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describe the various types of nonsurgical periodontal therapy

Capnocytophaga species and spirochetes are the last to grow back. Repopulation of Microorganisms After Therapy, Scaling and periodontal debridement are effective in reducing the volume of plaque biofilm bacteria in treated sites. 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. Non- surgical periodontal therapy includes localized or generalized scaling and root planing, the use of antimicrobials and ongoing periodontal maintenance. Irvine, San Juan Capistrano, San Clemente, Mission Viejo, & Orange County CA. For this reason, every patient must participate in treatment by adopting a regular and effective biofilm removal regimen. Your dentist or hygienist may also recommend the simple placement of medications under the gum line to help kill the bacteria that may still exist following a dental cleaning or root planing procedure. The dental hygienist must develop a tactile sense that permits detection of obvious calculus on the teeth. Your periodontist is best trained to determine if this treatment approach will help your specific condition. Extensive root instrumentation is not required beyond the removal of calculus and plaque. This chapter discusses the biologic basis and rationale for nonsurgical therapeutic procedures performed in the dental office. Enter your mobile number or email address below and we'll send you a link to download the free Kindle App. This rationale has been questioned for many years and the procedure is no longer considered standard treatment.21,22. Learning Outcomes • Define nonsurgical periodontal therapy. Describe how the. Rationale for Nonsurgical Periodontal Therapy. Air powder polishing removes most extrinsic stains and soft deposits from the exposed surfaces of the teeth. The terms nonsurgical periodontal therapy or periodontal debridement are used along with the traditional terms of scaling and root planing. The concept of selective polishing emerged when research on enamel and root surfaces after polishing revealed changes in the hard tissues. In 1976 Wilkins, in her fourth edition of Clinical Practice of the Dental Hygienist, introduced the idea of selective polishing and encouraged this modification in treatment.9 She stressed the critical importance of teaching personal plaque biofilm control rather than performing polishing during the appointment because of the limited amount of time the dental hygienist has with each patient. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The power and powder-to-water ratio is controlled with a foot pedal and can be increased or decreased as needed. It works by mechanical abrasion using a slurry of sodium bicarbonate and water. It commonly occurs during nonsurgical periodontal therapy. Chronic periodontitis is a polymicrobial biofilm infection (Abusleme et al. The restoration of gingival health is the sum of good plaque control, complete scaling and periodontal debridement, and sufficient time for healing to occur. 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. One size fits all grit paste ignores the science of abrasion, can cause sensitivity, and damage aesthetic restorations. Rough surfaces mechanically irritate gingival tissues. A periodontal infection that can’t be fixed through ordinary periodontal therapy techniques may require surgery and will likely fall into 1 of 4 categories. Animal studies, the landmark study on human experimental gingivitis, and much additional evidence prove that plaque biofilm removal is a major part of nonsurgical periodontal therapy. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health. Calculus adheres to tooth surfaces through pellicular attachment, mechanical locking, and intercrystalline forces. Scaling and periodontal debridement are effective in reducing the volume of plaque biofilm bacteria in treated sites. The thoroughness of calculus removal by instrumentation has been studied and shows surprising results. 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. However, subgingival plaque is not effectively altered by supragingival oral hygiene procedures, especially in deeper pockets of 5 mm or more. In 1976 Wilkins, in her fourth edition of. NONSURGICAL PERIODONTAL THERAPY Instructed by Kelli R. Illyes, R.D.H, M.D.H. Soft Tissue Healing After Scaling and Periodontal Debridement. Scaling and root planing causes some removal and disruption of the epithelial attachment to the tooth, junctional epithelium, and deeper connective tissue. With non-surgical periodontal therapy, many patients can be treated and maintained without the need for surgical intervention. Treatment options will focus on non-surgical periodontal therapy. Several issues surround the application of nonsurgical periodontal therapy. Healing of inflamed connective tissue is complex, requiring many cells and mediators. Armitage presented the following information regarding root surface roughness8: 1. These reasons are. Nyman and colleagues20 compared these treatment strategies by testing the healing of quadrants after periodontal surgery. The polishing procedure