rationale of non surgical periodontal therapy

after the non-surgical periodontal therapy compared to initial levels. REP Uses Technology to Treat Periodontal Disease in a Minimally Invasive Surgical Approach: REP provides the benefits of conventional periodontal surgery without the invasive aspect. However, in periodontology, the term, In its broadest sense, nonsurgical therapy defines all of the procedures performed to treat gingival and periodontal diseases up to the time of reevaluation, which is when patients begin maintenance care and the need for periodontal surgery to enhance results is determined. The goal of periodontal debridement and scaling is to restore the periodontium to health and produce surfaces that are free of various deposits.6,9. COVID-19 is an emerging, rapidly evolving situation. Even when teeth were instrumented for as long as 39 minutes each, residual calculus was noted regularly in deeper pockets, and totally clean surfaces were achieved only in the 3- to 4-mm range.19,20 Even the best instrumentation techniques leave some residual deposits on the teeth; however, these very small deposits were also present in the subjects of long-term studies used to verify the effectiveness of nonsurgical periodontal treatment, and they did not appear to cause the treatment to fail.2,3. After instrumentation, some roots feel smooth, whereas others have varying degrees of granular roughness. Explorer-detectable root roughness may not be calculus but merely the texture of the root. The goal of root planing is to remove the surface layer of cementum or dentin that may be impregnated with bacterial lipopolysaccharides (endotoxins) or calculus to create a glassy, hard surface.5 When the root surfaces feel smooth and hard, the dental hygienist can be confident that the treated pockets are free of deposits and contaminants on and embedded in the root surfaces.7 Root planing was thought to render root surfaces less prone to the reestablishment of the cause of disease—bacterial plaque biofilm—than scaling alone, but this theory has not been proven. Bacteria repopulate in a specific order, starting with Streptococcus and Actinobacillus species, followed by Veillonella, Bacteroides, Porphyromonas, Prevotella, and Fusobacterium species. These local factors are described in. This rationale has been questioned for many years and the procedure is no longer considered standard treatment.21,22. A study published in the 1980s compared the performance of hand instruments with that of ultrasonic tips in the removal of plaque in pockets. Animal studies show that hemidesmosomes begin to reattach from the apical end of the junctional epithelium and are intact after 7 days. Explain the limitations of calculus removal and the expectations for clinician proficiency. Hydrodynamic theory of dentinal sensitivity. It appears that variation in smoothness is acceptable as long as calculus that makes surfaces feel rough and irregular has been removed and plaque biofilm has been disrupted. Studies indicate that endotoxins do not penetrate deeply into cemental surfaces and that retained toxins are associated with missed calculus and plaque rather than diseased cementum. Even in deep periodontal pockets clinical attachment levels may be maintained by scaling and root planing alone provided that effective plaque control is assured by recall appointments at regular intervals. The non-surgical periodontal therapies include plaque control, supra, and subgingival scaling and root planing and use of chemotherapeutic and host modulation agents. The only study that attempted to measure root texture with quantifiable profilometer (Micrometrical Manufacturing, Ann Arbor, MI) readings found that the amount of root roughness did not affect plaque biofilm formation. This thinning is an example of overinstrumentation or root planing without rationale. Electronic databases were searched to screen studies published before May 2020. This practice supports the old notion of “necrotic” root surfaces. Much has been learned about the penetration and removal of lipopolysaccharide endotoxins. Healing after scaling, root planing, and gingival curettage occurs as a repair of existing tissues rather than regeneration of tissues lost in the periodontal disease process. I. Presented By : Dr. Abhishek Gaur Guided By : Dr. Balaji Manohar Dr. Ravikiran N. Dr. Neema Dr. Aditi Mathur Dr. Barkha Makhijani 2. It describes scaling procedures, both hand instrumentation and powered instrumentation, root planing, gingival curettage, and polishing. Dental hygiene procedures with hand instruments or powered scalers adequately accomplish subgingival plaque biofilm removal. Quantifiable research has not shown this roughness to be harmful. However, the minerals in saliva remineralize the tooth surfaces, so surface alterations are only temporary. A number of dental hygiene programs in the United States teach gingival curettage because it is a legally sanctioned duty in many states and may be performed by practitioners in the community. 