Recent approaches to periodontal therapy

Periodontal diseases encompass a variety of disease classifications, all involving inflammation of the supporting tissues of the teeth. When progressive, these diseases ultimately lead to the destruction of attachment apparatus including bone and periodontal ligament, culminating in eventual tooth loss. Inflammation extends from superficial gingival structures, effecting adjacent submerged bone and periodontal ligament. Progression modifies an initially highly favourable, reversible diagnosis of gingivitis to a less favourable, somewhat irreversible situation: periodontitis. Periodontal diseases manifest variable and sometimes unpredictable prognoses, are generally somewhat complicated and costly to treat and often require long-term follow-up for maintenance and monitoring. Treatment aims at restoration of health and control of future disease within a functional, albeit reduced, periodontium. In the strictest sense, periodontal diseases are not 'cured'. The conventional, usually successful, approach to the treatment of patients with gingivitis or chronic periodontitis has involved non-surgical mechanical periodontal therapy [1,2]. Some patients manifest localised or generalised continuous attachment loss and periodontal destruction. These sites are prime candidates for alternative therapeutic regimens. This review highlights some of the recent advances in periodontal therapy and evokes some questions that should be addressed during future studies.