I.T.S-Centre for Dental Studies & Research, India

The main goal of periodontal therapy is to treat the infection caused by periodontal pathogenic biofilm and to arrest or

slow down further attachment and bone loss, ultimately preventing tooth loss. Successful treatment is evidenced clinically

by a reduction of probing pocket depths (PPD) and a decrease in bleeding scores (i.e. bleeding on probing) along with the

reformation of a dentogingival environment that allows effective oral-hygiene measures. These clinical improvements should

ideally be accompanied by gain of clinical attachment level (CAL) and radiographic bone-fill. Even though conventional

periodontal therapy – consisting of non-surgical debridement and/or surgical access, including various types of access flaps or

tissue-resective techniques – may lead to substantial clinical improvements, residual pockets may either persist or the healing is

associated with significant loss of attachment and increase in soft-tissue recessions. In addition, deep residual pockets associated

with the presence of intrabony defects or Class-II and Class-III furcation involvements have been strongly associated with

increased risk for tooth loss. Consequently, one of the clinically most important goals of periodontal therapy is the reduction or

complete eradication of deep pockets (i.e. of sites ≥ 6 mm) and elimination of furcation defects. Ideally, treatment of intrabony

and furcation defects should result not only in probing-depth reduction, gain of clinical attachment, and radiographic bonefill,

but also in defect closure via periodontal regeneration (i.e. formation of root cementum, periodontal ligament, and alveolar

bone). The rationale for integrating regenerative/ reconstructive protocols in the overall treatment concept is supported by

findings from clinical studies that show generally larger clinical improvements following such approaches when compared to

conventional treatments, such as open-flap debridement (OFD).

Dental and Oral Health