Osseous surgery--how much need we compromise?

Abstract

It is essential that the execution and results of osseous surgery be carefully analyzed. Perhaps the two most compelling reasons are (1) that we should understand the effects on tooth mobility and their implications for complex restorative dentistry, and (2) to facilitate the accurate assessment of postoperative "success," bearing in mind not only improvement of the environment, but also increased chances of survival for the operated teeth. We have discussed the effects of osseous surgery on tooth mobility. In the light of recent information, a more accurate assessment of the need for splinting can be made. There has always been some controversy about osseous recontouring. Of late, there has been a particular resurgence of scepticism as to the efficacy of osseous resective procedures compared with more conservative forms of therapy. Scientific investigation demands the doubting mind and the analytical approach in order to establish the truth or fallacy of current ideas. This approach is essential to the continued existence of periodontics as a clinical science. These investigations should be based on a full understanding of the therapeutic measures being investigated, as it is misleading to assess the results of a procedure when that procedure is either not used to its full advantage or inappropriately used. It is hoped that these comments will be helpful in deciding whether definitive osseous correction in a given case is desirable or possible, in terms of both bone removal and permanent splinting. The author also hopes that this article has served to enhance the possibilities of more complete osseous correction when indicated, in order to achieve minimal pocket depths, and to permit proper comparison with other modes of periodontal therapy. It is, however, crucial to realize that whatever modality of therapy utilized, it is merely one phase in the treatment spectrum. Maintaining a stable state for the patient over many years is the ultimate goal, beside which any given technical procedure pales in significance. Periodontal therapy is an ongoing process in which patient recall plays a central role.