PERIODONTAL THERAPEUTICS - A VIABLE OPTION

Research in recent years in periodontology has seen a shift from surge ry towards medicine. While surgery, particularly regenerative, and inc luding implants, continues to form an important element of periodontal treatment, the volume of treatment required and the results of recent and ongoing: non-surgical studies clearly show that most future perio dontics will be based on a physician-type approach. Improved diagnosti cs based on more precise periodontal disease classification, simplific ation of mechanical oral hygiene equipment and procedures, and the dev elopment of conventional and non-conventional chemical and physical ad juncts may be expected to reduce the rate of common periodontal diseas e advance, resulting in less complex treatments, and more of the latte r coming to lie within the competence of the generalist and the hygien ist working together. The rationale for non-surgical adjunctive therap y is extensive, far beyond the usual antimicrobial logic. It will also be important to control the oral microflora for systemic reasons, sin ce increasingly strong links are being established between focal infec tion of oral origin, much of it periodontal, and a range of systemic d iseases, including coronary heart disease, stroke, gastrointestinal di sorders, and low birth weight, apart from severe, overt systemic infec tions. All these developments derive from a greatly improved understan ding of the fundamentally ecological nature of the natural microbial b iofilm that is dental plaque, and of its interactions with its human h ost.