Nonsurgical therapy for teeth and implants-When and why?

As periodontal and peri-implant diseases represent opportunistic infections, antiinfective therapy is the method of choice. Correctly performed, the treatment outcomes will include resolution of the inflammation concomitant with shrinkage of the tissues, reflected in reduced probing depths. Depending on the patient data obtained after initial antiinfective therapy, further - mostly surgical - treatment may be rendered to reach the goals of a healthy periodontium and peri-implant tissues. Patient compliance is as important as operator skills for optimal treatment outcomes. Regenerative therapy may be applied in compliant patients and for appropriate defects. This article depicts the historical development of periodontal therapy during the 20th century and addresses the various outcome parameters to be used in daily decision making. Obviously, nonsurgical therapy has gained clinical relevance, resulting in highly satisfactory treatment outcomes in many cases. The critical probing depth above which positive attachment gain is registered varies from one treatment modality to another. It is a concept that helps facilitate decision making for additional therapeutic measures after initial therapy. Treatment of peri-implant mucositis prevents development of peri-implantitis. Hence, nonsurgical treatment of mucositis is frequently performed during the continuous monitoring of oral implants. This chapter of Periodontology 2000 presents evidence for the prevention and therapy of peri-implant diseases.