Introduction

Patients, Pockets, Pathogens: New Approaches to Periodontal Management

Robert L. Merin, DDS, MS, and Alan R. Stein, DDS

Copyright 2002 Journal of the California Dental Association.

When we became contributing editors for an issue of the CDA Journal on periodontics, we wanted to include articles dealing with new research and technologies, and we wanted the information to be clinically relevant for the general practitioner. After the articles came back from review, it became clear that two issues of the Journal would be required to publish them all. Although the April and May Journal articles fit together as a package, we tried to place them in the most logical grouping for each issue. The May issue will include articles on the following topics:

1. Demographics affecting periodontal and implant therapy with suggestions on how to position your practice.

2. Therapeutic choices in the molar region. This article gives suggestions on when to perform traditional procedures (such as endodontics, root resection, crown lengthening and periodontal surgery), and when to extract a molar and place an implant.

3. The immediate dental implant. This article gives practical suggestions on this emerging technology.

4. Laser curettage: Where do we stand? The article takes a critical look at the use of the laser for curettage.

These issues on periodontics are about technology. Dentists live in a rapidly evolving world of technological change and must analyze the usefulness of many new technologies. We often hear dentists question whether dental lasers work or site-specific antimicrobials are any good. However, these are the wrong questions. Just as a hammer is a very bad technology for accurately cutting wood, it is extremely effective for driving nails. We should be asking: "Is a specific technology effective in a specific application?" We must not only look at whether a new technology works in a given application, but also whether it is more efficacious than conventional treatment. We must also evaluate the potential for side effects, immediate and remote. To complicate the analysis, a minor change in the technology or a new procedure may render a previously useful technology useless; or just the opposite, make a heretofore useless one extremely effective.

In these issues, our authors evaluated specific applications and techniques. We hope you will use them as a starting point for your own analysis. With apologies to the academicians of the world, we assert that all targeted research has a bias, intentional or not. That is human nature. It is your professional obligation to determine what is best for your patients. Analyze a new technology. Does its method of action make sense on a biological basis? What is the potential for harm? Read all the literature you can find and find out who paid for the research and what their bias and motivation is. Look to your peer- reviewed journals, nonprofit testing organizations such as the ADA and CRA, and position papers from the American Academy of Periodontology or the California Society of Periodontists. Ask your colleagues about their experiences, but remember that they too have biases. Finally, when you decide to incorporate a new technology, technique, or material into your practice, chart and track your cases so you can review their effectiveness and safety.

The editors and authors hope you enjoy this issue, and we look forward to any dialogue it may generate. The articles that follow will bring us one step closer to providing the best care for our patients.

Greetings from the California Society of Periodontists

The California Society of Periodontists is proud that its members helped with this issue of the CDA Journal. The CSP is a nonprofit organization of periodontists committed to enhancing and promoting excellence in periodontics in California and protecting the health and safety of the public. CSP has always worked with CDA in attempting to serve the highest and most noble interests of California dentists and periodontists in their service to California citizens. We are committed to continuing this long-standing relationship, just as we are committed to continue to serve our members in their responsibilities to the public.

A listing of periodontist members of CSP can be found in this issue of the Journal.

Gerald I. Drury, MS, DDS
President, California Society of Periodontists

Contributing Editor

Robert L. Merin, DDS, MS, is the immediate past president of the California Society of Periodontists. He is also a lecturer at the University of California at Los Angeles School of Dentistry and a consultant for the West Los Angeles Veterans Administration. He maintains a private practice in Woodland Hills, Calif. Dr. Merin is a diplomate of the American Board of Periodontology and a staff member of West Hills Hospital and Northridge Hospital.

Co-Contributing Editor

Alan R. Stein, DDS, is a clinical assistant professor in the Division of Diagnostic Sciences at the University of Southern California School of Dentistry. He is also the director of continuing education in the Department of Dentistry at Northridge Hospital Medical Center and a past chief of the department. Dr. Stein is also a past president of the San Fernando Valley Dental Society. He maintains a private general dentistry practice in Northridge, Calif.