The decision to when indicate periodontal surgery has been traditionally based on the presence of residual pathology after non-surgical cause related therapy, mainly the presence of deep probing depths and bleeding on probing. The new classification of periodontal diseases has focused the categorisation of periodontitis not only on severity but also on complexity what has important implications on how to implement periodontal therapy in general and periodontal surgery specifically. Furthermore the focus on personalised therapies derived from the grading of periodontitis patients according to risk of further progression also changes to approach to periodontal therapy. In this presentation we shall put the focus on how to apply staging and grading of periodontitis patients into treatment plans which involve periodontal surgery.
The main difference between Periodontitis Stages III and IV is amount of teeth lost for periodontal reasons and the presence of functional disturbances. The treatment of these patients requires not only periodontal therapy, but a multidisciplinary approach where the integration of dental implants and orthodontics restores the patient lost dentition and its function. In this presentation we shall present the basic foundation of multidisciplinary integration and the clinical decision making in the treatment of these complex cases. Different clinical cases will be presented and discussion and interaction with the audience will be seeked