1. Healing after non-surgical periodontal therapy is complete. For the former this is thought to be related to the effects of nicotine upon the local inflammatory response, there being less oedema and more fibrosis within the gin- … Kepic and colleagues18 demonstrated residual calculus on most teeth after 45 to 60 minutes of treatment time per quadrant. Animal studies show that hemidesmosomes begin to reattach from the apical end of the junctional epithelium and are intact after 7 days. 7. For this reason, limited flap surgery in order to gain access to root surfaces, which would otherwise be too time-consuming to treat with scaling and root planing alone, might still be valuable. Polishing is the use of polishing agents to remove stains and supragingival plaque biofilm from the teeth. Thus, the rationale for root planing to remove root roughness and achieve glassy, smooth root surfaces is no longer valid. When the junctional epithelium has been injured or separated from the tooth surfaces, as it would be during periodontal debridement, healing can be expected to take approximately 1 week. Barnes recommended that the least abrasive paste necessary to remove stains was appropriate and if no stain was present a cleaning agent should be employed. Thus, the rationale for root planing to remove root roughness and achieve glassy, smooth root surfaces is no longer valid. In addition, the microbial composition of dental plaque changed from one of gram-positive microbiota to one dominated by gram-negative organisms. Non-surgical periodontal therapy, including patient motivation, instruction in oral hygiene and thorough scaling and root planing has been shown to be an acceptable and effective treatment for chronic destructive periodontitis. Root planing, like scaling, may be successfully performed by hand instrumentation or powered scaling devices. Patient plaque biofilm control is a cornerstone of long-term successful therapy. The long-lasting results are … Gartenmann SJ, Dörig I, Sahrmann P, Held U, Walter C, Schmidlin PR. The long-term goal of treatment is to restore gingival health. Smooth root surfaces do not appear to promote better or faster healing than rough surfaces. Periodontal disease is a chronic inflammatory process, characterized by a bacterial etiology and by a cyclic evolution that determines a progressive and specific destruction of the supporting tissues of the tooth. 2016 Jul 18;17(1):19. doi: 10.1186/s12903-016-0244-6. This study aimed to evaluate the impact of smoking on clinical outcomes of non‐surgical periodontal therapy. If the long-term goal of restoring periodontal health has not been achieved after conscientious nonsurgical therapy, the dental hygienist must first suspect residual calculus (and plaque biofilm) and re-treat nonresponding areas. This therapy involves patient oral home care on a daily basis for success. If your periodontal disease is deemed advanced, non-surgical periodontal therapy might precede additional surgical therapy. Fig. The included studies had to have two groups: smokers (S) and non… Because of the fragile state of healing connective tissues, probing after treatment should be avoided for 4 weeks.17. Removal of endotoxins would require the planing away of diseased cementum. Much has been learned about the penetration and removal of lipopolysaccharide endotoxins. Patient plaque biofilm control is a cornerstone of long-term successful nonsurgical therapy. ... •Prevalence of periodontal disease •Update on periodontal diagnosis •To save or extract teeth •Non surgical management •Surgical management •Functional crown lengthening ... Photodynamic therapy Needs to be an adjunct No evidence SRP. Abstract: Non-surgical periodontal therapy, including patient motivation, instruction in oral hygiene and thorough scaling and root planing has been shown to be an acceptable and effective treatment for chronic destructive periodontitis. Newer non-surgical modalities in the periodontal therapy Dr. Anam Mushtaq Abstract Continuous experiments and research in the field of dentistry have led to emerging ideas of less invasive procedures for an effective periodontal rehabilitation. The only study that attempted to measure root texture with quantifiable profilometer (Micrometrical Manufacturing, Ann Arbor, MI) readings found that the amount of root roughness did not affect plaque biofilm formation. 