Subgingival scaling and root planing (SRP), as the main non-surgical treatment method, is an effective way to control periodontal inflammation. This article will review the latest advancements in SRP techniques, including good application of ergonomics, minimally invasive non-surgical periodontal treatment, laser assisted subgingival scaling, use of periodontal endoscopy, subgingival sandblasting, etc.

Flap surgery is one of the most widely used basic periodontal surgeries. The periodontal condition should be evaluated before surgery. The incision, flap raising, reduction and suture are designed according to the purpose of operation and anatomical factors. With the innovation of surgical concepts, instruments and biological materials, flap surgery has been improved accordingly. This article briefly reviewed the progress of the flap surgery, and introduced the steps and key points of the surgery step by step, in order to provide a learning reference for dentists and stomatological students.

Periodontal surgery is an important part of the sequential treatment of periodontal disease. The minimally invasive and precise suture of the wound is one of the key steps to ensure the success of the surgery. Oral cavity is an open and complex environment, with different soft and hard tissue forms and functions. When performing accurate suture in periodontal surgery, the surgeon is not only required to master the basic surgical skills, but also to select the appropriate surgical instruments, suture needles,stitches, and suture methods according to the specific conditions of the surgical area and the purpose of the operation, so as to effectively ensure the postoperative wound healing quality, tissue functional recovery and aesthetic effect. The purpose of this article is to introduce the suture needles, stitches, surgical instruments and common suture methods used in periodontal surgery widely carried out in clinic.

The classification of periodontitis was revised twice in 1999 and 2018, and the S3 level clinical practice guidelines for periodontitis stage Ⅰ-Ⅲ and stage IV were issued by European Federation of Periodontology (EFP) in 2020 and 2022 respectively. This article briefly introduces the diagnosis, management, treatment and meanings of periodontitis under the new classification. According to the four types of stage IV periodontitis cases, this artical also provides reasonable treatment schemes to help clinicians to better interpret the above guidelines which is conductive to improve the efficiency of clinical treatment of periodontitis.

Objective: A case of stageⅢgrade C periodontitis was treated by endoscope-assisted subgingival scaling and root planing, which provided more treatment options for patients with severe periodontitis. Diagnosis and treatment: A 23-year-old female patient with stageⅢgrade C periodontitis suffered from teeth loose, masticatory weakness, and gingival bleeding. There were also displacements and gaps in her upper anterior teeth, which affected the life quality and the aesthetics of the patient. Periodontists controlled the periodontal inflammation by endoscope-assisted subgingival scaling and root planing. Results: After the above periodontal basic treatment, the patient with severe periodontal inflammation achieved ideal curative effect without surgical treatment, laying a good periodontal foundation for the follow-up multidisciplinary treatment. Conclusion: Endoscopy-assisted subgingival scaling and root planing can provide an ideal and more minimally invasive treatment effect for patients with severe periodontitis, which has a good clinical application prospect.

Objective: The systemic treatment on a case of generalized stageⅣ grade C periodontitis was illustrated in this article, which is prospective to provide ideas and clinical experience for treatment of such severe periodontitis cases. Diagnosis and treatment: A thorough initial periodontal therapy, the alveolar ridge preservation, implant restorations and the periodontal maintenance were conducted in this case. Results: The goal of recovering health and reconstructing function were achieved and the patient was satisfied with the treatment effect. Conclusions: For such complex cases of generalized stageⅣ grade C periodontitis, a systemic design and standardized methods combined with necessary interdisciplinary approaches are particularly requested.

Objective: This case report reported the sequential treatment process of stageⅣ class C periodontitis with iron deficiency anemia. It aimed to provide clinical experience in treating complex periodontitis with systemic diseases. Diagnosis and treatment: This case was a young woman with severe alveolar bone destruction accompanied by moderate iron deficiency anemia. Considering the influence of systemic conditions on periodontitis, the dentist formulated a personalized periodontal sequential treatment plan and carried out the treatment simultaneously with the physician. Results: The periodontal inflammation and anemia of the patient were significantly controlled after treatment and good clinical results were achieved. Conclusions: Iron deficiency anemia is a potential systemic risk factor for periodontitis, and patients with severe periodontitis tend to have inflammatory anemia, and the two affect each other. Therefore, it is important to emphasize the impact of anemia and other systemic risk factors on the diagnosis and treatment of periodontitis.

