Periodontal-Restorative Interrelationships

Paul A. Fugazzotto is in full-time clinical practice specializing in periodontics and implant therapy. In addition to maintaining his practice, Dr. Fugazzotto has published over 90 articles in revered journals, has authored two textbooks, and lectured nationally and internationally on all facets of periodontology and implant and restorative dentistry.

Contributors ix

Chapter 1 Examination and Diagnosis 3
Paul Fugazzotto and Sergio DePaoli

Establishing an Appropriate Treatment Plan 3

Determining Periodontal Treatment Endpoints 19

Rationale for Pocket-Elimination Periodontal Surgery 20

Junctional Epithelial Adhesion or Connective Tissue Attachment? 22

The Signifi cance of Furcation Involvements 23

The Infl uence of Restorative Margins 23

Does Pocket-Elimination Therapy Work? 23

Conclusion 26

Chapter 2 The Role of Crown-Lengthening Therapy 31
Paul Fugazzotto

Management of the Apico-occlusal Dimension 32

Incision Design 40

Conclusion 84

Chapter 3 Treating the Periodontally Involved Furcation 89
Paul Fugazzotto

Defi nitions of Furcation Involvements 89

Diagnosing Premolar Furcation Involvements 94

Treatment of Class I Furcations 95

Treatment of Class II Furcations 98

Treatment of Class III Furcations 109

Maxillary vs. Mandibular Furcations 110

Selecting the Appropriate Treatment Modality 110

Conclusions 113

Chapter 4 The Role of Mucogingival Therapy 117
Paul Fugazzotto

Indications for Mucogingival Surgery 120

Nonattached Gingival Autografts 122

Lateral Pedicle Flaps 126

Connective-Tissue Grafts 131

Guided Tissue Regeneration 133

Indications for Emdogain Use 134

Constructing a Clinically Based Treatment Decision Tree 138

Mucogingival Therapy at the Time of Crown-Lengthening Surgery 139

Conclusions 140

Chapter 5 Restoration of the Periodontally Treated Tooth 147
Frederick Hains

The Feather 147

The Chamfer 150

The Shoulder 150

Periodontal Ramifi cations and Prosthetic Adaptations 154

Impressions 161

Chapter 6 Developing Treatment Algorithms for Restoration or Replacement of the Compromised Tooth 165
Paul Fugazzotto and Frederick Hains

Diagnostic Requirements 165

Assessing the Individual Tooth 166

The Ability to Safely Perform Crown-Lengthening Surgery 167

Endodontic Considerations 167

Implant Receptor Site Considerations 168

Assessing Cost-Benefi t Ratios 168

Complexity of Care 172

Predictability of Care 173

The Cost of Retreatment 176

Conclusion 180

Index 183