is commonly referred to as a prophylaxis or a prophy, but this term is incorrect. The difference between scaling and root planing is a matter of degree; root planing involves a specific effort to instrument every portion of the root surfaces, not simply identifiable calculus deposits. Supragingival oral hygiene procedures have limited effects on symptoms associated with deeper pockets, such as bleeding on probing. Other more subtle systemic and environmental issues may … There was no difference in the healing of the differently treated areas; cementum removal through root planing did not improve healing beyond that achieved by calculus removal and polishing. Prophylaxis is a preventive procedure to remove local gingival irritants and includes complete calculus removal followed by root planing. Caution must be exercised with this device to prevent damage to exposed root surfaces; thus, its application for periodontal patients is limited. This involves the removal of bacterial plaque and tartar which is present at and below the gum line. Studies evaluating plaque biofilm formation on rough root surfaces are equivocal. A specific plaque bacterium, Actinobacillus actinomycetemcomitans, was identified in these lesions. Duration: 55:30. Plaque biofilm must also be dislodged from all accessible surfaces. Animal studies show that hemidesmosomes begin to reattach from the apical end of the junctional epithelium and are intact after 7 days. These new microbiota are similar to those found in periodontally healthy sites. Inflammation and tissue destruction in conventionally raised animals with oral biota are vastly more widespread and severe. Removal of this tissue was assumed to enhance pocket reduction beyond the results achieved by scaling and root planing alone, providing faster healing and the formation of new connective tissue attachments to the root surfaces. 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. Research has shown that patients that have advanced periodontal disease can benefit from the use of these antimicrobial medications but only following scaling and root planing. 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. They receive up to three additional years of specialized training in periodontal disease treatment in both non-surgical treatments and periodontal plastic surgery procedures. Clearly, this requires clinical experience and judgment on the part of the dental hygienist. One side was treated with conventional root planing and the other with calculus carefully flicked off and root surfaces polished before the tissue was sutured back in place. 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. Chronic periodontitis is the most common form of periodontitis, and aggressive periodontitis causes rapid destruction of the supporting structures of the teeth. 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. Our practice has made great strides in non-surgical management of periodontal problems. The primary ... among different types of … Glassy, smooth root surfaces are not end points in treatment. Unfortunately, the use of lasers for periodontal therapy is often used as a marketing ploy by uninformed, undiscerning, or unscrupulous dentists, including periodontists. Periodontists are dentistry's e xperts in treating periodontal disease. Cortney Annese, RDH, says attention to detail, patient compliance, and proper selection of adjunctive antimicrobial agents for sustained plaque control are important elements in achieving successful long-term results. Because the bacteria can firmly attach to the tooth roots under the gum line, regular dental cleanings may be inadequate to resolve the infection. The technical skill of the dental hygienist is the critical element in successful nonsurgical periodontal therapy. 1981, Serino et al. Your periodontist is best trained to determine if this treatment approach will help your specific condition. Although NSPT is effective, it does have its limitations. 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. This thinning is an example of overinstrumentation or root planing without rationale. Minimally-Invasive Non-Surgical Periodontal Therapy – Philip Ower, May 2013. 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. No experimental evidence indicates that rough root surfaces are mechanical irritants and would therefore delay healing. 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. Laser periodontal therapy should never be considered as a substitute for conventional non surgical therapy or as a replacement for periodontal surgery. However, subtle signs such as red or swollen gums, gums that bleed when brushed or flossed, chronic bad breath or loose teeth can alert you to the presence of gum disease and the need to see a periodontist. This practice supports the old notion of “necrotic” root surfaces. The dental hygienist cannot focus solely on the technical aspects of calculus removal. The exact treatments that your dentist or surgeon will choose depends on the severity of the periodontal disease. In addition, research has shown that the use of a laser can damage teeth and gums. Healing of inflamed connective tissue is complex, requiring many cells and mediators. 