a history of periodontitis represent a unique group of individuals who previously succumbed to a bacterial challenge. Therefore, it is important to address the management and survival rate of implants in these patients. Systematic reviews often are cited in this article, because they provide a high level of evidence and facilitate reviewing a vast amount of information in a succinct manner.Dental Implants in the Periodontal PatientGary Greenstein, John Cavallaro, Dennis Tarnow10.1016/j.cden.2009.08.008Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-4113128http://www.dental.theclinics.com/article/PIIS0011853209000743/abstract?rss=yesGingival recession is an intriguing and complex phenomenon. Recession frequently disturbs patients because of sensitivity and esthetics. Many surgical techniques have been introduced to treat gingival recession, including those involving autogenous tissue grafting, various flap designs, orthodontics, and guided tissue regeneration. This article describes different clinical approaches to treat gingival recession with emphasis on techniques that show promising results and root coverage.Treatment of Gingival RecessionMoawia M. Kassab, Hala Badawi, Andrew R. Dentino10.1016/j.cden.2009.08.009Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-4129140http://www.dental.theclinics.com/article/PIIS0011853209000780/abstract?rss=yesPeriodontal disease is a major public health issue and the development of effective therapies to treat the disease and regenerate periodontal tissue is an important goal of today's medicine. This article highlights recent scientific advancements in gene therapy, stem cell biology, and RNA interference with the intent of identifying their potential in periodontal tissue regeneration. Results from basic research, preclinical, and clinical studies indicate that these fields of research may soon contribute to more effective regenerative therapies for periodontal disease.Future Approaches in Periodontal Regeneration: Gene Therapy, Stem Cells, and RNA InterferenceGiuseppe Intini10.1016/j.cden.2009.09.002Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-4141155http://www.dental.theclinics.com/article/PIIS0011853209000950/abstract?rss=yesPeriodontal and restorative dentistry are mutually important facets of clinical dentistry. Today's clinicians have many treatment options at their disposal, including biotolerant restorative materials and implants, to maintain periodontal health. It is crucial for the clinician to understand the biologic principles that form the foundation for restorative reconstruction of the periodontally involved tooth. This article discusses new techniques and trends in the critical management of the restorations, particularly at the gingival margins, and explores the role of implant dentistry as an option for the restorative plan of the periodontal patient.Restorative Options for the Periodontal PatientSebastiano Andreana10.1016/j.cden.2009.10.001Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-4157161http://www.dental.theclinics.com/article/PIIS0011853209000962/abstract?rss=yesPeriodontal disease is treated by various approaches, including simple oral hygiene practices, professional mechanical debridement, antimicrobial therapy and periodontal surgery. There is evidence to associate periodontal disease with several systemic diseases and conditions, including myocardial infarction, adverse pregnancy outcomes, diabetes mellitus, and respiratory disease. This article reviews the published literature that describes the effects of periodontal treatment on cardiovascular diseases, adverse pregnancy outcomes, diabetes mellitus, and respiratory disease. While some progress has been made, further research is required to understand the value of periodontal interventions in the prevention of systemic diseases.“Does Periodontal Therapy Reduce the Risk for Systemic Diseases?”Frank A. Scannapieco, Ananda P. Dasanayake, Nok Chhun10.1016/j.cden.2009.10.002Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-4163181http://www.dental.theclinics.com/article/PIIS0011853209001232/abstract?rss=yesIndex10.1016/S0011-8532(09)00123-2Dental Clinics of North America 54, 1 (2010)2010-01-01Dental Clinics of North America2010-01-01541S0011-8532(09)X0005-4183189