Nonsurgical and surgical treatment of periodontitis: how many options for one disease?

Abstract

Treatment of periodontitis aims at preventing further disease progression with the intentions to reduce the risk of tooth loss, minimize symptoms and perception of the disease, possibly restore lost periodontal tissue and provide information on maintaining a healthy periodontium. Therapeutic intervention includes introduction of techniques to change behavior, such as: individually tailored oral-hygiene instructions; a smoking-cessation program; dietary adjustment; subgingival instrumentation to remove plaque and calculus; local and systemic pharmacotherapy; and various types of surgery. No single treatment option has shown superiority, and virtually all types of mechanical periodontal treatment benefit from adjunctive antimicrobial chemotherapy. Periodontal treatment, because of the chronic nature of periodontitis, is a lifelong commitment to intricate oral-hygiene techniques, which, when properly implemented, will minimize the risk of disease initiation and progression.

Systematic review and meta‐analysis of double‐blind, placebo‐controlled, randomized clinical trials using probiotics in chronic periodontitis

“…The resolution of inflammation through the reduction of bacterial load is the primary goal of periodontal therapy . Scaling and root planing (SRP) is considered the gold standard treatment for CP, as it removes soft and hard microbial deposits and reduces the periodontal pathogenic count . However, in certain cases, such as deep probing depths, inaccessible root furcation, and interproximal areas of malposed teeth, proper access for instrumentation is not possible …”

Clinical evaluation of a newly developed chairside test to determine periodontal pathogens

“…For the clinical practitioner not very experienced with the different forms of periodontitis, microbiological testing can be a helpful tool for quality assurance and can help choose a personalized treatment approach. In this context it is important that positive results of microbiological testing do not necessarily imply antibiotic prescription, since most of subgingival bacteria can successfully be reduced by mechanical treatment only …”

“…In this context it is important that positive results of microbiological testing do not necessarily imply antibiotic prescription, since most of subgingival bacteria can successfully be reduced by mechanical treatment only. 21 Many microorganisms largely present in periodontal pockets are not cultivable, 22,23 and standard microbiological cultivating procedures are unsuccessful. Other immunological and molecular procedures such as quantitative polymerase chain reaction (qPCR) for determination of bacterial DNA have gained more and more importance.…”

Antimicrobial activity of copaiba oil (Copaifera ssp.) on oral pathogens: Systematic review

“…Several treatments are proposed to treat both caries and periodontal disease (Bjørndal et al, ; Claffey, Polyzois, & Ziaka, ; Cobb, ; Graziani, Karapetsa, Alonso, & Herrera, ; Singhal, Acharya, & Thakur, ). However, the search for new therapies, especially those that used natural products with large efficacy and low cost, are warranted.…”