Therapeutics Advances
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Stomatol. Nov 20, 2014; 3(4): 38-51
Published online Nov 20, 2014. doi: 10.5321/wjs.v3.i4.38
Non-surgical periodontal therapy: An update on current evidence
Rahul S Bhansali
Rahul S Bhansali, Department of Periodontology and Implantology, Shri Guru Gobind Singh College of Dental Sciences and Research Center, Burhanpur 450331, India
Author contributions: Bhansali RS contributed to conception and design, acquisition of data, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published.
Correspondence to: Dr. Rahul S Bhansali, MDS, Reader, Department of Periodontology and Implantology, Shri Guru Gobind Singh College of Dental Sciences and Research Center, Lalbagh Road, Burhanpur 450331, India. drrahulbhansali@yahoo.co.in
Telephone: +91-94-22278157 Fax: +91-94-22278157
Received: September 29, 2014
Revised: November 6, 2014
Accepted: November 17, 2014
Published online: November 20, 2014
Processing time: 74 Days and 9.6 Hours
Abstract

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 host-mediated 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 meta-analysis of mechanical non surgical periodontal therapy (NSPT) (subgingival debridement, laser therapy and photodynamic therapy) and the adjunctive chemotherapeutic 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.

Keywords: Systematic reviews; Mechanical nonsurgical periodontal therapy; chemotherapeutic approaches; Host modulation therapy; Laser

Core tip: The present review focuses on the best available evidence, for the current management of the chronic periodontal patients, gathered from systematic reviews and meta-analysis of mechanical non surgical periodontal therapy (NSPT) (subgingival debridement, laser therapy and photodynamic therapy) and the adjunctive chemotherapeutic 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 for mechanical and chemotherapeutic approaches of NSPT.