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Migration of maxillary anterior teeth because of the loss of periodontal support can alter the appearance of the esthetic zone. The loss of contacts between adjacent teeth results in the recession of interdental papillae. To restore sustainable periodontal health and the normal, esthetic appearance of a healthy 37-year-old woman with generalized advanced chronic periodontitis in the maxillary arch, a combined periodontal and orthodontic technique was used. This approach resulted in stable periodontium and an esthetically pleasing appearance of the maxillary anterior area. [ABSTRACT FROM AUTHOR]

This paper examines various esthetic periodontal considerations during orthodontic treatment. The management of excessive gingival display caused by altered passive eruption is reviewed, with emphasis on causes, recognition, diagnosis and surgical management of this problem. A case of orthodontic treatment of excessive gingival display associated with altered passive eruption of the maxillary incisors is reviewed to demonstrate appropriate management. With proper diagnosis, soft-tissue periodontal procedures after completion of orthodontic treatment can enhance the patient's final appearance.

Tobacco use is an important risk factor for advanced periodontitis, poor response to periodontal therapy, oral neoplasms, and dental implant failure. Given the effect of tobacco use on oral health, the dental office may be an ideal place for tobacco cessation intervention, especially since a large proportion of smokers visit their dentist on a regular basis. This paper reviews various tobacco cessation strategies for the dental office and provides practical information on assessing patients' readiness to quit and choosing appropriate tobacco cessation interventions.

Scaling and root planing (S&RP) are regarded as the main modalities for treating periodontal disease. The goal of these treatments is to arrest the disease process, maintain a healthy periodontium and preserve the dentition. As prevention becomes a larger component of everyday dental practice, dentists are performing S&RP more often as part of their periodontal maintenance programs. Therefore, it is essential for dentists to know the latest S&RP techniques and methods. This paper reviews the current knowledge and experiences related to mechanical non-surgical periodontal therapy and focuses on the types of S&RP instruments that are available, their advantages and disadvantages, their efficacy in debridement, and their effects on the hard tissues of the oral cavity.

There is a growing body of scientific evidence indicating that nicotine contributes to the progression of periodontal disease, and is detrimental to healing following periodontal therapy. Smokers show a higher prevalence and greater severity of periodontal disease than non-smokers. Nicotine has toxic effects on peripheral, circulation, which cause gingival vasoconstriction. As a result, a decreased number of immune cells are available in the gingival tissue, which translates into a weakened defence-reparative system. Nicotine can also depress primary and secondary immune response by reducing the chemotactic and phagocytic activities of leukocytes. Clinically, smoking has been associated with increased pocket depths, calculus deposition,alveolar bone loss, acute necrotizing ulcerative gingivitis, and osteoporosis in postmenopausal women. Despite efforts by various investigators, the precise mechanisms underlying the effects of smoking on periodontal status and wound healing remain unresolved. This paper reviews the relationship between smoking and periodontal disease. It also includes a historical overview of the research, and a review of the effects of smoking on oral bacteria, the immune system and exocrine glands. In addition, risk assessment for periodontal disease, clinical features of smokers' periodontitis, response of smokers' periodontal disease to treatment, and ideas for future research are discussed.