Periodontitis is an inflammatory disease affecting the periodontium i.e. the tissues that surround and support the teeth. Periodontitis manifests as progressive loss of the alveolar bone around the teeth, and if left untreated, can cause loosening and subsequent loss of teeth. Periodontitis is initiated by microorganisms that adhere to and grow on the tooth's surfaces, besides an over -aggressive immune response against these microorganisms. The primary goal of periodontal therapy is to preserve the natural dentition by accomplishing and preserving a healthy functional periodontium. Many treatment modalities have been introduced to improve the therapeutic result of periodontal treatment which may also damage the periodontiumiatrogenically.

The radio-sensitivity of a tissue or organ is measured by its response to irradiation. Loss of moderate numbers of cells does not affect the function of most organs. However, with loss of large numbers of cells, all affected organisms display a clinical result. The severity of this change depends on the dosage and thus the extent of cell loss. Moderate doses to a localized area may lead to repairable damage. Comparable doses to a whole organism may result in death from damage to the most sensitive systems in the body.

One of the most difficult and elusive goals of Periodontics in the field of reconstruction and regeneration is the surgical reconstruction of the lost interdental papilla. This clinical and aesthetic dilemma demands more attention from the clinician. Several non-surgical and surgical techniques have been proposed to manage the interproximal space. Non-surgical approaches modify the interproximal space and the surgical techniques aim to re-contour, preserve and reconstruct the soft tissue between the teeth. Platelet rich fibrin has been extensively used in hard and soft tissue augmentation, but not tried for augmenting interdental papilla. The purpose of this case series is to describe a novel approach of papilla reconstruction in the maxillary anterior region with the use of platelet rich fibrin. This procedure obtained optimal fill in all the cases postoperatively. Thus, the use of PRF may be the panacea for interdental papilla augmentation.

The efficacy of periodontal surgery in the treatment of periodontal diseases not yet been systematically evaluated. The objective of this review was to systematically evaluate the efficacy of periodontal surgical procedures in the various treatment modalities. Periodontal disease is multifaceted in nature and scope. The problems created due to this inflammatory condition are different eg. gingival enlargement, osseous deformities, mucogingival problem which ultimately may lead to tooth loss. There are different surgical treatment modalities to treat periodontitis and its clinical manifestation. There is no one way or single method to approach this inflammatory condition. The ultimate treatment selection is determined by training, ability, and philosophy to attain complete regeneration of the lost periodontal tissue.

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