Novel Management of the Periodontal Patient: Surgery and Beyond

Most patients who have periodontitis respond to routine management, which can include scaling and root planning, periodontal flap surgery (regenerative or respective) and, when treatment fails, the placement of endosseous implants.

In general 80% of patients will respond to routine therapy, but the problem remains: what do we do about those who do not respond? Are there new developments currently available or on the horizon that will also later what we now accept as being routine therapy, meaning that more patients will respond to treatment and that treatment might either be less invasive, or more predictable, or both?

There is mounting evidence that patients who so-called refractory periodontitis might be hyper-immune. As such, novel approaches to managing these patients will likely include host modulation therapy (using a collagenase inhibitor such as Periostat®), anti-inflammatory treatment (in combination with host modulation therapy), both of which can be combined with mechanical treatment (scaling and root planning and /or surgery) to effect better outcomes.

Learning Objectives:

• Understand refractory periodontitis and the novel approaches available for better outcomes
• Review the administration and side effects of both systemic and locally administered antimicrobial (LAAs)
• Identify the needs for adjunctive topical therapies for the patient when clinical improvements of periodontitis have been observed
• Identify new trends in therapy, their potential for complications and the potential for a novel approach to managing periodontitis
• Understand how novel periodontal therapies might impact general health

New approaches to managing difficult periodontal patients.

1 CE Credits

Amount: $19.95

Professor Periodontology Faculty of Dentistry University of Toronto Professor Laboratory Medicine and Pathobiology Faculty of Medicine University of Toronto Head Division of Research Department of Dentistry Mount Sinai Hospital University of TorontoHoward Tenenbaum, DDS, Dip Perio, PhD, FRCD(C) Dr. Tenenbaum received his D.D.D. from the University of Toronto in 1978 and then completed his specialty in Periodontology as well as a Ph.D. in bone cell biology by 1982. This was followed by a 2-year post-doctoral MRC fellowship in Bethesda at the National Institutes of Health. In addition to his degrees, Dr. Tenenbaum has a Fellowship from the Royal College of Dentists of Canada, as well as the International College of Dentists and the Academy of Dentistry International. Dr. Tenenbaum is a Professor of Periodontology, and was Head of that Discipline for 8 years (1997-2005), at the Faculty of Dentistry, University of Toronto. He was also Associate Dean for Biological and Diagnostic Sciences for 6 years having just stepped down September 2007 to pursue his research more actively. He is a cross-appointed Professor in the Department of Laboratory Medicine and Pathophysiology, Faculty of Medicine, University of Toronto and is the Head of the Division of Research in the Department of Dentistry at Mount Sinai Hospital. Dr. Tenenbaum also serves as an FDA panel member for Dental Devices and Drugs (USA) and is Vice-Chair of the Federal Dental Care Advisory Committee (Canada). Dr. Tenenbaum has had research funding from the Medical Research Council of Canada, CIHR (Canadian Institutes for Health Research) and other agencies for the past 25-years and has pursued ongoing research in the fields of bone cell biology, periodontics, and orofacial pain. He has lectured nationally and internationally on several topics including orofacial pain and management of refractory periodontal diseases.