Clinical Periodontology and Implant Dentistry, 4th edition

Edited by:
  • J. Lindhe,
  • T. Karring &
  • N. P. Lang
(Ed) Copenhagen: Blackell Munksgard, 2003 price £99, pp1,072 ISBN 1405102365 | ISBN: 1-405-10236-5

Over 20 years, this has developed into the foremost European text on periodontology, with just 7 of the 53 distinguished contributors living in other countries. The volume is superbly presented and easily assimilated. Undoubtedly it will benefit both specialist and general practitioners, and can be recommended as a reference volume for students.

To list the book's strengths would require more words than I am allowed. Clarity of writing and illustrations are compelling aids to the reader, and the division into three concept sections -- basic, clinical and implant -- is made with a logical progression of topics. As a clinician, I am impressed by the care taken over illustration. Both clinical and radiographic photographs are of an extremely high standard. Diagrams are clear and easily understood. As a researcher, I appreciate the selective but helpful references.

There are several new chapters in this edition. A new chapter which I really appreciated was entitled 'Genetics in Relation to Periodontitis'. Although this topic is an ongoing saga from week to week, the account given was clear and helpful for anyone with a modest understanding of the subject. There are other helpful new chapters in all 3 sections of the book, expanding and updating the information on diseases, periodontal treatment and implants.

A chapter which I found less helpful was on 'Periodontitis as a Risk for Systemic Disease'. Despite the obvious caution of the authors of this chapter, we are not given a full view of the many criticisms made of this theory in recent years, in particular that periodontitis is merely a 'ghost factor' for smoking. Smoking is involved in the causes of many diseases, including periodontitis, and in cardiovascular disease, for instance, periodontitis disappears as a risk factor if the effect of smoking is removed by studying lifelong nonsmokers. Indeed, the supposed association also disappears. Similarly, prematurity and low birth weight have not been confirmed as effects of periodontitis in some large studies outside the USA, and Hawthorne effects on metabolic control have not been ruled out in any study apparently implicating periodontitis as a contributing factor to diabetes.

Some general dental practitioners will find this an enjoyable book to read for continuing education, but I suggest that it should be used in conjunction with appropriate courses on periodontology. Specialist trainees and practitioners may rightly consider it their main reference textbook.