Treatment goals
- Elimination of pathogenic bacteria
- Infection control
- Regeneration of the periodontium
- Maintaining health and prevention of recurrence with frequent visits
Non-surgical periodontal therapy
The ultimate goal of non-surgical pocket/root instrumentation is to remove plaque, calculus and microbial endotoxin from the tooth surface and restore gingival health. It is accomplished with an effective self-performed everyday plaque control performed with a toothbrush, dental floss and interdental brushes.
Non‐surgical periodontal treatment may be carried out using various types of instruments, for example hand instruments, sonic and ultrasonic instruments, and laser devices.
Reevaluation of the treatment should occur 4-6 weeks after the completion of scaling and root planning procedures. This permits time for corrections of conditions, such as overhanging margins and sufficient practice with oral hygiene measures. It results in marked improvements in clinical conditions by eliminating the bacterial load at all tooth sites below the threshold level at which the individual host can cope with the remaining infection.
Transient unpleasant root hypersensitivity and gum recession frequently accompany the healing process. Many patients do not require additional treatment after scaling and root planning. However, the majority of patients will require ongoing maintenance therapy to sustain periodontal health.
Before and after periodontal treatment
Surgical periodontal therapy
Surgical periodontal treatment or corrective phase is considered as an adjunct to cause-related therapy. It is usually performed to facilitate removal of subgingival plaque and calculus, and thereby enhance the long-term preservation of the periodontium.
Surgical periodontal procedures include periodontal pocket elimination, plastic periodontal surgery and regenerative treatment.
Over time, periodontal pockets become deeper, providing a larger space for bacteria to live, accumulate and advance under the gum tissue. These pockets can result in bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted. During a periodontal pocket procedure, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.
Obtaining periodontal regeneration has always been a major challenge in periodontology and remains the gold standard of periodontal therapy. For that purpose, membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage natural ability to regenerate bone and tissue.