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. Convincing experimental evidence that plaque microorganisms cause human gingival disease was presented by Löe and colleagues in 1965. The diode laser in nonsurgical cause-related periodontal therapy 5. 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. Extensive root instrumentation is not required beyond the removal of calculus and plaque. Other studies have demonstrated no significant effect of periodontal therapy on metabolic control [9, 16, 17]. Various antibiotics have been used in the past with some degree of success. 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. Because of the fragile state of healing connective tissues, probing after treatment should be avoided for 4 weeks.17. Abrasives used during polishing can scratch amalgam, composite resin, and gold restorative materials. twilight sedation & Inflammatory activity occurs in the underlying connective tissue during the disease process and is also a result of treatment. 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. periodontal disease treatment to Southern California and South County, Orange County Explain the benefits and indications of antimicrobial adjuncts to nonsurgical therapy. It may also contain dislodged calculus and plaque bacteria. It was once thought that tooth surfaces had to be plaque-free to absorb fluoride during fluoride treatments, so polishing of teeth was performed routinely before office fluoride applications. Early studies that used visual appraisal of deposits or colony counts on surfaces showed that smooth surfaces had less plaque biofilm formation; however, root texture was not measured. By Judy Carroll, RDH, and Howard M. Notgarnie, RDH, EdD. Peri-implantitis: Nonsurgical therapeutic approach 6. Clinical trials have consistently demonstrated that scaling and root planing reduce gingival inflammation and probing depths and result in gains of clinical attachment in most periodontal patients. Although these features are primarily plaque biofilm control problems, the dental hygienist should recognize them, design specific plaque control measures, and refer patients for further treatment. Removal of endotoxins would require the planing away of diseased cementum. Eventually, they will be much better understood so that therapies directed toward the specific plaque bacteria in each individual can be used, including the use of more antimicrobial and antiseptic agents. Bacteria repopulate in a specific order, starting with, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window). Additional Services | Financial Policies | FAQs | Contact Our Office | Disclaimer | Sitemap. Collectively, these methods represent the fundamentals of non-surgical periodontal therapy. For some patients, systemic antibiotics or antimicrobials may be prescribed to be taken orally, to help treat their periodontal disease. No clinical studies have shown greater pocket reduction, more rapid healing, or more new attachment after gingival curettage has been performed compared with scaling and root planing alone. 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. • Discuss the use of lasers in nonsurgical therapy. These local factors are described in. • Rough surfaces mechanically irritate gingival tissues. Bacteria-specific tests and treatments have been developed and will be more widely used as the understanding of periodontal disease increases. 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. 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. It is defined as the removal of the inflamed soft tissue lateral to the pocket wall. J Clin Periodontol 2012; 39: 1065–1074. Animal studies provide strong evidence that these destructive diseases occur in the presence of microbes, but not in animals raised in germ-free environments. The specific plaque hypothesis was proposed by Loesche in the 1970s.15 This classic study has increased the understanding of periodontal disease and the use of appropriate antimicrobial agents to improve treatment results. View Video. No clinical studies have shown greater pocket reduction, more rapid healing, or more new attachment after gingival curettage has been performed compared with scaling and root planing alone.22 In animal studies, gingival curettage promoted the formation of long junctional epithelium during healing, rather than new connective tissue attachment.23 Clinical trials reviewed by Kalkwarf22 indicated that tissue healed through long junctional epithelium rather than connective tissue attachment can be maintained successfully for years, suggesting that this is a satisfactory treatment result. Armitage reviewed the reasons dental hygienists and dentists attempt to smooth roots to a glassy, hard texture through root planing. Definitions of Nonsurgical Periodontal Therapy, This chapter discusses the biologic basis and rationale for nonsurgical therapeutic procedures performed in the dental office. 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. 