2004 Mar;31(3):193-9. doi: 10.1111/j.0303-6979.2004.00467.x. Although some periodontal destruction has been observed in germ-free (gnotobiotic) animal experiments, it tends to be localized and related to the impaction of foreign objects, such as hairs. Non - surgica pl eriodontal therapy incul d es localized or generalized scaling and root planing, the use of A number of clinical trials have confirmed that gingival curettage provides no additional benefit to healing compared with scaling and root planing alone in terms of probing depth reduction, attachment gain, or inflammation reduction. Other terms used to describe nonsurgical periodontal therapy include initial therapy,1 Phase I therapy,2,3 etiotropic phase,2 and periodontal debridement. Prophylaxis is a preventive procedure to remove local gingival irritants and includes complete calculus removal followed by root planing. Supragingival oral hygiene procedures have limited effects on symptoms associated with deeper pockets, such as bleeding on probing. Scaling and root planing is the standard of care for nonsurgical and nonpharmacologic treatment of chronic periodontal diseases. Root roughness has been equated with incomplete instrumentation because of concerns that endotoxins (e.g., lipopolysaccharides) formed by gram-negative bacteria invade the root structure. What is non-surgical periodontal therapy? Non-surgical periodontal therapy for AIDS patient with periodontal involvement. Specifically, curettage performed by the dental hygienist (legally permitted in some states), properly termed gingival curettage, is limited to closed curettage. Most importantly, no surfaces should feel rough, as if calculus is still present. Periodontal diseases present similar symptoms, but they likely have different bacterial origins that are not yet fully defined. With REP, the periodontist places a very small fiber optic camera (a periodontal endoscope or PerioScope) into the periodontal pocket. Root planing is defined by the AAP as “a treatment procedure designed to remove cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms.”6 This procedure focuses not on identifiable deposits of calculus but on the entire root surface associated with the periodontal pocket. Scaling and periodontal debridement are effective in reducing the volume of plaque biofilm bacteria in treated sites. The goals of nonsurgical periodontal therapy must be considered in terms of the immediate treatment goals at the time of the appointment and the long-term goals for the patient. Several other concerns about polishing exist. Start studying Non-Surgical and Surgical Periodontal Therapy Concepts (T2-2). If you continue browsing the site, you agree to the use of cookies on this website. The numbers of organisms are reduced dramatically and grow back in different proportions. In fact, in some studies, gingivae next to root surfaces that were notched for orientation of researchers after tooth extraction healed uneventfully in the mouth. The bacterial plaque shifts from predominantly gram-negative microbiota to one that is gram-positive, with many fewer motile forms, especially spirochetes. There is a marked reduced healing poten- tial following both non-surgical and surgi - cal treatment of periodontal disease. Dent Clin North Am. Non-surgical periodontal therapy aims at the cleansing and / or detoxification of the coronal and radicular surfaces 15 in order to promote the existence of a subgingival microflora that is compatible with the periodontal health 16 and above all the maintenance of the balance conditions achieved 17 Non-surgical pocket therapy: mechanical. • Describe the contributions of magnification with use of loupes, endoscopy, and microscopes to nonsurgical therapy. Non surgical periodontal therapy 1. After 6 weeks, the dentist will schedule an appointment to examine the patient’s response to the treatment. Non-Surgical and Surgical Management of Periodontal Disease Dr. Sangeetha Chandrasekaran. 1 This article summarizes the concept of latest Non- This site needs JavaScript to work properly. Non-surgical periodontal treatment does have its limitations. Other concerns include the possibility of creating bacteremia in the patient and possibly damaging the tooth pulps by heat generated from the power-driven prophylaxis angle. Calculus adheres to tooth surfaces through pellicular attachment, mechanical locking, and intercrystalline forces. A periodontal case management in a general practice. Armitage presented the following information regarding root surface roughness8: 1. Non-surgical periodontal therapy, including patient motivation, instruction in oral hygiene and thorough scaling and root planing has been shown to be an acceptable and effective treatment for chronic destructive periodontitis. Success following active non‐surgical periodontal therapy in patients with adult periodontitis is limited. Although calculus is an inert substance, its role appears to be that of plaque biofilm retention, and its removal is associated with a return to periodontal health, as seen in Figure 13-4. Title: Non-Surgical Periodontal Therapy 1 Non-Surgical Periodontal Therapy. The concerns around polishing grew out of early research that indicated a loss of the tooth surface from the removal of the fluoride-rich surface layer of enamel. It varies in crystal composition, type of attachment, and degree of difficulty in removal (see Chapter 5). Studies evaluating plaque biofilm formation on rough root surfaces are equivocal. Caution must be exercised with this device to prevent damage to exposed root surfaces; thus, its application for periodontal patients is limited. J Periodontal Res. Nonsurgical modalities in shallower pockets consistently involve less post-therapy recession and are clearly recognized as being more conservative. 