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Review of Cohen: "Role of Periodontal Surgery"

Doctor Cohen had a difficult task in discussing the role of surgery in periodontal therapy. Everybody will agree that most of the current ideas on the efficacy of the various surgical treatment methods are based purely on experience and opinions. Periodontal surgery, like most other treatment procedures, has developed entirely on empirical grounds. In general surgery, it has been known for centuries that the amputation of a gangrenous limb may save the patient's life because it prevents further development of the destructive process. The early periodontists' motivation for doing gingival and osseous surgery was to remove rotten granulation tissue and necrotic bone, thereby eliminating the disease. As histopathologists started to study the periodontal lesion, it became clear that the granulation tissue was a product of local inflammation, and that it was a manifestation of defense and healing; in the early thirties, this was clearly expressed by Westin,' who further emphasized that the alveolar bone adjacent to the granulation tissue was in no way necrotic, and that it had all the potentialities of healing, when conditions allowed it. Therefore, it was necessary to find other reasons for gingival and osseous surgery, and over the last two decades, various reasons have been suggested.