Periodontology – The Essentials


The second edition of my textbook on periodontology is now available. The text has evolved from a popular script for undergraduate students in the 1990s at Heidelberg University. Three very successful German editions (2001, 2006, and 2012) have been published by Thieme, and I am glad and grateful that my publisher has provided me with an opportunity to largely update the English version of 2005 now as well.

As a new feature quality of evidence from an ever increasing number of systematic reviews has been carefully assessed and, in part, summarized in evidence boxes. Several chapters have been largely expanded if not rewritten, for instance those on periodontal microbiology, pathogenesis of biofilm-induced periodontal diseases,  epidemiology of periodontal diseases, general medical considerations, and medication and supplements.

The reader will notice, though, that our essential approach of treatment has not really changed for decades, not the least because of  the painstaking work of certain Scandinavian and US American periodontists in the 1960s, 70s and 80s. It is because of them that periodontology quickly adopted the emerging principles of what is now called evidence-based medicine.


For half a century, periodontology has spearheaded scientific progress in dentistry. A tiny portion of the vast body of literature that has shaped modern periodontology has recently been listed by the American Academy of Periodontology on the occasion of its centennial. [1]. What has kept us clinicians, teachers and scientists busy was, for example, the discovery that bacteria of the oral cavity, which play a critical role in most periodontal diseases, organize themselves in a biofilm; and that the pathogenesis of periodontitis, as that of any chronic disease, is complex and multifactorial. Opportunities and constrains of guided tissue and other forms of periodontal regeneration had been developed in painstakingly designed animal and clinical experiments, and somewhat ailing implant dentistry has eventually got a firm scientific foundation. Not least, a century-old suspicion that periodontal infections interact, in a bidirectional way, with other systemic diseases and conditions was revived and new intervention studies address possible beneficial effects of periodontal therapy on general health.

A true revolution on the horizon is, however, the application of well-defined evidence in daily practice. Despite the claim that, in particular, periodontists practice their profession up-to-date, dentists had long been inclined to pursue commercial interests, be it their own or those of providers of new and fancy developments.

That won’t be possible any longer. Since electronic search engines and, in particular, biomedical data bases are generally available, and electronic access to original articles including all backfiles is possible, new generations of practitioners shall be in the position to quickly identify, critically assess and filter the exploding amount of new data and retrieve relevant information as regards a specific clinical question or problem, online and in real time. Dentists are more and more used to ask the crucial question, “Is there any evidence?”

The recent surge of systematic reviews of, in particular, well-designed intervention studies has proved that our profession has a sound scientific foundation. The available evidence has to be graded, though, and recommendations should address patient-relevant issues.  Real evidence-based medicine does include a strong interpersonal relationship between the patient with chronic disease and the therapist. Thus, continuity of care and emphatic listening is of paramount importance for conjoint decision making which does not entirely rely on the available scientific evidence but, to a large extent, also on individual circumstances.

As before, the present 2nd edition of Periodontology – The Essentials attempts to condense latest developments and concepts in an easily searchable volume. Although undergraduate dentistry and dental hygienist students are again the main target audience for the compendium, general dental practitioners and specialists in other fields of dentistry may benefit from quickly checking specific periodontal details in their daily practice as well

[1] Kornman KS, Robertson PB, Williams RC. The literature that shaped modern periodontology. J Periodontol 2014; 85: 3-9. 2014.

13 December 2015 @ 7:45 am.

Last modified December 13, 2015.


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