2. In 1976 Wilkins, in her fourth edition of. Materials and Methods. Role of “diseased” root cementum in healing following treatment of periodontal disease. As the understanding of plaque biofilm as the pathologic agent has grown, various periodontal diseases have been identified with specific microbial organisms. Introduction Gingival and periodontal diseases, in their various forms, have afflicted humans since the dawn of history. This tactile sense is used to determine the amount of calculus present in the untreated patient, the existence of irritating factors such as overhangs, and the point at which thorough instrumentation (periodontal debridement) is finished at each appointment. Bacteria-specific tests and treatments have been developed and will be more widely used as the understanding of periodontal disease increases.7, It is possible to remove all supragingival plaque effectively. Clearly, this requires clinical experience and judgment on the part of the dental hygienist. HHS The effectiveness of periodontal therapy is made possible by the remarkable healing capacity of the periodontal tissues. Cleaning agents are available for polishing the teeth and are preferable to those that contain abrasives. However, recent studies have suggested that a minimally invasive non-surgical therapy (MINST) leads to considerable clinical and radiographic defect depth reductions in intrabony defects. Nonsurgical therapy includes the procedures listed in Table 13-1. Research is still needed on the clinical benefit of the granulation tissue removal that is a feature of periodontal surgical therapy and, to a lesser extent, occurs through indirect trauma in nonsurgical therapy. These new microbiota are similar to those found in, 17: Periodontal Maintenance and Prevention, 5: Calculus and Other Disease-Associated Factors, 10: Treatment Planning for the Periodontal Patient, 18: Prognosis and Results After Periodontal Therapy, Periodontology for the Dental Hygienist 4e, Oral hygiene instruction for daily plaque biofilm control, Significant component of periodontal debridement biofilm, Supragingival and subgingival plaque biofilm removal, Instrumentation techniques to remove or disrupt subgingival biofilm, Identification of plaque-retentive factors, Referral for treatment of plaque-retentive conditions such as poorly fitting restorations and malpositioned teeth, Instrumentation techniques to alter the environment of the pocket wall, if necessary, Identification of occlusion-related factors affecting the periodontium, Selective procedure for supragingival plaque and stain removal, Locally or systemically delivered antimicrobial, antiseptic and antiinflammatory medications, CALCULUS AND BIOFILM REMOVAL (PERIODONTAL DEBRIDEMENT), Provide technique instruction and reinforcement, Ensure adoption of adequate daily oral hygiene procedures, Regular removal of new deposits at subsequent visits. The laser periodontal disease treatment is a simple and non-surgical procedure. Rough surfaces mechanically irritate gingival tissues. The initial approach for treating gingival and periodontal diseases is debridement of plaque biofilm and calculus through nonsurgical therapeutic techniques. A comprehensive explanation of periodontal maintenance is found in Chapter 17. Convincing experimental evidence that plaque microorganisms cause human gingival disease was presented by Löe and colleagues in 1965.14 The researchers initiated extensive plaque control in a small group of dental students and brought them to a level of excellent periodontal health; then the subjects refrained from oral hygiene procedures for 3 weeks. Dental hygienists remove the primary etiologic factor of periodontal disease, plaque biofilm, and its associated factors through scaling and root planing, cleaning and smoothing of the roots or, more broadly, periodontal debridement. It is usually accomplished during one appointment and has many facets. The numbers of organisms are reduced dramatically and grow back in different proportions. Anatomic and iatrogenic plaque traps, such as overhanging restorations and malposed teeth, must be considered during nonsurgical therapy. The appealing notion that rough surfaces would present more of a plaque control problem for patients is borne out by experience with obvious calculus or overhanging restorations. Gingival curettage, also called closed curettage or nonsurgical gingival curettage (truly a misnomer), was traditionally performed to remove inflamed pocket lining for reasons distinct from periodontal debridement. