Supracrestal Non-Surgical Therapy in Periodontal Diseases

Khushboo Goel

doi:10.31729/jnma.3235

Abstract

Periodontal diseases are the complex disease with a dynamic relationship between biofilm and the host immunoinflammatory response. The goal of periodontal therapy is to preserve the natural dentition and increase their longevity by creation of a favorable environment around the teeth. The mainstay to achieve this is by the non-surgical periodontal therapy, followed by surgical and other recent treatment modalities. However, there seems no sure indication to choose amongst them that are clinically significant and offer long term predictability. We report here two cases that had supracrestal defects and were treated with less invasive instrumentation and repeated full mouth scaling and root planing. This avoided a surgical intervention and was more cost-effective in treating moderate to severe young chronic periodontitis patients. The decision for the type of treatment needs to be critically assessed with a better understanding of the outcome, morphology of the defects, and type of teeth involved. Fundamentals like positive reinforcements, compliance and self-performed plaque control will always remain an integral component regardless of nonsurgical or surgical periodontal therapy.

Highlights

Periodontitis is recognized as an inflammatory disease induced by microbial biofilm and host response
Full mouth scaling and root planing (FMS) combined with oral hygiene efforts and effective compliance provides a favorable environment in supragingival and subgingival niches and helps in arresting the disease progression
We present here two cases of supracrestal defects that underwent FMS without antiseptics with the objective to explore the conservative approach in the treatment of moderate to severe chronic periodontitis

Summary

INTRODUCTION

Periodontitis is recognized as an inflammatory disease induced by microbial biofilm and host response. A 22-year-old female presented to the Department of Periodontology and Oral Implantology with the chief complaint of swollen gums since one year She denied any current and past medical history, adverse habits, allergies, and medications. FMS (without antiseptics) at four weeks and repeated session at three months (Figure 1d) were performed by an experienced periodontist. This procedure was performed with the help of the ultrasonic device, and hand instrument (Gracey curets, Hu-Friedy Instruments, Chicago, IL.) using only light pressure with complete overlapping of instrumentation strokes of limited duration to obtain smooth surfaces within 24 hours.[3] At six months (Figure 1e) spontaneous repositioning of upper and lower front teeth was observed. At nine months an increased stability of gingival margins was achieved (Figure 2c)

DISCUSSION

Findings

Healing in NSPT occurs mostly in six weeks with greatest