Periodontitis – Surgical and Non-Surgical Treatment Methods

Category: Periodontology

Instructor(s): Marisa Roncati, Mariano Sanz, Roberto Rossi, Eduardo Montero, Elena Calciolari, Vanya Lipcheva

Course structure: Lessons: 7 lessons | Duration: 11 h 44 min

Course overview

This is detailed and evidence based information on surgical and non-surgical treatment
methods of periodontitis.
The course will analyze the international protocols for the treatment of periodontitis stages I-III:
– use of Host-modulators (omega-3, low doses of doxycycline, statins, bisphosphonates, probiotics and trace elements)
– surgical methods of treatment
– treatment of an aggressive form of periodontitis.
After this course, you will have ready to use protocols for the treatment of all kinds of periodontitis.

Curriculum

1. Introduction. Clinical practice guidelines: non-surgical and surgical treatments for periodontitis

• Lesson program:
• – Treatment of periodontitis of stage I-III by S3-level CPG
• – Etiotropic therapy: goals, tools and meaning
• – Choice of treatment method: implantation vs surgical periodontology
• – Flap surgery: advantages
• – Scaling vs root polishing
• – Recommendations for the non-surgical periodontitis treatment method
• – Indications for non-surgical methods
• – Flap surgery vs tool processing
• – Flap surgery vs resective therapy
• – Postoperative recommendations for the patient and maintenance therapy.
• Recommended for: Implantologist, Periodontist, General dentists.

2. Non-surgical methods for the treatment of periodontitis

• Lesson program:
• – The relationship of systemic diseases and periodontal diseases
• – Clinical effect of a diode laser
• – Protocol of III stage periodontitis treatment with diode laser
• – Indications for non-surgical treatment methods
• – Methods of detecting subgingival calculus: tools and techniques
• – Root planing: disadvantages
• – Advantages of laser therapy in the periodontitis treatment
• – Etiotropic non-surgical therapy
• – Scientific justification of the use of laser in periodontal treatment
• – Square therapy: step-by-step protocol
• – Economic justification of laser therapy
• – Surgical vs non-surgical methods of periodontitis treatment
• – Surgical protocol for the treatment of periodontitis in aesthetic zone
• – Indications for implantological periodontitis treatment
• – Laser therapy in the treatment of periimplantitis and mucositis
• – Oral hygiene in the conditions of Covid-19: Ronca beats.
• Recommended for: Implantologist, Periodontist, General dentists.

3. Host modulators: a paradigm shift in the treatment of periodontitis

• Lesson program:
• – Guidelines for the periodontitis treatment: 4 main stages
• – Additional therapy for subgingival instrumental treatment
• – Modulator of the host organism: biological justification for use
• – Theory of polymicrobial synergy and dysbiosis
• – The role of inflammation in the pathogenesis of periodontitis: paradigm shift
• – Evidence base for the use of the host body modulator:
• Sub-antimicrobial dose of doxycycline (SSD)
• Local use of statins
• Local application of bisphosphonates
• Local use of metformin
• Non-steroid anti-inflammatory drugs
• Omega-3 polyunsaturated fatty acids
• Use of probiotics
• Micronutrients and vitamins.
• Recommended for: Implantologist, Periodontist, General dentists.

4. S3-level treatment guideline for an evidence-based treatment of periodontal diseases

• Lesson program:
• – The main goals of the 4 stages of therapy
• – Stage 1 of therapy:
• Recommendations on the selection of oral hygiene products and methods
• Control of gum inflammation: additional methods of therapy
• Control of risk factors: smoking and diabetes mellitus.
• – Stage 2 of therapy:
• Protocol of subgingival instrumental processing
• Protocol of disinfection of the entire oral cavity
• Hand vs ultrasonic instruments
• Justification of the use of systemic antibiotics
• Indications for the use of local antibiotics
• Host-modulators: evidence base.
• – Stage 3 of therapy:
• Flap surgery vs tool processing
• Criteria for choosing a flap design
• Resection periodontal surgery vs flap surgery
• Protocol of treatment of intraosseous defects and choice of materials
• Treatment of furcation defects.
• – Stage 4 of therapy:
• Prevention of relapses
• Maintenance therapy.
• Recommended for: Implantologist, Periodontist, General dentists.

5. Regeneration of infra bony defects in periodontal patients

• Lesson program:
• – Basic surgical principles of periodontitis treatment
• – Three-wall defect: diagnosis, treatment protocol, prognosis
• – Rules for making incisors when working in the aproximate zone
• – Features of suturing: methodology and recommendations
• – Defect of the cortical plate from the vestibular and palatine sides: principles of restoration
• – Formation of a bone defect in posterior area
• – Flap enlarging gingival papillae: technique
• – Flap design when working in the frontal area
• – Methods of working with gingival papillae: a minimally invasive approach
• – Bone graft in the periodontitis treatment
• – Double flap technique
• – Single and double wall defects: non-surgical treatment methods
• – Criteria for the patient's readiness for surgical treatment of periodontitis.
• Recommended for: Implantologist, Periodontist, General dentists.

6. Surgical approach for infra-bony defects

• Lesson program:
• – Clinical and radiological signs of periodontal diseases
• – Classification of periodontal diseases
• – 3-wall and 2-wall defects: clinical aspects, diagnosis, prognosis
• – The mechanism of wound healing
• – Guided tissue regeneration: biological foundations
• – Indications for the use of bone graft
• – Use of resorbable and non-resorbable biomaterials
• – Flap design and suturing techniques
• – Treatment of an aggressive form of periodontitis in a young patient: a clinical example
• – Protocol of guided bone regeneration with tooth mobility: an example.
• Recommended for: Implantologist, Periodontist, General dentists.

7. Treatment of the stage IV periodontitis patient

• Lesson program:
• – Classification of periodontal diseases
• – Periodontitis of the IV degree of severity: criteria for diagnosis
• – Treatment plan for a patient with IV degree periodontitis
• – Moving teeth in patients with periodontal tissue diseases
• – The effect of intrusive and retrosive orthodontic movements in patients with healthy but reduced periodontitis
• – Prosthetics on implants in patients with periodontal diseases
• – Protocol of treatment of a patient with pathological migration of teeth.
• Recommended for: Implantologist, Periodontist, General dentist.