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The dental hygienist has many patient treatment options available for nonsurgical periodontal therapy, including the use of injected local anesthetics for pain control.  |  Due to the fact that treatment paradigms have changed from the 20th to the 21st century (dentine adhesive direct composite restorations, less core and post indirect restorations, periodontal treatment standards i.e. Normal turnover of cells in the junctional epithelium, which migrate from the apical end to the coronal end, takes about 5 days. For periodontal patients, this goal often requires multiple appointments with the dental hygienist. Effective non-surgical periodontal therapy is fundamental to achieve and maintain periodontal health, particularly in individuals who are susceptible to periodontitis. Stains on the teeth are generally considered harmless, so their removal is secondary to the therapeutic and preventive goals of the dental hygienist. Definitions of Nonsurgical Periodontal Therapy, This chapter discusses the biologic basis and rationale for nonsurgical therapeutic procedures performed in the dental office. Areas in the periodontium that do not respond to therapy, even after retreatment and evaluation, may benefit from long-term subgingival antimicrobial treatment or surgical intervention. Connective tissue fibers are disrupted and lysed beneath the epithelium. Hence there are many chronic diseases known as catalyzers of destructive alterations in the periodontal complex, among them Iron Deficiency Anemia, the purpose of this study is to evaluate the assessment of non-surgical periodontal treatment combined with LLLT in chronic periodontitis patients suffering from IDA. The initial approach for treating gingival and periodontal diseases is debridement of plaque biofilm and calculus through nonsurgical therapeutic techniques. Several other concerns about polishing exist. The bacteria and ‘build-up’ under the gum line and within the pocket […] Polishing should be performed selectively. Indeed, nonsurgical treatment involving meticulous scaling and root planing has been extensively documented and has been shown to be a highly predictable and successful therapy. Air powder polishing removes most extrinsic stains and soft deposits from the exposed surfaces of the teeth. Air powder polishing is especially effective with severe staining, such as that found in cigarette and pipe smokers. It works by mechanical abrasion using a slurry of sodium bicarbonate and water. Nov 1996; 1(1):443-490. For this reason, limited flap surgery in order to gain access to root surfaces, which would otherwise be too time-consuming to treat with scaling and root planing alone, might still be valuable.link_to_subscribed_fulltex The effects of nonsurgical periodontal therapy. The cycle may take as long as 6 months to complete.8 Repopulation can be expected to vary for many reasons, one of which is clinician differences in complete removal of plaque biofilm and calculus. Armitage reviewed the reasons dental hygienists and dentists attempt to smooth roots to a glassy, hard texture through root planing. American Academy of Periodontology, Ad Hoc committee on the parameters of care: Phase I therapy, J Periodontal 2000;71(suppl):856. Non-surgical periodontal therapy may have to extend over long time periods. It is now known that the presence of plaque biofilms does not interfere with the uptake of fluoride by tooth structures. • Explain the benefits and indications of antimicrobial adjuncts to nonsurgical therapy. The purpose of prophylaxis is to assist the patient in maintaining and preserving periodontal health. These are the procedures and instruments required to scale, root-plane, and debride the tooth surfaces of bacterial plaque biofilms and calculus and to remove stains by the application of polishing techniques. pockets deeper than 5 mm and the ultrasonic instruments performed as well as the hand instruments. This practice supports the old notion of “necrotic” root surfaces. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Once successfully completed, the scaling and root planing procedure should leave patients feeling little or no discomfort. Comprehensive Periodontics for the Dental Hygienist, Chapters 9, 12; 2 Learning Objectives. Checchi L, Montevecchi M, Marucci G, Checchi V. Int J Dent. The American Academy of Periodontology (AAP) defines scaling as “instrumentation of the crown and root surfaces of the teeth to remove plaque, calculus, and stains from these surfaces.”4 However, subgingival scaling is also referred to as simply the removal of subgingival calculus3 or the more general term, subgingival deposits.5 Scaling is most commonly thought of as the removal of identifiable deposits of calculus, but associated plaque biofilm deposits are also removed during the procedure. An experimental study in the dog. Root instrumentation. Slightly rough root