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Carranza's Clinical Periodontology.

Newman MG, Takei H, Carranza FA WB Saunders Co. Philadelphia, Pennsylvania 9th edition, 2002 1033 pages; illustrated; indexed; CD-ROM; hardcover ISBN: 0721683312 $99.00

Most actively practicing dental hygienists are familiar with this textbook. For many of us, it fueled the desire to work in the oral health care field and to help people fight periodontal disease. This latest edition shows more collaboration (yes, dental hygienists are among the list of contributors) with Drs. Takei and Newman now co-authoring with Dr. Carranza, who took over in the 70s for Dr. Glickman, the original author. The preface notes that the audience for the textbook consists of students and practitioners of general dentistry. This acknowledges the recent shift of the majority of periodontal patient care to general practice rather than periodontal specialty practice.

Most of the elegant figures in the early editions of the book are still present and form the basis for understanding periodontal health and disease concepts, such as passive eruption and infrabony pockets. Each chapter has an outline, conclusion section, and references. Each one also uses a second color for organization, which is very effective.

There are some clinical examples that need to be looked at more closely and updated accordingly, especially when it is difficult to see details because of fading and discoloring of photographs over the years. Possibly juxtaposing the diagrams of basic concepts with the clinical photographs would also yield clarity and better understanding.

The text does incorporate the latest periodontal disease classification system and explains it by working with the overall classes and then going into more detail in each class. However, later in the textbook, historic terms such as juvenile and refractory periodontitis are still confusingly used alone. The new classification of bacteria native in periodontal diseases also is included. The chapter on epidemiology is made more interesting by the use of questions as section headings, many of which ask about the typical patient's profile relative to overall studies. The risk assessment chapter is short but very well done, which is important since this is the future direction in the field. Future editions could possibly incorporate the periodontal risk calculator as was discussed by Page, et al., in a recent Journal of the American Dental Association article (2002;133(5): 569-76). However, advanced diagnostic techniques are discussed, as well as the limitations of conventional periapical radiography and probing.

The updated chapter on AIDS and periodontal disease is very thorough, as well as the chapters on systemic interactions under the titles of the "Influence of Systemic Diseases on the Periodontium" and "Periodontal Medicine." However, it was a disappointment that abfraction was not discussed in the oral examination portion. But, the clinical signs of adult periodontitis were very well covered.

A timely feature is a chapter on female patients and their health changes over a lifetime due to hormonal changes. However, the importance of a physician's consult for a pregnant patient before any medication is given (and then only with patient consent), should have been stressed. In addition, the reference to Briggs' Drugs in Pregnancy and Lactation notes the use of the 1994 edition, although the 2002 edition must have been readily available when this textbook was given its final reading.

The latter part of the book is devoted to the techniques used in periodontal nonsurgical and surgical therapy. The textbook does not disappoint since the latest techniques are included, making the term `clinical' in the title very accurate. The various plastic and esthetic surgery procedures can be viewed in minute detail. Nonetheless, the scientific basis for each disease and therapeutic method is explored. The latest scaling and curettage instruments, loupes, and ultrasonic equipment are included, along with the new dental endoscope. However, again, some of the citings have not been updated in this area.

The CD-ROM that accompanies the textbook made it helpful and convenient to look at the book's graphics on my computer, especially the color plates. However, the black and white clinical photographs were not shown in color on the CD-ROM, which was disappointing. This is possibly because some of them were historical photographs that were retained over the years only in black and white. It would be more effective if any existing original color photographs were incorporated into the CD-ROM in future reprints or editions. However, the addition of diagrams from the textbook into the CD-ROM balances this minor problem. With questions also incorporated into the CD-ROM, the textbook now is a valuable resource for teaching.

The book would readily serve as a reference for dental hygiene faculty, but may be expensive for undergraduate students. However, practicing dental hygienists interested in clinical periodontology would be wise to include this textbook in their reading, especially when reviewing the advances in surgical therapy that are available to patients with more advanced treatment needs.

Reviewed by Margaret J. Fehrenbach, RDH, MS, a dental hygiene educational consultant in Seattle, Washington.
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Author:Fehrenbach, Margaret J.
Publication:Journal of Dental Hygiene
Article Type:Book Review
Date:Sep 22, 2002
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