Related Experiment Video
Updated: Apr 28, 2026
Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease
Published on: May 9, 2022
Comparative Effect of Non-surgical Versus Surgical Therapy for Stage III/IV Periodontitis: A Retrospective Cohort
Gui-Fen Cao1, Anna Dai1, Ren-Jie Lin2
1Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China.
Introduction And Aims:
Periodontitis is a major cause of tooth loss and a persistent challenge in clinical management. Although both non-surgical periodontal therapy (NSPT) and surgical periodontal therapy (SPT) are widely used for advanced periodontitis (Stages III/IV), their long-term comparative effectiveness in Chinese patients remains not well established. This retrospective study aimed to compare the clinical efficacy of NSPT versus SPT and to identify predictors of long-term treatment success.
Materials And Methods:
This retrospective study included 2982 patients who received NSPT and 212 patients who underwent SPT, all diagnosed with stage III/IV periodontitis. Participants had a baseline periodontal evaluation and at least one re-evaluation between April 2017 and September 2022. Clinical parameters including probing depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP) were retrieved from a hospital-based electronic periodontal record system. Statistical analyses included independent t-tests, linear regression, and multilevel models, adjusted for age, sex, smoking, and follow-up compliance.
Results:
Over a mean follow-up of 1.56 years, patients receiving SPT demonstrated significantly greater reductions than NSPT in PD (1.16 ± 1.06 versus 0.77 ± 0.81 mm), CAL (0.97 ± 1.13 versus 0.68 ± 0.90 mm), and BOP% (0.28% ± 0.27% versus 0.23% ± 0.29%) (all P < .01). However, this therapeutic advantage of SPT diminished with longer follow‑up (>3 years). Regular supportive periodontal care was consistently associated with improved clinical outcomes, regardless of whether intervention was SPT or repeated NSPT.
Conclusions:
In a large Chinese cohort with advanced periodontitis, SPT provided superior short-term clinical improvements compared to NSPT. However, long-term outcomes depend on sustained maintenance care. These findings highlight that successful periodontal management relies on both patient compliance and clinician awareness of the long-term value of NSPT.
Clinical Relevance:
SPT offers superior short-term outcomes, while NSPT with maintenance achieves comparable long-term stability. Long-term success depends more on maintenance adherence than initial therapy.