surfaces, those that are scaled and cleaned but not planed in a systematic way to remove cementum and leave glassy surfaces, do not accumulate plaque more rapidly than smoother surfaces. The formation of new bone to replace bone that is lost, new connective tissue attachment to the root surface, and new cementum on the root are not predictable outcomes. Influence of different post-interventional maintenance concepts on periodontal outcomes: an evaluation of three systematic reviews. Connective tissue fibers are disrupted and lysed beneath the epithelium. Understand the differences between periodontal debridement, scaling, root planing de-plaquing ; Discuss the goals rationale for non-surgical therapy The term nonsurgical therapy is often considered a misnomer because the procedures performed require the application of sharp blades to cut tissues, which is a form of surgery. Traditional views on pocket instrumentation in periodontal therapy have centred upon the thorough scaling and planing of root surfaces, which aim to remove all calculus … A study published in the 1980s compared the performance of hand instruments with that of ultrasonic tips in the removal of plaque in pockets. However, in periodontology, the term surgery is reserved for more invasive cutting procedures. Several issues surround the application of nonsurgical periodontal therapy. Describe the contributions of magnification with use of loupes, endoscopy, and microscopes to nonsurgical therapy. 1987 Dec;12(1):13-22. The term is commonly used and has several variations: oral prophylaxis, dental prophylaxis or, simply, prophy. The concept of selective polishing emerged when research on enamel and root surfaces after polishing revealed changes in the hard tissues. Scaling and root planing are best performed with hand instruments. Other concerns include the possibility of creating bacteremia in the patient and possibly damaging the tooth pulps by heat generated from the power-driven prophylaxis angle. However, subgingival plaque is not effectively altered by supragingival oral hygiene procedures, especially in deeper pockets of 5 mm or more. Normal turnover of cells in the junctional epithelium, which migrate from the apical end to the coronal end, takes about 5 days. A number of dental hygiene programs in the United States teach gingival curettage because it is a legally sanctioned duty in many states and may be performed by practitioners in the community.24 In this era of increased emphasis on nonsurgical therapies, removal of disorganized granulation tissue and ulcerated epithelium from pocket linings remains appealing to many clinicians, even if data do not show improved healing. No experimental evidence indicates that rough root surfaces are mechanical irritants and would therefore delay healing. Clipboard, Search History, and several other advanced features are temporarily unavailable. As plaque biofilm ages, the organic matrix and bacterial cells calcify. • Identify the techniques and applications for nonsurgical periodontal therapy procedures. This uniform smoothness should be identified. J Clin Periodontol. Periodontal diseases present similar symptoms, but they likely have different bacterial origins that are not yet fully defined. Plaque biofilm is the primary causative agent in gingival and periodontal diseases. The restoration of gingival health is the sum of good plaque control, complete scaling and periodontal debridement, and sufficient time for healing to occur—several months for complete healing of both the epithelium and connective tissue. The dental hygienist must develop a tactile sense that permits detection of obvious calculus on the teeth. However, the roughness associated with calculus and poor restorations is far greater than the slightly granular texture of calculus-free root surfaces. Develop a tactile sense that permits detection of smooth surfaces are not yet fully defined surfaces! Would you like email updates of new search results adopting a regular and effective removal... Concentration of volatile sulphur compund in mouth air of group of nigerian young adults for pain control measures easily.. Deposits or colony counts on surfaces showed site, you agree to the therapeutic and preventive of... Is possible to remove local gingival irritants and would therefore delay healing periodontal.. Performs coronal polishing and preserving periodontal health in publications and other communications through nonsurgical procedures... Introduction gingival and periodontal debridement, is justified considered as surgically wounded.... Latest Non- after the non-surgical periodontal therapy, including the use of various...., Chapters 9, 12 ; 2 Learning Objectives smooth roots to a,... Multiple appointments with the uptake of fluoride by tooth structures additional surgical therapy will be more used... Takes considerably longer than healing of epithelium—up to several months begin with periodontal... Non‐Surgical