|Year : 2020 | Volume
| Issue : 1 | Page : 1-2
Shouldn't “Periodontology” be the “branch of choice” for postgraduation?
Journal of Indian Society of Periodontology, Professor, Department of Periodontology, Institute of Dental Studies and Technologies, Kadrabad, Modinagar, Ghaziabad - 201 201, Uttar Pradesh, India
|Date of Web Publication||2-Jan-2020|
Journal of Indian Society of Periodontology, Professor, Department of Periodontology, Institute of Dental Studies and Technologies, Kadrabad, Modinagar, Ghaziabad - 201 201, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kumar A. Shouldn't “Periodontology” be the “branch of choice” for postgraduation?. J Indian Soc Periodontol 2020;24:1-2
I don't need to explain what periodontics means to all of us and what it stands for. Periodontium forms the basis of dentistry and practically all the branches of dentistry can boast of providing excellent treatment in their respective departments only if periodontium is healthy.
The origin of periodontium lies in neural crest cells. Although of ectodermal origin, the neural crest has also been called the fourth germ layer because of its importance. The neural crest cells migrate considerably to produce a phenomenal number of differentiated cell types. It has even been said, perhaps hyperbolically, that “the only interesting thing about vertebrates is the neural crest”. The neural crest cells originate from neural tube. The neural tube is the embryonic precursor to the central nervous system, which is made up of the brain and spinal cord. The importance of brain and spinal cord for our body needs no description here. Similarly, importance of periodontium for existence of tooth is known to everyone. May be its all in its origin!
One of the most sought after subjects is “Orthodontics”. The movement of the teeth in Orthodontics to create beautiful smiles is purely based on the remodeling of bone and periodontal ligament (PDL), which are a part of periodontium. How successful will orthodontic treatment be if teeth were ankylosed (no PDL) or would orthodontists be able to treat cases with same confidence and get excellent results if periodontium was compromised. The excellent treatment results which orthodontists show is because the patients have healthy periodontium.
Another major attraction for students is Endodontics. After examining the extent of caries on an Intra oral periapical radiograph (IOPA), the next thing which any endodontist will notice is the status of periodontium of a tooth which required root canal therapy (RCT). If periodontium is healthy they are confident to get good results. How many endodontists will guarantee predictable outcome post-therapy in a tooth which has bone loss or furcation involvement?
Removable partial dentures (RPD) and fixed partial dentures (FPD) are successful only if adjacent teeth have excellent periodontium. The law for FPD (Ante's Law) is defined in periodontal terminology. The Ante's law being defined in periodontal terms and not in any prosthodontic terms, says it all. The healthy periodontium of adjacent teeth are of prime importance and one of the key considerations for the practice of removable or fixed partial denture therapy.
Pediatric dentistry is a branch which has amalgamation of treatment modalities of all the branches like RCT, restorations, space maintainers, preventive and interceptive orthodontics, and prosthetic solutions like crowns and bridges. For all practical purposes, all these treatment modalities will only be successful if the child has healthy periodontium. Otherwise the success of all these treatments will get jeopardized if periodontium is compromised or we may not be able to even execute these treatment modalities.
Esthetic dentistry and smile designing are the “in things” in today's high profile practices. Esthetics is not just “white esthetics.” “Pink esthetics forms an indispensable part. The Pink esthetics is provided by healthy periodontium.
The prevalence of periodontal diseases is quite high in Indian population. It is said to be the range of 60-70% which actually means every six to seven persons out of ten will have some periodontal disease or the other. The importance of stating this fact here is that high prevalence of periodontal disease in population means that you encounter a lot of periodontal patient in your practice. If we know how to diagnose patients and convince the periodontal patient, the bulk of our practice would comprise of periodontal patients.
Last but not the least, the periodontium plays a great role in helping us during extraction of teeth. The extraction of the tooth by mere rotation/bucco-lingual direction is solely because the tooth is attached to the bone by PDL. By these movements you basically severe these ligaments and extract the tooth.
Now imagine if there was no PDL, the teeth would be ankylosed i.e., directly attached to the bone. Every extraction would require cutting through the bone which is a very traumatic procedure. It will lead to destruction of bone and compromise our prosthetic therapies and especially our most loved and sought after “Implant Therapy”. Maintenance of bone after extraction is very critical for implant success. Although I must categorically state here that indiscriminate and injudicious use of implants is harming the practice of Periodontology.
With such a high prevalence of periodontal diseases and the treatment in all branches of dentistry dependent on healthy periodontium, a branch that deals with treatment modalities of diseases of periodontium and helps in maintaining and restoring periodontium to health has to be important in scheme of things for dentistry. Having the knowledge of basics of Periodontology becomes important for every clinician to practice successful dentistry and get predictable results.
Despite so much dependence of all branches on healthy periodontium, does our branch get its due importance in clinical scenario of dentistry? Do general practitioners and practitioners of other branches of dentistry pay importance to health of periodontium and its maintenance and involve periodontist whenever required?
With practice of dentistry dependent so much on healthy periodontium and it's maintenance, shouldn't our branch be the “branch of choice” for postgraduation by students?
But is it?…The answers are obvious and well known. I don't need to state the truth.
Have we gone wrong somewhere? Let's introspect and put our minds together and do something about it.