Shalu Bathla MDS (Gold Medalist)
Reader Department of Periodontology and Oral Implantology MM College of Dental Sciences and Research
Mullana, Ambala, Haryana, India
Assisted by Manish Bathla MD
Assistant Professor Department of Psychiatry MM Institute of Medical Sciences and Research
Mullana, Ambala, Haryana, India
Forewords SG Damle
Thomas E Van Dyke
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Periodontics Revisited
© 2011, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editor and the publisher.
First Edition: 2011
9789350253670
Typeset at JPBMP typesetting unit
Printed in India
5Dedicated to
My Dear Son
7Contributors
- Amit Aggarwal
- Assistant Professor
- Department of Oral Medicine and Radiology
- MM College of Dental Sciences and Research
- Mullana, Ambala, Haryana, India
- Atul Sharma
- Assistant Professor
- Department of Oral and Maxillofacial Surgery
- MM College of Dental Sciences and Research
- Mullana, Ambala, Haryana, India
- Gayathri S Rao
- Assistant Professor
- Department of Oral Medicine and Radiology
- SDM College of Dental Sciences and Hospital
- Dharwad, Karnataka, India
- Harpreet Singh Grover
- Professor and Head
- Department of Periodontology
- SGT Dental College and Hospital
- Gurgaon, Haryana, India
- Jagdish C Bathla
- Consultant Psychiatrist
- Bathla Psychiatric Hospital
- Karnal, Haryana, India
- Manish Bathla
- Assistant Professor
- Department of Psychiatry
- MM Institute of Medical Sciences and Research
- Mullana, Ambala, Haryana, India
- RK Sharma
- Professor
- Department of Periodontology
- PGIMS, Government Dental College
- Rohtak, Haryana, India
- Sanjay Kalra
- Consultant Endocrinologist
- Bharti Hospital
- Karnal, Haryana, India
- Sanjeev Salaria
- Professor
- Department of Periodontology and Oral Implantology
- MM College of Dental Sciences and Research
- Mullana, Ambala, Haryana, India
- Seema Nayyar
- Reader
- Department of Conservative Dentistry and Endodontics
- MM College of Dental Sciences and Research
- Mullana, Ambala, Haryana, India
- Shailja Chatterjee
- Assistant Professor
- Department of Oral and Maxillofacial Pathology
- MM College of Dental Sciences and Research
- Mullana, Ambala, Haryana, India
- Shaveta Sood
- Assistant Professor
- Department of Periodontology
- HS Judge Institute of Dental Sciences
- Punjab University
- Chandigarh, India
- Shashikant Hegde
- Professor and Head
- Department of Periodontology and Oral Implantology
- Yenepoya Dental College
- Mangalore, Karnataka, India
- Suresh DK
- Professor and Head
- Department of Periodontology and Oral Implantology
- MM College of Dental Sciences and Research
- Mullana, Ambala, Haryana, India
- Sushant Garg
- Professor and Head
- Department of Prosthodontics
- MM College of Dental Sciences and Research
- Mullana, Ambala, Haryana, India
- Veenu Madaan Hans
- Assistant Professor
- Department of Periodontology and Oral Implantology
- Kalka Dental College
- Meerut, Uttar Pradesh, India
- Vikram Jeet Singh Dhingra
- Consultant Plastic Surgeon
- MM Institute of Medical Sciences and Research
- Mullana, Ambala, Haryana, India
- Vishnu Das Prabhu
- Professor
- Department of Oral and Maxillofacial Pathology
- Yenepoya Dental College
- Mangalore, Karnataka, India
Maharishi Markandeshwar University Mullana (Ambala)-133203 Haryana, INDIA Tel. : 0091-1731-304524, Fax : 0091-1731-274325 E-mail: sgdamle@gmail.com |
It is a great pleasure to write foreword for the book of Periodontics Revisited by Dr Shalu Bathla, Reader, Department of Periodontology and Oral Implantology, MM College of Dental Sciences and Research, Mullana, Ambala, Haryana, India. The editor is enthusiastic, energetic and possesses amazing potential and competence in teaching. I am aware of her diligent and industrious nature. She has always been curious to keep herself abreast with the latest developments in the profession. She has excellent command and competence in this field and her approach is realistic and unusually supported with novel ideologies propounded and derived out of research. Undoubtedly, this book is a wonderful compilation and fabulous work on Periodontology as she had tried to cover all features and characteristics of the periodontium from the fundamentals to the recent trends in the treatment of periodontal diseases. This is a unique presentation with exhaustive coverage of the relevant issues useful and advantageous to the readers from all angles. In fact, the novelties derived and propounded through latest researches and inventions have completely transformed the standard and pattern of Dental Education. Besides serving as a textbook, this book can also be beneficial for the researchers who are curious to study this subject. In fact, there have been tremendous modifications and amendments which have ultimately affected the teaching patterns.
