Decision Making in Periodontology


Decision Making Periodontology illustrates the thought precesses in the field of periodontics that determine optimal therapy for an individual patient. The approach entails the use of a decision tree for each clinical problem or situation; this is accompanied by a brief explanation of the basis for each decision. The chapters present common clinical problems in a format that enables the reader to find solutions more easily than in traditional texts. In addition, several readily available references are included ...
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Decision Making Periodontology illustrates the thought precesses in the field of periodontics that determine optimal therapy for an individual patient. The approach entails the use of a decision tree for each clinical problem or situation; this is accompanied by a brief explanation of the basis for each decision. The chapters present common clinical problems in a format that enables the reader to find solutions more easily than in traditional texts. In addition, several readily available references are included with each chapter. The text is organized into eleven sections from the most basic to the most complex for assistance with problem solving in dental practices. Sections include: History Taking, Indications for Collecting and Recording Data, Signs and Symptoms, Initial Therapy Evaluation, and Detecting and Recording Findings, Differential Diagnosis and Treatment Planning (among others) that focus on clinician's concerns.

The book contains black-and-white illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: Kirk W. Noraian, DDS, MS (University of Chicago Medical Center)
Description: This second edition of this text uses algorithms to approach various clinical situations, supported by brief explanations, illustrations and some photographs. The first edition was published in 1988.
Purpose: The author wishes to stimulate thought and discussion through the algorithms presented and sets the stage for some controversy.
Audience: Although a broad audience is targeted, including undergraduate dental and postgraduate periodontics students, teachers of periodontology, and experienced clinicians, the text provides a better point of departure for periodontists and postgraduate students in periodontics. The language is very readable at all levels and the format is straightforward.
Features: The algorithms flow well and are easily comprehensible even without the accompanying text. No color illustrations are used, but the black-and-white illustrations are well conceived and well presented with the exception of several photographs that reproduced a little dark. However, the accompanying text is sufficiently descriptive of the illustrations and photos. The references are readily verifiable but probably prove to be rather fundamental for advanced students of periodontics. Though broken down into chapters in the table of contents, the chapters themselves are not well marked in the body text.
Assessment: This book provides a good basic review of the clinical situations associated with periodontics, and its value to all phases of the profession should not be underestimated. Recent advances, especially in the areas of guided tissue regeneration, implantology, and infectious diseases, warrant replacing the first edition.
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Product Details

  • ISBN-13: 9780801675263
  • Publisher: Mosby, Incorporated
  • Publication date: 12/1/1992
  • Edition description: 2nd ed
  • Edition number: 2
  • Pages: 266

Meet the Author

Walter B. Hall is a Professor of Periodontology University of the Pacific School of Dentistry San Francisco, California. Former Chairman of Periodontics University of Oregon, University of Washington, Pacific Schools of Dentistry.
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Table of Contents

