Results after 30 years of maintenance. Proper patient selection, patient compliance, and assessment of optimal treatment options are required for successful results of therapy. This literature review is concerned with the ability of personal oral hygiene and mechanical instrumentation to establish and maintain periodontal health. Periodontol 2000. Lasers Med Sci. Br Dent J. This review aims to highlight concepts relating to nonsurgical and surgical periodontal therapy, which have been learned and unlearned over the past few decades. Periodontitis results from the loss of a delicate balance between microbial virulence factors and a proportionate host response. azithromycin, ciprooxacin, and augmentin. Abstract Healing following non‐surgical periodontal therapy was studied and the results of instrumentation performed by 6 operators compared. and ADSCs showed organized newly formed tissues with the Exo. 2012;39:947–54. The various methods used in nonsurgical therapy, Creative Commons Attribution-NonCommercial-ShareAlike 3.0. J Periodontol. SIGNIFICANCE: Cyanoacrylates can be used as an alternative to silk sutures for periodontal wound closure. Clinical and microbiological benefits of metronidazole alone or with amoxicillin as adjuncts in the treatment of chronic periodontitis: a randomized placebo-controlled clinical trial. Periodontitis is a highly prevalent, destructive disease and has been estimated to result in $54 billion of lost productivity yearly worldwide. Periodontal self-care: evidence based support. The results and conclusions of the systematic reviews found in the periodontal literature are discussed in this paper. antimicrobial photodynamic therapy vs. local minocycline in addition to non-surgical therapy of deep periodontal pockets: a controlled randomized clinical trial. following surgical and non‑surgical periodontal treatment. J Clin, therapyIII.Singleversusreapetedinstrumentation.JClinPeriodontol, edition.UnitedStateofAmerica;Elsevierlimited.2004, and chemotherapy in the diagnosis and treatment of periodontal. If this statistical significance is clinically significant needs to be critically assessed by the clinician upon the treatment planning and decision making. Song X, Yaskell T, Klepac-Ceraj V, Lynch MC, Soukos NS. 1977;4(4):240–9. Host modulation for smokers undergoing periodontal maintenance: a review of current evidence. Google Scholar. For control group, they were rinsed with gargle. Centers for Disease Control and Prevention. 2013;84(Suppl 4):S135–52. 2000;27(1):30–6. Rabbani GM, Ash MM, Caffesse RG. J Clin Periodontol. 14. Schlageter L, Rateitschak‑Plüss EM, Schwarz. Root surface, smoothness or roughness following open debridement. An. Van der Weijden GA, Hioe KP. Preshaw PM. 2001;25:77–88. Key words: Chronic periodontitis, nonsurgical periodontal therapy, efficacy. A systematic review and meta-analysis of preclinical in vivo trials. Advances in Power Driven Instrumentation. Adipose-derived stem/stromal cells and their Exo. Curcumin prevented bacterial adhesion and biofilm formation in a dose-dependent manner. Meimandi M, Ardakani MRT, Nejad AE, Yousefnejad P, Saebi K, Tayeed MH. Heitz-Mayfield LJA, Lang NP. Caton J, Ryan ME. Surgical and nonsurgical periodontal therapy. J Clin Periodontol. Hand curettes produced the surfaces with the lowest roughness values and the least apparent irregularities in the SEM photographs. Maria L. Geisinger. However, use of cyanoacrylates resulted in reduced bacterial colony counts thereby exhibiting antibacterial properties. gel with good gingival adhesion for 14 days after the scaling and root planing of patients with chronic periodontitis would improve the treatment outcome, when compared with the use of a regular hydrophyllic gel. PubMed Lang NP, Suvan JE, Tonetti MS. Risk factor assessment tools for the prevention of periodontitis progression: a systematic review. In the present era of increasing antibiotic resistance, ozone therapy is an alternative medical treatment that rationales to increase the amount of oxygen to the body through