Non-surgical periodontal therapy:An update on current evidence

• 作者: Rahul S Bhansali
• 来源期刊: 世界口腔医学杂志
• 学科: 医学
• 关键词: Systematic REVIEWS Mechanical NONSURGICAL PERIODONTAL THERAPY CHEMOTHERAPEUTIC approaches HOST modulation THERAPY Laser
• 年，卷（期）: 2014,（4）
• 页码范围: 38-51
• 页数: 14页
• 分类号: R

摘要

Periodontal disease is an inflammatory condition that involves a complex interaction between pathogenic bacteria,environmental and acquired factors and host related factors.Till recently periodontal treatment was directed primarily towards reduction of bacterial load by subgingival debridement of root surfaces and modification of environmental risk factors.The current paradigm of periodontal disease stresses greater role of hostmediated inflammatory response in tissue destruction characteristic of periodontal disease.Various therapeutic modalities have been developed adjuvant to mechanical periodontal therapy.The use of laser and photodynamic therapy show great promise but their effectiveness has still not been conclusively proven.Chemotherapeutic agents,either systemic and local antimicrobials or host modulating drugs,played pivotal role in better and more predictable management of periodontal disease.The present review focuses on the best available evidence,for the current management of the chronic periodontal patients,gathered from systematic reviews and metaanalysis of mechanical non surgical periodontal therapy(NSPT)(subgingival debridement,laser therapy and photodynamic therapy)and the adjunctive chemothera-peutic approaches such as systematic and local antibiotics and antiseptics,subgingival pocket irrigation and host modulation therapies.The review also attempts to briefly introduce future developments in some of these modalities.At the end,the review summarizes the analysis of the current evidence that suggests that thorough subgingival debridement remains the mainstay of NSPT and that adjunct use of chemotherapeutic agents may offer better management of clinical parameters in periodontitis patients.