I. History Taking 1. Medical History 2. Laboratory Tests and their Significance 3. Dental History 4. Plaque Control History II. Indications for Collecting and Recording Data 5. Indications for Periodontal Examination 6. Indications for Radiographic Examination III. Signs and Symptoms 7. Gingival Color Change 8. Gingival Bleeding 9. Split Interdental Papilla 10. Localized Periodontal Pain 11. Generalized Periodontal Pain IV. Detecting and Recording Findings 12. Probing 13. Differentiating Types of Furcation Involvement 14. Differentiating Degrees of Mobility 15. Determining and Recording Occlusal Findings 16. Radiographic Evaluation 17. Interpreting Bone Loss on Radiographs 18. Vertical Bone Defects 19. Overhanging Margin 20. Root Exposure 21. When to Use Microbial Tests for Specific Periodontal Pathogens in Diagnosis and Treatment Planning V. Differential Diagnosis 22. Periodontal Health, Gingivitis, and Adult Periodontitis 23. Differential Diagnosis of Juvenile Periodontitis and Rapidly Progressive Periodontitis 24. Necrotizing Ulcerative Gingivitis and Periodontitis 25. Primary Acute Herpetic Gingivostomatitis 26. Primary Versus Secondary Occlusal Trauma 27. Gingival Enlargement Diagnosis 28. Pure Mucogingival Versus Mucogingival-Osseous Problems 29. Differential Diagnosis: Problems of Endodontic and Periodontal Etiology 30. Differential Diagnosis of Periodontal Diseases in Human Immunodeficiency Virus Infection 31. Diagnosis and Management of Human Immunodeficiency Virus-Associated Oral Mucosal Lesions 32. Diagnosis and Management of Human Immunodeficiency Virus-Associated Periodontal Diseases in Adults 33. Diagnosis and Management of Human Immunodeficiency Virus-Associated Oral and Periodontal Changes in Children 34. Desquamative Gingivitis 35. Cracked Tooth Syndrome VI. Prognosis 36. Developing a Prognosis 37. Hopeless Teeth VII. Treatment Planning and Treatment Gingivitis and Adult Periodontitis 38. Sequence of Treatment Walter B. Hall 39. Referral to a Periodontist 40. Referral to a Periodontist by a General Practitioner 41. Prophylaxis Versus Root Planing 42. Surgery Versus Repetitive Root Planing 43. Selection of Surgical Approaches 44. Selection of the Appropriate Periodontal Surgical Technique 45. Furcation Involvements 46. Adjunctive Plaque-Control Devices 47. Maxillary Molars with Root Proximity/Periodontal Problems 48. Periodontally Compromised Potential Abutment Teeth 49. Periodontal Chemotherapy Pure Mucogingival Problems 50. Establishing the Adequacy of Attached Gingiva 51. Active Recession Versus Stability 52. Restorative Plans and Gingival Grafting 53. Orthodontics and Gingival Augementation 54. Pure Mucogingival Concerns of Patients Scheduled for Orthodontics: A European View 55. Prevention of Recession 56. Esthetics and Gingival Augmentation 57. Esthetic Evaluation of Patients with a High Lip Line 58. Free Gingival Graft, Connective Tissue Graft, or Guided Tissue Augmentation 59. Recession Treatment: Root Coverage or Not? 60. Coverage in Marginal Tissue Recession 61. A New Classification of Indications for Periodontal Surgery and Augmentation Occlusal Trauma 62. Primary Occlusal Trauma 63. Secondary Occlusal Trauma 64. Canine Disclusion (Cuspid Rise) Versus Group Function 65. Selective Grinding Versus Splinting 66. Selective Grinding Versus Night Guard 67. The Adult Orthodontic Case 68. Permanent Splinting Gingival Enlargement 69. Treatment of Gingival Enlargements 70. Circumscribed Gingival Enlargements Periodontic-Endodontic Combined Problems 71. Necrotizing Ulcerative Gingivitis and Periodontitis: Treatment 72. Indications for Molar Tooth Resection: Hemisection Versus Root Amputation 73. Sequencing Endodontics and Root Resection VIII. Initial Therapy Evaluation 74. Surgical Therapy Versus Maintenance 75. Evaluation of Furcation Status of Molars Before Surgery 76. "Through and Through" Furcation 77. Periodontal Reasons to Extract a Tooth IX. Guided Tissue Regeneration 78. Guided Tissue Regeneration Versus Mucogingival-Osseous Surgery 79. The European Approach to Guided Tissue Regeneration: Case Selection 80. The European Approach to Guided Tissue Regeneration: Membrane Selection 81. Guided Tissue Regeneration for Treatment of Vertical Osseous Defects 82. Guided Tissue Regeneration for Treatment of Furcation Defects on Molars 83. Guided Tissue Regeneration in Osseous Dehiscences 84. Guided Tissue Regeneration in Two-Walled Osseous Defects 85. Guided Tissue Regeneration Strategy to Maximize Aesthetics: Selection of the Surgical Approach and the Type of Membrane X. Surgical Treatment Mucogingival-Osseous Surgery 86. Apically Positioned Flap Procedure 87. Palatal Flap Design 88. Osseous Recontouring 89. Osteoplasty 90. Bone Fill - Regenerative Procedures 91. The Application of Bone Fill - Regenerative Procedures 92. One-Walled Osseous Defect 93. Two-Walled Osseous Defect: Crater Type 94. Three-Walled Osseous Defect 95. Approaches to the Distal Ridge Pocket 96. Suturing Following Periodontal Surgery 97. Dressing Following Surgery 98. Postsurgical Medication 99. Restoration Following Surgery Gingival Augmentation 100. Dehiscence and Fenestration 101. Free Gingival Graft Procedure 102. The Connective Tissue Graft vs. Guided Tissue Regeneration 103. Coronally Positioned Pedicle Graft 104. Free Gingival Graft Utilitizing the Strip Technique 105. Root Coverage in Cases of Localized Recession 106. Denudation 107. Ridge Augmentation 108. Dressing Following Pure Mucogingival Surgery 109. Restoration Following Pure Mucogingival Surgery XI. Decision Making in Postsurgical Reevaluation 110. Postsurgical Reevaluation 111. A Behavioral Approach to Recall Visits XII. Osseointegrated Implants 112. Basic Considerations in Selecting a Patient for Implants 113. Selection of Implant Modalities for Partially Dentulous Patients 114. Soft Tissue Plastic Surgery Around Implants 115. Osseointegrated Implants for the Partially Edentulous Maxilla 116. Osseointegrated Implants for the Totally Edentulous Maxilla 117. Osseointegrated Implants for the Partially Edentulous Mandible 118. Osseointegrated Implants for the Totally Edentulous Mandible 119. Guided Bone Augmentation for Osseointegrated Implants 120. Perimplantitis: Etiology of the Ailing or Failed Dental Implant 121. Perimplantitis: Initial Therapy for the Ailing, Failing, or Failed Dental Implant 122. Perimplantitis: The Surgical Management of Implant Repair 123. Patient with a Single Endentulous Space 124. Multiple Single Implants or Implants as Abutments XIII. Miscellaneous Issues, Problems, and Treatments 125. Informed Consent 126. Periodontal Dressings 127. Dentin Hypersensitivity 128. Impacted Third Molars 129. Partially Erupted Third Molar 130. Periodontal Considerations for Crown Lengthening 131. Crown Lengthening: A European View 132. Crown Margin Placement 133. Solitary Deep Periodontal Defects 134. Third Molar Extraction and Guided Tissue Regeneration 135. Guided Tissue Regeneration Associated with Lower Third Molar Surgical Extraction 136. Localized Chemotherapeutic Approaches: Indications and Contraindications for Tetracycline Fiber Therapy 137. Localized Chemotherapeutic Approaches: Technique 138. Laser Surgery in Periodontics 139. Esthetic Concerns and Surgery 140. A Patient with Periodontal Disease Involving the Maxillary Anterior Teeth

