Nonsurgical periodontal therapy in 2000: a literature review.
BACKGROUND
This article addresses the advantages and limitations of nonsurgical periodontal therapies to treat patients with mild-to-moderate chronic periodontitis.


METHODS
Controlled clinical trials were selected that assessed the efficacy of the following treatment methods: mechanical instrumentation, ultrasonic débridement, supragingival irrigation, subgingival irrigation, local drug delivery, administration of systemic antibiotics and host-response modulation. Evidently, data with regard to alterations of probing depth, clinical attachment levels and inflammatory status were evaluated.


RESULTS
Comparison of the data from test and control groups revealed the following results. Manual and ultrasonic débridement can be used to treat most patients with mild-to-moderate chronic periodontitis. Patients who do not practice optimal plaque control can enhance their personal hygiene procedures by using supragingival irrigation. Subgingival irrigation usually does not provide any benefit beyond that achieved with root planing. Systemic and locally delivered antimicrobial agents appear to be most beneficial among patients who do not respond to conventional treatment. Host modulation may enhance root planing modestly.


CONCLUSIONS
The data indicate that most patients with mild-to-moderate periodontitis can be treated with nonsurgical therapies. However, clinicians need to be aware of the limitations of each technique with regard to the magnitude of improvement that it can induce at specific sites.
Greenstein
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Department of Periodontology, University of Medicine and Dentistry, Newark, N.J., USA.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002908:Chronic Disease; D012534:Dental Scaling; D004318:Doxycycline / Q000627:therapeutic use; D006801:Humans; D061965:Matrix Metalloproteinase Inhibitors; D010518:Periodontitis / Q000145:classification / Q000209:etiology / Q000628:therapy*; D011480:Protease Inhibitors / Q000627:therapeutic use; D007507:Therapeutic Irrigation; D014464:Ultrasonic Therapy
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D061965:Matrix Metalloproteinase Inhibitors; D011480:Protease Inhibitors; D004318:Doxycycline