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Updated: Jun 20, 2025

Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease
Published on: May 9, 2022
Key themes in periodontal treatment: Lessons learned from 40-year experiences
Joseph M Montesano1, Ronald M Fried2, Irina F Dragan1,3
1Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.
Background:
Periodontitis is one of the most prevalent oral diseases with significant implications for systemic health. This study aims to explore themes influencing successful long-term outcomes in periodontal treatment through a historical lens, focusing on various factors influencing the longevity of periodontal health and dentition stability.
Methods:
Utilizing an inductive qualitative thematic analysis approach, this study utilized a retrospective chart review of 19 patient records spanning, on average, 40 years.
Results:
Four major themes contributing to periodontal stability were identified: (1) adequate patient plaque control; (2) regular periodontal maintenance; (3) collaboration between hygienists and periodontists; and (4) the application of various periodontist/dentist-performed procedures.
Conclusion:
Current findings underscore the importance of these factors in preserving patients' periodontal health by emphasizing conservative treatment approaches in the maintenance and retention of the natural dentition.
Key Points:
Adequate patient plaque control is essential for maintaining a patient's periodontal health and dentition long-term. A regular periodontal maintenance schedule should be assigned and modified as necessary for each individual patient's care. Collaborative care with hygienist colleagues and ensuring there are flexible treatment options for patients can lead to successful treatment outcomes when hygiene alone is not sufficient.
Plain Language Summary:
Periodontitis is a widespread oral disease with significant systemic health implications. This study examined patient records to identify factors contributing to long-term periodontal stability and maintenance of teeth. By analyzing 19 patient charts over an average of 40 years using a qualitative approach, four key themes were identified in successful patient treatments: effective patient plaque control, regular periodontal maintenance, collaboration between dental hygienists and periodontists, and the addition of other approaches by periodontists and dentists when necessary. The study underscores the importance of these factors in preserving periodontal health and retaining natural teeth with conservative treatment approaches. This research highlights the critical role of sustained, multifaceted dental care and professional collaboration in achieving successful long-term oral and systemic health outcomes.
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