Objective: This case reports periodontal sequence treatment for 22-month of a patient with generalized stageⅢgrade C periodontitis, hoping to provide some reference for this type of patient. Diagnosis and treatment: A 41-year-old male patient was treated with a combination of periodontal initial therapy, periodontal flap surgery, periodontal regenerative surgery, free gingival graft and implant surgery, followed by supportive periodontal therapy. Results: Through these comprehensive oral treatment, the patient’s periodontal condition returned to health. The bone of second premolar of left mandibular increased due to periodontal regenerative surgery. Furthermore, the width of the keratinized mucosa in the area of missing teeth was more than 2mm, and the missing teeth were repaired, and the dentition integrity was restored. Conclusions: Patients with stageⅢperiodontitis often require comprehensive sequential periodontal therapy, and pre-implant soft tissue assessment and management followed by combined periodontal implant therapy facilitates long-term peri-implant soft tissue stability.

Objective: This article reported a case of multidisciplinary combined treatment of epulis due to dens invaginatus. Diagnosis and treatment: After clear diagnosis and informed consent, the patient underwent multidisciplinary treatment, including periodontal initial therapy and root canal treatment, followed by epulis excision and apical surgical resection; after inflammation control, connective tissue grafting was carried out for gingival soft tissue augmentation and prosthodontic treatment to restore the aesthetics. Results: Two and a half years after epulis resection, no recurrence of epulis; no percussion pain in the tooth, no sinus tract; no obvious recession of the labial gingiva, no obvious periodontitis, and stable clinical results of the restoration. Conclusions: Dens invaginatus is a rare disease, for the treatment of dens invaginatus, the key lies in early detection, and at the same time combining with the type of invagination, pulpal infection and the degree of periodontal destruction to choose the appropriate treatment programs.

Objective: A case of maxillary molar missing combined with opposite tooth elongation caused by pathological tooth displacement was treated in a comprehensive approach to provide insight for the multidisciplinary diagnosis and treatment of severe periodontitis. Diagnosis and treatment: A 50-year-old female patient presented with severe periodontitis, opposite teeth elongation after maxillary posterior teeth missing, insufficient implant space, and decreased masticatory function, which seriously affected the patient’s physical and mental health. A multidisciplinary treatment plan was developed by dentists through periodontal treatment to control periodontal inflammation, orthodontic treatment combined with supracristal fibrotomy to press the overstretched teeth, implant restoration of missing teeth, and periodontal maintenance treatment. Results: After the comprehensive treatment, the patient’s periodontal health was restored, the occlusion relationship was improved, and the integrity of the dentition was restored. Conclusions: Comprehensive consideration should be given to the diagnosis and treatment of patients with severe periodontitis, and the oral health of patients should be protected as much as possible. In this case, a healthy, functional, and stable treatment effect was achieved through the multidisciplinary team treatment.

Objective: To evaluate the clinical effect of guided tissue regeneration (GTR) combined with bone grafting in treatment of teeth with questionable prognosis. Diagnosis and treatment: In this paper, we reported a young patient with stageⅢclass C periodontitis treated with well-planned non-surgical and surgical periodontal treatment to restore the normal physiological structure and function of periodontal tissue. Teeth with questionable prognosis with severe attachment loss and/or furcation involvement were treated with non-surgical periodontal treatment, GTR and bone grafting procedure. Results: There was significant increase in the bone density of intra-bony defects. Periodontal parameters including periodontal probing depth and tooth motility were also significantly improved. Conclusions: For treatment of teeth with questionable prognosis, regenerative periodontal surgery could achieve favorable clinical outcomes in young periodontitis patients.

Objective: This study aimed to analyze the current challenges in cultivating research thinking abilities among postgraduate students specializing in periodontology, and explore effective strategies to enhance their research thinking capabilities. Method: By collecting relevant literature and data, this research assessed the current status and challenges in developing research abilities among postgraduates in periodontology. It proposed targeted recommendations and measures to address these challenges. Results: The study revealed existing issues in cultivating research thinking abilities among postgraduate students specializing in periodontology. It analyzed the factors contributing to these challenges. Conclusions: The paper proposes improvement strategies including enhancing research-oriented curriculum, optimizing laboratory facilities, and improving faculty mentoring in research. These efforts aim to foster comprehensive development of research thinking abilities among postgraduates specializing in periodontology, thereby cultivating high-level talents proficient in both clinical practice and research innovation.