Nonsurgical periodontal therapy in 2000: A literature review

Background, This article addresses the advantages and limitations of nonsur gical periodontal therapies to treat patients with mild-to-moderate chronic periodontitis. Types of Studies Reviewed. Controlled clinical trials were selected that as sessed the efficacy of the following treatment methods: mechanical instrume ntation, ultrasonic debridement, supragingival irrigation, subgingival irri gation, local drug delivery, administration of systemic antibiotics and hos t-response modulation. Evidentiary data with regard to alterations of probi ng depth, clinical attachment levels and inflammatory status were evaluated . Results, Comparison of the data from test and control groups revealed the f ollowing results. Manual and ultrasonic debridement can be used to treat mo st patients with mild-to-moderate chronic periodontitis. Patients who do no t practice optimal plaque control can enhance their personal hygiene proced ures by using supragingival irrigation. Subgingival irrigation usually does not provide any benefit beyond that achieved with root planing. Systemic a nd locally delivered antimicrobial agents appear to be most beneficial amon g patients who do not respond to conventional treatment. Host modulation ma y enhance root planing modestly. Clinical implications, The data indicate that most patients with mild-to-mo derate periodontitis can be treated with nonsurgical therapies. However, cl inicians need to be aware of the limitations of each technique with regard to the magnitude of improvement that it can induce at specific sites.