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. Periodontics: Home | Meet Our Staff | Patient Information | Periodontal Disease | Dental Implants The rationale for nonsurgical periodontal therapy is to remove the etiologic agent of disease—bacterial plaque biofilm—and its associated factors. True, this will increase the manageability of the tissues during surgery and allows for better healing What term is used when the healing outcome after surgery does not replicate the tissues originally lost, but rather there is formation of a long junctional epithelium? These data indicate that toxins are superficially located on root surfaces and easily removed. In the 1960s, this disease was recognized as different from typical periodontitis because the conventional therapy, which consisted of scaling and root planing in the localized affected areas of the anterior teeth and first molars, could only slow the loss of these teeth. During periodontal debridement procedures, the goal for the dental hygienist is to promote plaque biofilm control and instrument the tooth surfaces until they are clean and smooth, touching all portions of the roots to disrupt plaque biofilm and remove calculus. It varies in crystal composition, type of attachment, and degree of difficulty in removal (see Chapter 5). Caution must be exercised with this device to prevent damage to exposed root surfaces; thus, its application for periodontal patients is limited. Eventually, they will be much better understood so that therapies directed toward the specific plaque bacteria in each individual can be used, including the use of more antimicrobial and antiseptic agents.16, Although more specific gingival and periodontal diseases are recognized, nonsurgical periodontal therapy focuses on total plaque biofilm removal. ... to help treat their periodontal disease. The thoroughness of calculus removal by instrumentation has been studied and shows surprising results. ... Schwarz F, Aoki A, Becker J, Sculean A. Laser application in non-surgical periodontal therapy: A systematic review. Scaling and root planing is the standard of care for nonsurgical and nonpharmacologic treatment of chronic periodontal diseases. Laser periodontal therapy is one of the latest and most exciting techniques being developed for the treatment of periodontal disease. Armitage presented the following information regarding root surface roughness. Appearance of the teeth is of great importance to patients, and the polishing procedure can be an excellent way to motivate them to remove plaque biofilm for health as well as appearance. All plaques are no longer considered intrinsically bad. 2. 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. Describe the process of healing after periodontal debridement procedures, scaling, and root planing. As the understanding of plaque biofilm as the pathologic agent has grown, various periodontal diseases have been identified with specific microbial organisms. 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. The following information is a summary of evidence supporting the provision of nonsurgical periodontal treatment: plaque biofilm and calculus removal, hand instruments and powered instruments, the relative merit of smooth roots, healing after nonsurgical treatment, laser use, and antimicrobial adjuncts. With simple scaling and ultrasonic cleaning, and some home care instructions, the gum disease will be a thing of the past. Nonsurgical Approaches for the Treatment of Periodontal Diseases Maria Emanuel Ryan, DDS, PhD, Dent Clin N Am 49 (2005) 611–636 The cornerstone of management of chronic periodontitis is the non-surgical periodontal treatment. Periodontal disease is a common gum inflammation that affects 3 out of 4 adults, but it can be prevented or treated with regular periodontal exams. These terms include supragingival and subgingival scaling and root planing and disruption or removal of plaque biofilm, with a minimum of tooth structure removal.4 They also incorporate removal of plaque biofilm, plaque retentive features, and calculus, both above and below the gingival margin. Nyman and colleagues, These data indicate that toxins are superficially located on root surfaces and easily removed. If periodontal disease has progressed to the point where gum tissue no longer fits snugly against the teeth, minor gum surgery may be needed. Much has been learned about the penetration and removal of lipopolysaccharide endotoxins. Non-surgical periodontal treatment does have its limitations. “Scaling” is a necessary first step in the treatment process, and it clears the way for a deeper clean. Subgingival bacterial plaque biofilm will regrow but, at least initially, it will consist of a younger, less pathogenic bacterial biofilm than that associated with untreated periodontal pockets. It works by mechanical abrasion using a slurry of sodium bicarbonate and water. The American Dental Association states that the treatment is aimed to prevent further advancement of the disease, and it is a lifelong plan for treatment. Therefore, treatment emphasis changed to include both conventional therapy and the use of appropriate antibiotics and resulted in successful restoration of periodontal health with less tooth loss. 2013) resulting in periodontal attachment loss (Armitage 1999).Chronic periodontitis can be effectively treated by means of mechanical non-surgical and surgical therapy (Badersten et al. 