Nonsurgical periodontal treatment: review of the evidence

An increasing number of patients have become aware of the detrimental effects of periodontal disease and tooth-loss and they seek periodontal care. The cornerstone of management of chronic periodontitis is the non-surgical periodontal treatment. The primary goal of periodontal therapy is to preserve the natural dentition by achieving and maintaining a healthy functional periodontium. Many adjunctive treatment modalities have been introduced lately to enhance the therapeutic outcome of periodontal treatment. The aim of this review is to search for systematic reviews which evaluate these therapeutic modalities and discuss their efficacy. The databases of Medline via Ovid, Embase and the Cochrane Database of Systematic Reviews were searched for up to date systematic reviews in English language. The results and conclusions of the systematic reviews found in the periodontal literature are discussed in this paper. The efficacy of different oral hygiene regimens in maintaining and improving gingival health, the efficacy of the nonsurgical periodontal treatment, the full mouth disinfection, the systematic antimicrobial therapy, the local adjunctive therapies, the host modulation treatment, the Photodynamic and laser therapy are discussed. It appears that there is no certain magnitude of initial probing pocket depth where nonsurgical periodontal therapy is no longer effective. Some of the aforementioned modalities have been found to offer statistical significant benefit in clinical outcomes than the scaling and root planing alone. If this statistical significance is clinically significant needs to be critically assessed by the clinician upon the treatment planning and decision making.