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This is the third edition of Decision Making in Periodontology. Much has changed since the first two editions were published in 1988 and 1992. Large sections of the 1992 text have been completely redone. New contributors, experts in particular aspects of the field, have been added. Many illustrations are new. The basic concept of "decision-making" has not changed. The prefaces to the earlier editions are still pertinent. Surgical periodontics has progressed remarkably in the past 5 years. Guided tissue regeneration, though various contributors may disagree upon its current status, has become a staple approach to both pure mucogingival and mucogingival-osseous problems. Implantology has become a staple procedure in periodontics.

Decision Making in Periodontology illustrates the thought processes that determine optimal therapy for an individual patient. The approach entails the use of a decision tree for each clinical problem or situation; this is accompanied by a brief explanation of the basis for each decision. The chapters describe common clinical problems and allow the reader to find solutions that take much longer to retrieve from traditional texts. In addition, several readily available references are included with each chapter.

Decision Making in Periodontology is intended to serve the needs of several groups in the dental care field. Experienced clinicians may seek answers to specific problems and compare their methods with those outlined. Teachers of periodontology may use this text as a stimulus to rethink modes of presenting information and as a model to test whether students have grasped the concepts they have been taught and are able to use them in a practical manner. Undergraduate students will find it useful in integrating concepts they have been taught in a more pedantic way, and postgraduate students may argue the merits of the decision-making process outlined and rewrite the decision trees. Auxiliary personnel will find it helpful in understanding why specific things happen in certain ways within the dental office. In the rapidly progressing and contentious field of periodontology, some of the decision making presented by our international group of authors may be controversial; however, if the decision trees presented here stimulate thought and discussion, the book will have fulfilled its purpose.

Many thanks to Janet Russell, for the third edition for Mosby-Year Book. Repeated thanks go to B.C. Decker who originated the concept of "decision-making" texts in medicine and published the first edition. Thanks also to Elizabeth, who prepared the text, to Dr. Eric Curtis, who prepared the illustrations, and to my wife, Francella, and my sons, Scott and Gregory, for their encouragement during the preparation of the text.

Walter B. Hall

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