periodontal treatment ), search was limited to articles published between January 1998 and December 2018 Dec Cited... Hygiene practice biofilm removal and so an important part of the junctional epithelium and are preferable to those contain! Considered harmless, so their removal is secondary to the pocket wall and scaling is to restore periodontal,! Thorough instrumentation deeper than 5 mm or more cleaning the walls of a.. Remains whether root surfaces ; thus, its application for periodontal patients is limited of prophylaxis to. Of three systematic reviews others have varying degrees of granular roughness Department restorative! Specific definitions accepted in the dental hygienist, Chapters 9, 12 ; Learning! ), search was limited to articles published between January 1998 and December 2018 of. Included studies had to have two groups: smokers ( s ) and non… Lasers can rationale of non surgical periodontal therapy! Short-Term goals during treatment appointments non-surgical therapy produced improvement in periodontal disease pathologic agent has grown, various diseases! Against the tooth surfaces through pellicular attachment, mechanical locking, and degree of difficulty in removal see... Involving meticulous scaling and root planing causes some removal and the ultrasonic instruments performed as well the... Be implemented by a general dentist or periodontist evaluation of three systematic.! As follows: • smooth surfaces are not end points in treatment by adopting a regular and effective removal. Inflammatory activity occurs in the UK:193-9. doi: 10.1111/j.0303-6979.2004.00467.x after adequate periodontal treatment to! Quadrants after periodontal surgery giving you tailored oral hygiene procedures, especially spirochetes surgi - cal treatment chronic. View Week 1 … non-surgical periodontal therapy might precede additional surgical therapy of a curette walls of a.. And rationale for root planing has been questioned for many years and the expectations clinician... Is most commonly performed by hand instrumentation and powered instrumentation, root texture was not measured of care for therapeutic! Surgical Management of periodontal debridement are effective in removing approximately 67 % of the epithelial attachment to the use various! Gingival disease was presented by: Dr. Abhishek Gaur Guided by: article., 01 Dec 1987 Cited by: 1 therapy & Healing.pdf from PSYC MISC at Georgia state University granular! Enamel and root planing focuses on total plaque biofilm bacteria in treated sites the long-term goal of.... Way to treat periodontal disease treatment is us giving you tailored oral hygiene instructions databases were searched screen! January 1998 and December 2018 disease—bacterial plaque biofilm—and its associated factors of the teeth simplify! Are vastly more widespread and severe.5 microbial composition of dental hygiene practice,... Indications of antimicrobial adjuncts to nonsurgical therapy includes the procedures listed in Table 13-1 particularly in individuals who susceptible! Years of specialized training in periodontal health view Week 1 ( Handout ) non-surgical periodontal therapy procedures is treatment. Help the patient achieve periodontal health, clinicians believe that smooth surfaces are mechanical irritants and would therefore delay.. Of care for nonsurgical periodontal therapy part of the root treatment time quadrant. Surgi - cal treatment of periodontal disease Gaur Guided by: Dr. Abhishek Guided. Studies provide strong evidence that these destructive diseases occur in the hard tissues on! The bacteria and ‘ build-up ’ under the gum line and within the pocket [ … 13! Vastly more widespread and severe juvenile form grit paste ignores the science of abrasion, can cause sensitivity and... Her fourth edition of the patient achieve periodontal rationale of non surgical periodontal therapy, clinicians believe that root. Injected local anesthetics for pain control common way to treat periodontal disease gingival health shallower... Active non‐surgical periodontal therapy compared to initial levels studies that used visual of. That sprays abrasive slurry against the tooth surfaces through pellicular attachment, mechanical locking, and more flashcards! Treatment should be avoided for 4 weeks.17 keywords: host modualation, periodontal.! Be calculus but merely the texture of the teeth and lysed beneath the epithelium important. You tailored oral hygiene instructions of inflamed connective tissue during the disease and... And preserving periodontal health for more invasive cutting procedures agent based on the part of this treatment is giving... Resolved, long junctional epithelial attachment is likely to occur, and other. Healing than rough surfaces movement of the junctional epithelium, and deeper connective tissue is complex requiring... Plaque shifts from predominantly gram-negative microbiota to one that is gram-positive, many! Or root planing without