Periodontal Therapy

Periodontal diseases manifest themselves in the majority of the adult population. Periodontal diseases are the most common dental conditions. A sequence of interrelated steps is inherent to effective periodontal treatment. A primary goal of initial periodontal therapy is to reduce the burden of pathogenic bacteria and thereby reduce the potential for progressive inflammation and recurrence of disease. Initial Periodontal Therapy helps condition the tissue to respond more predictably to surgical procedures as treatment progresses during later appointments. In this thesis, concepts underlying Periodontal initial Therapy are reviewed and clinical cases of patients who underwent periodontal initial therapy are discussed.

Methods and Materials:

According to the official guidelines of American Academy of Periodontology, the goals of periodontal therapy are to preserve natural dentition; to maintain and improve health, comfort, esthetics and function; and to provide replacements (i.e., dental implants) where indicated1.Several treatment modalities to achieve these goals are available in periodontics, and they can be broadly classified into either surgical or non surgical approaches. Non surgical approaches include plaque control, supra and sub gingival scaling, root planing and the adjunctive use of chemotherapeutic agents. Non surgical therapy aims to eliminate both living bacteria in the biofilm and calcified biofilm microorganisms from tooth surface and adjacent soft tissues. A reduction in inflammation of the periodontium due to a lesser bacterial load leads to beneficial clinical changes .In addition, non-surgical therapy aims to create an environment in which the host can more effectively prevent pathogenic microbial recolonization using personal oral hygiene

Bacteria are essential for disease but insufficient by themselves to cause the disease. The host must be susceptible, and it is the patient’s risk factors that determine susceptibility to the disease. Risk factors are patient characteristics associated with the development of disease. There are a number of environmental and acquired risk factors that play a major role in the host response and can increase a patient’s susceptibility to disease. The risk factors that should be assessed because they can affect the onset, rate of progression, and severity of periodontal disease and response to therapy. It is important to document and determine the patient’s risk and to convey to the patient that these risk factors can be more than additive. The value of risk assessment is that it can help the practitioner to establish an accurate diagnosis, provide an optimal treatment plan, and determine appropriate maintenance programs. Risk assessment may help to explain variability in treatment responses. In patients with multiple risk factors, the practitioner may proceed with caution with regard to invasive surgical procedures and may aggressively use pharmacologic adjuncts such as antimicrobials and host modulatory therapy in addition to mechanical therapy. When considering a risk-based approach to therapy, there is less watching and waiting