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Color Fig. 30 1 A, Incipient marginal gingivitis. Note the slight puffiness and bleeding (arrow) around the upper right lateral incisor B. Edematous type of gingival inflammation. Note the loss of stippling, increase in size, abundant plaque and materia alba, and change in color. C, Close-up view of edematous type of gingival inflammation. Note the red, shiny, smooth gingiva D, Fibrocytic type gingival inflammation. Pockets of moderate depth are present, but the gingiva retains its stippling in some areas. E, Severe generalized gingival inflammation and inflammatory gingival enlargement. F, Fibrotic gingival inflammation. Note the abundant calculus and the gingival recession The patient has pockets of modéra te-to-severe depth in the mandibular anterior teeth and more shallow pockets in the maxillary teeth
Color Fig 48 1 Results of Phase I therapy. A and B, Severe chronic periodontitis. A, Severe chronic periodontitis characterized by deep pockets, attachment loss, and severe swelling and redness ol the gingiva. B, Healing results, 3 weeks after elimination ol irritants. Tissue has returned to a more normal contour with redness and swelling dramatically reduced. C to H, Moderate chronic periodontitis. C, Patient presenting with moderate attachment loss and probe depths in the 4- to 6-mm range. Note the gingiva appears pink because it is fibrotic and the inflammation is deep in the periodontal pockets. D, Lingual view pretreatment with more visible inflammation and heavy deposits of calculus E and F, The same areas with significant improvement in gingival health 18 months after scaling, root planing, and plaque control therapy were provided; the patient returned for regular maintenance visits. G, Presenting radiograph of the lower anterior teeth. H, Radiograph taken 18 months alter Phase I therapy and maintenance. The follow-up radiograph shows no increase in bone loss during the 18 months.
Sonic and Ultrasonic Instrumentation
Cregor \. Petersilka and Thomas F. Flemmig
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