On November 9, EFP leaders had live-streamed a webinar in which their guidelines were provided based on conclusions drawn from the 2014 EFP workshop in Segovia, Spain. The 11th European workshop was by and large about prevention, and extensive systematic reviews and position papers had been published earlier this year in the Journal of Clinical Periodontology. A video of the webinar can be seen here.
The panel comprising Professors Mariano Sanz, Maurizio Tonetti, Iain Chapple and Søren Jepsen had an emphasis on primary prevention in subjects without periodontal or peri-implant diseases, especially the former of which had largely been ignored in recent decades. Tonetti stressed several times that, while prevention of dental caries and oral cancer has been very successful, periodontal disease has apparently lost ground.
I vividly remember a particular oral examination in Kuwait when the external examiner, a professor from Sweden, had not shown and I and then chairman of the surgical department, Tryggve Lie from Norway, had to quiz the bright candidate by ourself. It was quite an inspired exam, much about figuring out whether deeper understanding of underlying biological mechanisms of pathogenesis and healing of periodontal disease was present or not .
When we discussed periodontal regeneration, I asked the candidate at one point whether she could recall the cover of the new edition (the fourth, of 2003) of what is still referred to as Lindhe’s textbook. No, she said but we had a copy at hand. It had actually puzzled me for some time, in particular the authors had not mentioned their source. It apparently showed a histological section of an implant which was in touch with two remaining roots. On page 658, in chapter 28 on Regenerative Periodontal Therapy, the image appears again. The legend tells,
” Fig. 28-13. Microphotograph of a titanium implant placed in contact with retained root tips (a). A distinct cementum layer (arrows) and periodontal ligament (PL) in continuity with that on the roots (R) is visible on the implant surface.”