Professor Andrea Sculean, University of Bern/Switzerland, emphasizes that regenerative periodontal therapy methods should never be conducted as a single therapy and only be considered in addition to the classical periodontitis therapy. As periodontitis is a bacterial infection, first the infection has to be treated and the periodontal situation stabilized. For that matter, the conservative therapy involving the use of ultrasonic and hand instruments as well as the possible administration of antibiotics is conducted first. After a healing period of preferably at least 3 months the dentist decides if further periodontal treatment is necessary using regenerative therapy methods.
Main indications for the regenerative therapy are intrabony defects and class II furcation defects in maxillary a mandibular molars. In contrast, the regenerative therapy is not indicated for molars with class III defects. These teeth can be treated with a resective therapy including root amputation, hemisection and premolarization or have to be extracted. Provided that the patient is enrolled in a strict recall program the teeth that are treated with a regenerative or resective therapy can be successfully maintained on a long-term basis. From the perspective of a periodontist, these therapy forms should be chosen over the extraction and the tooth maintained whenever possible.