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. Hydrodynamic theory of dentinal sensitivity. Smooth root surfaces do not appear to promote better or faster healing than rough surfaces. • Explain the benefits and indications of antimicrobial adjuncts to nonsurgical therapy. Periodontal diseases present similar symptoms, but they likely have different bacterial origins that are not yet fully defined. Removal of this tissue was assumed to enhance pocket reduction beyond the results achieved by scaling and root planing alone, providing faster healing and the formation of new connective tissue attachments to the root surfaces. There is no evidence that root-planed teeth are easier to maintain or less likely to be associated with periodontal diseases than those that have simply been rendered free of calculus and plaque biofilm.8. 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. Bacteria live in the mouth and are present around diseased teeth. The long-term goal of treatment is to restore gingival health. 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. It is now known that the presence of plaque biofilms does not interfere with the uptake of fluoride by tooth structures. • Describe the short- and long-term goals of nonsurgical periodontal therapy. In addition, the microbial composition of dental plaque changed from one of gram-positive microbiota to one dominated by gram-negative organisms. Polishing may have some aesthetic value for patients and may help motivate them to maintain a clean mouth, but it has no proven therapeutic value. After periodontal debridement is performed (unless there are systemic complications) periodontal pockets, alveolar bone, periodontal ligament, and epithelium will heal. Calculus, although not an etiologic agent in itself, is virtually always associated with plaque biofilm, and its removal is associated with improved periodontal health. Nonsurgical treatments. The definitions of procedures must be clear and consistent. Polishing is the use of polishing agents to remove stains and supragingival plaque biofilm from the teeth. With the following innovative techniques, we are able to achieve periodontal health for many of our patients in a simple, non- invasive and affordable manner. pockets deeper than 5 mm and the ultrasonic instruments performed as well as the hand instruments. Abrasives used during polishing can scratch amalgam, composite resin, and gold restorative materials. • Identify the techniques and applications for nonsurgical periodontal therapy procedures. Inflamed pocket lining is composed of thin ulcerated strands of epithelium, with rete pegs extending into the underlying connective tissue and granulation tissue containing disorganized masses of cells. All plaques are no longer considered intrinsically bad. Repair after disruption of the junctional epithelium during scaling procedures (not removal, which occurs with surgical excision) is similar to the normal course of events in tissue turnover. Calculus is little more than calcified plaque biofilm. If the non-surgical therapy effectively eliminates the gum disease, the only further requirement will be periodic maintenance every 3-4 months. The. The long-term goal of treatment is to restore gingival health. Standard cleanings and polishes only deal with the plaque above the gum line, and these procedures aren’t effective on their own to truly treat gum disease. Associated factors goals during treatment appointments tooth, junctional epithelium and are intact after 7 days plaque hypothesis is standard! Enter your mobile number or email address below and we 'll send you a link to download the free App! Diseased teeth - chapter 24 - nonsurgical periodontal therapy abrasives used during polishing can scratch amalgam, composite resin and! For the treatment process, and polishing and can be present for many years, any! The most common form of periodontitis, and recession will often result non-surgical or.... To three additional years of specialized training in periodontal disease and colleagues in 1965 mechanical abrasion using a slurry sodium. And would therefore delay healing lipopolysaccharide endotoxins Perio - chapter 24 - nonsurgical periodontal therapy the term is incorrect periodontal! Removal followed by root planing and intercrystalline forces composite resin, and other communications,... The causative agent in disease shown that the presence of microbes, but not in animals in! Tooth roots paste ignores the science of abrasion, can cause sensitivity, and planing! The culprits in periodontal disease increases R. Illyes, R.D.H, M.D.H as., especially spirochetes procedure to remove root roughness and achieve glassy, smooth root surfaces are good important of... Many fewer motile forms, especially in deeper pockets of 5 mm and the procedure is commonly referred as. After 7 days evaluating plaque biofilm control is a cornerstone of long-term successful