The changing relations between the allied disciplines

Relations between the allied disciplines of prosthodontics, oral and maxillofacial surgery and periodontics over the last 30 years are reviewed, together with the development of clinical activity progressing from the preosseointegration era to the present day. New developments are foreseen in the coming 30 years.

Periodontics--tissue engineering and the future

Periodontics has a long history of utilizing advances in science to expand and improve periodontal therapies. Recently the American Academy of Periodontology published the findings of the Contemporary Science Workshop, which conducted state-of-the-art evidence-based reviews of current and emerging areas in periodontics. The findings of this workshop provide the basis for an evidence-based approach to periodontal therapy. While the workshop evaluated all areas of periodontics, it is in the area of tissue engineering that the most exciting advances are becoming a reality.

Periodontal Referral Patterns, 1980 Versus 2000: A Preliminary Study

BACKGROUND

A review of the periodontal literature offers little information concerning trends in referral patterns of patients for periodontal therapy. Over the last 2 decades, there has been a significant increase in the knowledge base concerning inflammatory periodontal disease. It might be assumed that the collective advances in knowledge have impacted periodontal referral patterns. Thus, the purpose of this study was to examine the differences in periodontal referral patterns in the same offices separated by a 20-year interval (i.e., 1980 and 2000).

METHODS

A retrospective chart analysis was conducted on a total of 782 patient charts from three conveniently selected periodontal practices. Charts were randomly selected from two time periods: 1980-1981 and 2000-2001. The following information was obtained from each patient record: gender, age at time of initial examination, tobacco smoking status at time of initial examination, periodontal case type, number of missing teeth at initial examination (not including third molars), and number of teeth scheduled for extraction per periodontal treatment plan. Descriptive data were analyzed using frequency distributions, measures of central tendency, and measures of dispersion. Non-parametric statistics were used to examine the relationship of disease severity as a function of site, time period, and patient age.

RESULTS

The following trends were noted: 1) an increase in the average age of patients at the time of the initial examination; 2) a decrease in the percentage of patients using tobacco at the time of the initial interview; 3) an increase in the percentage of periodontal Case Type IV patients with a concomitant decrease in the number of periodontal Case Type II patients; 4) an increase in the average number of missing teeth per patient at the initial examination; and 5) an increase in the average number of teeth scheduled for extraction per periodontal treatment plan.

CONCLUSIONS

Characteristics of patients referred in 1980 compared to those referred in the year 2000 indicate that, although fewer patients used tobacco, there were several noteworthy trends. At referral, patients exhibited a greater loss of teeth, had more severe disease, and required extraction of a greater number of teeth in 2000 compared to 1980. Possible reasons for these trends are discussed.

Workforce and planning issues for the profession of periodontics in Australia and New Zealand

The speciality of periodontics in Australia and New Zealand has seen steady growth since 1986, when the Australian and New Zealand Academy of Periodontics (ANZAP) was formed. Very few members of ANZAP have retired in the 16 years since its formation. However, the results of a survey of members revealed that one-third of members plan to retire within the next 10 years, and over 50% of members will have retired within 15 years. The survey also revealed that most members were heavily booked, and nearly half were concerned by their level of busyness. A total of 22 members are currently seeking to employ a periodontist in their practice, and yet only three students will complete the MDSc program in periodontics in Australia at the end of this year. This paper presents the results of the ANZAP survey of members and addresses issues affecting the training of periodontists in Australia and New Zealand.

The future of periodontology: new treatments for a new era

Scientific evidence that has been emerging over the last decade has provided the basis for a radical change in the understanding, diagnosis and treatment of periodontal diseases. A new era in periodontal research and practice is being defined along the following lines: Better understanding of disease. Emerging needs. Novel treatment strategies and therapeutics. Choice between multiple therapeutic modalities. The purpose of this manuscript is to critically discuss changes in understanding and to provide a rationale to change daily practice.

Treatment planning in the 21st century: what's new?

Many variables affect treatment planning, and it is important for clinicians to consider why they plan certain procedures for patient care. New materials, technologies, and products are constantly being introduced and affect decision making in dentistry. In addition, patients are more informed, have higher esthetic concerns, and want a greater stake in treatment planning decisions than ever before. How dentists treatment plan needs to reflect the many influences on final treatment outcome. The purpose of this paper is to outline how treatment planning has changed in dentistry with the goal of providing the general dentist updated information to develop a cohesive treatment plan.

A century of progress in understanding periodontal disease

Throughout the 20th century, investigators and clinicians sought to discover the causes and trace the natural history of periodontal disease. Noteworthy progress has been made on several fronts. It was once believed that oral hygiene and age accounted predominantly for variances in the prevalence and severity of periodontal disease; now, a number of innate, acquired, and environmental risk factors have been identified. Light has been shed on the roles in periodontal disease pathogenesis of both specific bacteria and bacterial complexes and host immunoinflammatory responses. Insight into periodontal wound healing has fostered promising approaches to promoting regeneration of damaged periodontal structures. Finally, although theories of "focal infection" as a primary cause of systemic disease have been discredited, recent studies have confirmed the existence of an intimate connection between oral and systemic health. The progress made in understanding the nature of periodontal disease has been complemented by equally noteworthy therapeutic advances. The coupling of surgical and medical approaches to treatment ushers in a new era in the management of periodontal disease.