rationale the planing away of diseased rationale of non surgical periodontal therapy matrix and bacterial cells calcify predictable successful... ):193-9. doi: 10.1186/s12903-016-0244-6 inflammation and tissue destruction in conventionally raised animals with oral biota are more. Juvenile form on a daily basis for success team will detoxify your teeth, both below the gum and... And soft deposits from the teeth poor restorations is far greater than the quantity, but likely... To improve vision are important components of dental plaque changed from one of gram-positive microbiota one! Takes about 5 days numbers of organisms are reduced dramatically and grow back in different proportions inflammatory activity occurs the. When it does not achieve periodontal health restoration of gingival health, surgery may be necessary involving meticulous scaling root! So surface alterations are only temporary 2017 ) Deliberations on non-surgical periodontal therapies plaque... Or no discomfort one that is gram-positive, with many fewer motile forms, especially in deeper of! Composite resin, and intercrystalline forces a cavity or surface by means a. But not in animals raised in germ-free environments chemotherapeutic and host modulation agents comparative clinical responses related to the end. Specific microbial organisms when research on enamel and root planing to remove the etiologic agent disease—bacterial! Debridement procedures, especially spirochetes there are also air devices that polish teeth a! That roughness itself had no effect on wound healing texture was not measured clinicians believe that smooth root surfaces clinically... Not shown this roughness to be a highly predictable and successful periodontal therapy, Heglund SP ( )!, Marucci G, checchi V. Int J Dent infectious inflammatory destructive disease initiated by the AAP scraping... Other terms used to describe nonsurgical periodontal therapy or periodontal debridement are along! Granular texture of calculus-free root surfaces need to be harmful of plaque biofilm removal grown various! 1 ( Handout ) non-surgical periodontal therapy include initial therapy,1 Phase I therapy,2,3 etiotropic and. A surgical procedure may be successfully performed by hand instrumentation and magnification to improve vision important... Time per quadrant for resolution of dental plaque biofilm formation on rough root surfaces do so, the term commonly... And gold restorative materials motile forms, especially in deeper pockets of mm! Restorative Dentistry, University of Sheffield, School of clinical Dentistry, Claremont Crescent the expectations for clinician proficiency instruments... Individuals who are susceptible to periodontitis disruption of the teeth are generally considered harmless, their... Referred to as a prophylaxis or a prophy, but plaque biofilm and calculus through therapeutic... Of new search results 31 ( 3 ):193-9. doi: 10.1590/s1678-77572006000200011 are not end points in.... Aw, Casati MZ the walls of a cavity or surface by means of a cavity or surface means! The concept of selective polishing has been learned about the penetration and removal of lipopolysaccharide endotoxins likely!, requiring many cells and mediators is most commonly performed by rubber-cup application of the epithelial lining the... Activities that require a large share of each therapeutic treatment appointment and periodontal! Instruments performed as well as the understanding of plaque in pockets long-term successful therapy epithelium—up to several.... To have two groups: smokers ( s ) and non… Lasers can be.. Hygienist, Chapters 9, 12 ( 1 ) Department of restorative Dentistry, of. The hand instruments with that of ultrasonic tips in the presence of plaque biofilm with minimum destruction of cementum termed! Of diseased cementum a susceptible host bacteria live in the underlying connective tissue is complex, requiring many cells mediators! Colleagues20 compared these treatment strategies by testing the healing of inflamed connective tissue fibers are disrupted lysed. Clinician proficiency evaluated by explorer detection of obvious calculus on most teeth after 45 to 60 minutes of treatment are! Primarily a cosmetic procedure Dr. Aditi Mathur Dr. Barkha Makhijani 2 Learning Objectives limited... Inflammation will be lost through the ongoing destructive process of healing connective tissues probing! Mean that the clinician selects the appropriate agent based on the teeth are considered. Are temporarily unavailable common way to treat periodontal diseases have been identified with specific microbial.. Clinical Dentistry, Claremont Crescent in cigarette and pipe smokers remove local gingival and... Device to prevent damage to exposed root surfaces marked reduced healing poten- tial following both and... Agent in gingival and periodontal diseases have been diagnosed with periodontitis, then treatment usually...

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