This work is exceptional outcome of tireless efforts of the editor and is bound to create an impact on the minds of the readers. This is a complete study and deserves applaud and acclamation because of its inherent qualities.
I wish her success in her venture and also mission of life.
SG Damle
Maharishi Markandeshwar University
Mullana (Ambala)-133203 Haryana, INDIA
Tel. : 0091-1731-304524,
Fax : 0091-1731-274325
11Foreword
Readers of this book will gain invaluable, practical insights into the science and practice of modern periodontology. Periodontology is a constantly evolving specialty that changes in principle and practice with new discoveries and reinterpretation of available information. Students and practitioners alike must have the most up-to-date information at their fingertips to succeed in a technology driven world. As patient care providers, it is our responsibility to constantly be aware of changes and improvements in our field. By gaining a firm understanding of modern periodontology, practitioners will be more prepared to interact with other specialties of dentistry and offer the highest level of care with the best evidence-based procedures available to them.
One of the few certainties of life is that change will occur. With this in mind, Dr Shalu has focused not only on traditional periodontics but also on emerging technologies and concepts that will drive the periodontology of the future. With clear didactic writing, experienced practitioners and students will be guided in how to provide exceptional care for patients using the most modern methods. Now, more than ever, health practitioners have to keep abreast of new developments and scientific discoveries. This book is a valuable tool that can be used to reinforce and expand the possibilities for learning and teaching.
Thomas E Van Dyke dds phd
Vice President, Clinical and Translational Research
Chair of the Department of Periodontology
The Forsyth Institute
13Preface
The support provided to my book Tips and Tricks in Periodontology by the students have motivated me to make this effort to write a textbook.
Periodontology is a rapidly changing branch of dentistry with new scientific revelations unveiling many mysteries. Some controversies, still surrounding the basic foundations of etiology, phenomenology, treatment methods, etc. make it very difficult for a student to understand its content.
The book is written in the first place with undergraduate dental students in mind, but is equally helpful for the postgraduate students also. The book is written as per the syllabus of the Dental Council of India.
Organization of the book: The text is organized into eleven sections; and each section is further subdivided into several chapters. With the matter subdivided into these smaller chapters, students will find easier to achieve their learning goals. Starting with the basics in section one, the text flows gradually from epidemiology; etiology; pathology; diagnosis; treatment including non-surgical, surgical and implantology with the inclusion of interdisciplinary approaches onto the recent advances in the field of periodontology.
Learning devices in the book: The effort has been made to learn the subject in a simpler and easier way by the use of tables, easy-to-understand line diagrams, original colored photographs, flow diagrams and points to ponder at the end of each chapter. Key information boxes are color coded to use as navigational aid for readers. Each chapter is supported by bibliography and also the important landmark studies related to the topic. MCQs are also included at the end of the chapter with answers in view of these being included in the exam system.
I do not claim exclusive credit for the book. No doubt there will be errors, few imperfections, omissions and over simplification. Hoping that rest of the material will be enough to stimulate insight and new trains of thoughts into the subject of Periodontics which will be immensely educative and helpful.
My job is not to make peoples' journey through life easier,
It's to let them know that the journey exists and that the destination is worth the travel.
Any suggestions and criticisms are most welcome at periodonticsrevisited@gmail.com
15Acknowledgments
Respected Parents and GOD, I lay this book at your feet.
