title: Nonsurgical treatment of periodontitis.
abstract: BACKGROUND
  Scaling and root planing (SRP) is the gold standard treatment for most patients with chronic periodontitis. Nevertheless, in the last years, different therapeutic strategies have been proposed to improve the results of SRP and hence to avoid the need of periodontal surgical interventions in some patients with advanced periodontitis. They are based on modifications of standard therapies (such as enhancement of instrument tip designs), on development of new technologies (such as lasers), or development of alternative treatment protocols (eg, full-mouth disinfection). The purpose of this review is, therefore, to update the scientific evidence based on randomized clinical trials (RCT) evaluating these advanced nonsurgical therapies that have been published between January 2010 and March 2012.
  
  
  METHODS
  RCTs published between January 2010 and March 2012 have been selected. Previous systematic reviews were used as a start point. Three distinct aspects were evaluated independently: the modification of conventional instruments, the advent of new technologies, and the development of new treatment protocols.
  
  
  RESULTS
  Twenty-two publications were selected: 4 were related to modifications of standard therapies (new tip designs and local anesthetics), 14 to new technologies (new ultrasonic devices, air abrasive systems, endoscope and lasers), and 4 to new treatment protocols.
  
  
  CONCLUSIONS
  These technological advances and the development of new protocols may improve patient-related outcomes and cost-effectiveness, although they have not shown significant differences in efficacy when compared with conventional SRP.
authors.affiliation: Section of Graduate Periodontology, Faculty of Dentistry, Complutense University, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Sanz
authors.forename: Bettina
authors.initials: B
authors.lastname: Alonso
authors.forename: Miguel
authors.initials: M
authors.lastname: Carasol
authors.forename: David
authors.initials: D
authors.lastname: Herrera
authors.forename: Mariano
authors.initials: M
authors.lastname: Sanz
mesh_terms: D000891:Anti-Infective Agents, Local; D002985:Clinical Protocols; D003762:Dental Instruments; D012534:Dental Scaling / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010512:Periodontal Index; D010518:Periodontitis / Q000628:therapy*; D016745:Root Planing / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local