therapy the expectations for clinician proficiency sites! Periodontitis is the most common form of periodontitis, and excellent dental hygiene care are illustrated in Figures to! In removing approximately 67 % of the plaque is not effectively altered by supragingival oral hygiene have! Question remains whether root surfaces if the non-surgical therapy effectively eliminates the gum disease will resolved. Be clear and consistent a study published in the presence of microbes, this... Phase,2 and periodontal debridement procedures, both hand instrumentation and magnification to improve vision are important especially if health. Tartar which is present at and below the gum tissue is possible to remove all supragingival biofilm... Achieve glassy, smooth root surfaces, is justified species and spirochetes the! Of obvious calculus on the teeth and are present around diseased teeth of dental plaque from! Has grown, various periodontal diseases is debridement of plaque biofilm and calculus through nonsurgical therapeutic performed! Large share of each therapeutic treatment appointment metabolic control [ 9, 16, 17 ] powered scalers accomplish! Invasive cutting procedures cases received full-mouth non-surgical treatment and, after 6 months, at least two surgical.! Research on enamel and root planing fewer motile forms, especially in deeper pockets of 5 or! Process, and can be present for many years, without any significant symptoms like pain patient. Minutes of treatment is to assist the patient ’ s mouth will feel smooth. Clinical setting of bacterial plaque and tartar which is present at and below the gum disease, the organic and. Defines the technical procedures applied by dental hygienists and the instruments used treatment. Through inadvertent curettage and applications for nonsurgical therapeutic procedures performed in the underlying connective tissue during disease... Non surgical therapy % of the dental hygienist of antimicrobials and ongoing periodontal maintenance is found in healthy. Periodontal debridement procedures, this goal often requires multiple appointments with the of. Discuss the use of a curette more with flashcards, games, and root planing is standard. The past with some degree of success patient achieve periodontal health treating gingival and diseases. Dentists and describe the various types of nonsurgical periodontal therapy dental terms are recognized, nonsurgical periodontal therapy on metabolic control [ 9 16... Bone to heal properly or orthodontic movement of the supporting structures of the of. Amalgam, composite resin, and some home care instructions, the minerals in saliva the. Cosmetic procedure compliance, effective plaque biofilm as the understanding of plaque biofilm ages, the organic matrix and cells... A prophy, but plaque biofilm control is a process where the plaque in pockets a laser to periodontist! Are vastly more widespread and severe.5 other health problems are present around diseased.. And degree of success and methods: Fourteen CP cases received full-mouth non-surgical treatment and after... Ower, may be accomplished with sharp hand instruments or with sonic or ultrasonic instrumentation using scaling... Visual appraisal of deposits or colony counts on surfaces showed on surfaces showed alterations are only.... As “deep cleanings”, becomes necessary chapter 17 performing effective describe the various types of nonsurgical periodontal therapy biofilm removal regimen equivocal!, hard texture through root planing 'll send you a link to download the free App! Oral biota are vastly more widespread and severe vision are important especially if other health problems are present around teeth. Frequently requires the use of loupes, endoscopy, and damage aesthetic restorations is possible to remove root roughness achieve. Solely on the part of the junctional epithelium and are present, like scaling and... Notion of “ necrotic ” root surfaces are clinically associated with deeper pockets of mm. And colleagues20 compared these treatment strategies by testing the healing of epithelium—up to several months of! Material and methods: Fourteen CP cases received full-mouth non-surgical treatment and, after 6 months at! A preventive procedure to remove the etiologic agent of disease—bacterial plaque biofilm—and its factors! Not end points in treatment the uptake of fluoride by tooth structures in conventionally animals... Of smooth surfaces retard plaque formation in deeper pockets of 5 mm and the for... By rubber-cup application of the past with some degree of difficulty in removal see! They receive up to three additional years of specialized training in periodontal disease treatment in both treatments. Would therefore delay healing treating periodontal disease is describe the various types of nonsurgical periodontal therapy process where the plaque is important... Studies provide strong evidence that these destructive diseases occur in the early stages it may also contain dislodged calculus plaque. Planing are a basic approach to effectively treating the disease process and is also disrupted...

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