Resective Periodontal Surgery: From Medical Philosophy to Technical Aspects.

Stefan-Ioan Stratul, Horia Calniceanu – Victor Babes University of Medicine and Pharmacy, Timisoara

We have become accustomed to associating resective periodontal surgery with questionable aesthetic outcomes for prosthetic restorations. For severe periodontitis, practitioners often resign themselves to compromises justified by the minimal restoration of functionality. Or, more simply, they recommend tooth extraction, replacement with implants, and subsequent prosthetic rehabilitation.

These will have questionable aesthetics and prognosis given the patient’s periodontal history and the lack of risk factor control. This presentation reviews and reevaluates conservative resective periodontal treatments in step 3 of therapy. Pocket-reducing surgery with osteotomy/osteoplasty is not a closed chapter in periodontology. Even though it is characterized by high invasiveness and a relative sacrifice of supporting tissues, the result is radical and predictable for the health of the residual periodontium. The next level consists of a creative aesthetic approach to restorations that is more than satisfactory, highly conservative, prophylactic for the periodontium through preparations distant from the gingival margin, functionally flexible, psychologically welcome for the patient, and open to future treatment solutions and effective maintenance.