No one walks alone and when one is walking on the journey of life just where you start to thank those that joined you, walked beside you, and helped you along the way. Over the years, those that I have met and worked with have continuously urged me to write a book, to put my thoughts down on paper, and to share my insights together with the secrets to my continual, positive approach to life and all that life throws at us. So at last, here it is in your hands. So, perhaps this book and its pages will be seen as “thanks” to many people who have helped make my life what it is today. I have poured my heart and soul into these pages, so now I pray that my words touch your heart, soul and mind.
A teacher affects eternity, he can never tell where his influence stops.
— Henry Brooks Adams
I am forever grateful to my mentors who have shaped me from human being to a dentist and to a periodontist; Mrs Sangeeta Bhatia, Dr RK Sharma, Dr Rajan Gupta, Dr SC Narula and Dr Shikha Tiwari. I am extremely thankful to my other teachers who have influenced me tremendously; Dr CS Samibi, Dr Ravi Kapur, Dr Sanjay Tiwari, Dr Nageshwar Iyer, Dr Poonam Sikri, Dr Shashikant Hegde, Dr Rajesh Kashyap, Dr Devender Choudhary, Dr Vimal Miglani, Dr Nikhil Srivastava and Dr Neeraj Gugnani.
A teacher I respect for his sincerity, straightforwardness and ability to work hard untiringly is Prof SG Damle; Vice Chancellor, MM University, Mullana, Ambala, Haryana, India. I am highly thankful to this renowned stalwart and icon of Pediatric and Preventive Dentistry for writing the foreword of this book.
I am also grateful to Prof Thomas E Van Dyke; Vice President, Clinical and Translational Research, Chair of the Department of Periodontology, The Forsyth Institute, Cambridge, Massachusetts, USA; for writing the foreword of this book, as no other person in the field of Periodontology is more respected than him. I have been fortunate to obtain his valuable expert guidance and knowledge.
I particularly thank Head of Department, Dr Suresh DK who had been a constant source of helpful ideas concerned with photography. Special thanks to Dr RK Sharma, Dr SK Salaria and Dr Veenu Madaan for their creative comments at every step during the preparation of the book.
I wish to express my gratitude to all the contributors who have helped me in preparing the manuscript of the book and providing their knowledge in the concerned field. I would like to thank the postgraduate students for proofreading of this book—Dr Akanksha, Dr Nitika, Dr Rachna, Dr Anushi, Dr Anish, Dr Rajni, Dr Sugandha, Dr Harveen Singh, Dr Deepak, Dr Jyotsna and Dr Amita. Thanks to Dr Amita, Dr Arvind, departmental colleagues and all of my students, your questions and insights have challenged and strengthened me to present this work in a more friendly way to your desk.
I appreciate the willing help of Dr SK Salaria, Dr Rohit Singal, Dr Tanu Bansal, Dr Ameesha Singla, Dr Siddharth Ahluwalia, Dr Parul Rana, and Dr Megha Verma for helping me to make the figures of the book.
I would like to acknowledge Shri Tarsem Garg, Chancellor, MM University, Mullana, Ambala, Haryana, India and the management who have given me a platform where I am today and a full access to the library for my manuscript.16
My thanks to Shri Jitendar P Vij (Chairman and Managing Director), Mr Tarun Duneja (Director-Publishing) and the editorial staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, who have done a great job “to put an icing on the cake” by way of their professional expertise to make my work reader-friendly and reach it to your desk.
I gratefully acknowledge my debt to my father-in-law Dr JC Bathla for nurturing the seeds of this endeavor at its infancy. My brother Mr Pankaj Chandna, sister-in-law Mrs Neelu Chandna and nephew Raghav has selflessly and lovingly been there for me. For the continuous blessing and encouragement I wish to express my gratitude to my parents Smt Santosh Chandna and Shri GR Chandna; mother-in-law Smt Pushpa Bathla for blessing me at all stages of life.
I wish to express my deepest thanks to my husband Dr Manish Bathla for great assistance in typing the manuscript and unconditional love and support during the many hours of forced isolation and commitment required to accomplish this feat.
The acknowledgment would not be complete if I do not express my thanks and love to my dear son Milind who unknowingly helped me by his smiles and love at times of difficulty and always motivated me by saying three little words “Buck-up Mummy”!