institution of ozone into the body. For HBO group, they were exposed to a pressure of 0.25 MPa. Kazmierczak M, Mather M, Ciancio S, et al. The cornerstone of management of chronic periodontitis is the non-surgical periodontal treatment. J Am Dent Assoc. Jonathan Shelswell, The clinical benefit of adjunctive antibiotics alongside non-surgical periodontal therapy with respect to periodontopathogenic bacteria?, Evidence-Based Dentistry, 10.1038/s41432-019-0061-2, 20, 4, (121-122), (2019). Int J Toxicol. horizontal bone loss when treated with NSPT. Chambrone L, Vargas M, Arboledan S, Serna M, Guerrero M, Sousa J, et al. 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Eur J Dent. 1985;13(3):121–2. 1996;67:478–85. Immediate online access to all issues from 2019. Complete elimination of such pathogenic microorganisms is perhaps over-ambitious. Antimicrobial therapy in periodontitis: the use of systemic antimicrobials against the subgingival biofilm. J Periodontol. J Clin Periodontol. PubMed At baseline and 3 months after the treatment the following parameters were recorded: pocket depth, Approximal Plaque Index, Modified Gingival Index, Simplified Oral Hygiene Index, bleeding on probing. Article Troil-Linden B, Saarela M, Mättö J, Alaluusua S, Jousimies-Somer H, Asikainen S. Source of suspected periodontal pathogens re-emerging after periodontal treatment. Article parametersofcare:PhaseItherapy,JPeriodontal2000;71(suppl):856. inserts,IntJPeriodontRestorDent1992;12:311. system on root surfaces in periodontal surgery. J Clin Periodontol. onthesubgingivalmicroora.JClinPeriodontol1985;12:676‑86. J Clin Periodontol. 2005;32(Suppl 6):214–28. was performed at baseline and 3 and 6 months following therapy by using a commercially available polymerase chain reaction test. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Powered versus manual toothbrushing for oral health. Systemic antibiotics in periodontal therapy. The measurement of the concentration of the VSC in the mouth air of the subjects was done objectively, using the Halimeter, before and after the therapy, and at recall visits 2 weeks and 6 weeks after therapy. Teles R, Wang CY. Subscription will auto renew annually. Periodontitis: consensus report of workgroup 2 of the 2107 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. In vitro evaluation of toothpastes with natural compounds. Geisinger ML, Robinson M, Kaur M, Gerlach RW, Griffin R, Geurs NC, et al. PubMed J Clin Periodontol. tothatofsurgicaltreatment.JClinPeriodontol1984;11:669‑81. 2004;135(4):496–504. J Clin Periodontol. Cosgarea R, Heumann C, Juncar R, Tristiu R, Lascu L, Salvi GE, et al. CONCLUSION: HBO had good therapeutic effects on human severe periodontitis, the effects can keep more than 1 year. Sgolastra F, Gatto R, Petrucci A, Monaco A. Tonetti MS. Cigarette smoking and periodontal diseases: etiology and management of disease. Google Scholar. PubMed Tunkel J, Heinecke A, Flemmig TF. Adjunctive effect of antimicrobial photodynamic therapy to nonsurgical periodontal treatment in smokers: a randomized clinical trial. 1981;52:119–23. Effect of supragingival plaque control on subgingival, and 37–87% at 12 months after completion of. The various methods used in nonsurgical therapy, such as hand instrumentation, ultrasonic and sonic scalers, and ablative laser therapy. Learn more about Institutional subscriptions. This article does not contain any studies with human or animal subjects performed by any of the authors. comparingscaling,osseoussurgeryandmodied. Application of pharmacokinetic principles allows effective suppression of the pathogenic microfiora, which, in turn, results in resolution of inflammatory signs. Nutrition may be important in redressing the balance between microbial challenge and the host response because it has been implicated in a number of inflammatory diseases and conditions, including type II diabetes mellitus, cardiovascular diseases, rheumatoid arthritis, and inflammatory bowel disease, all of which have also been associated with periodontal diseases. personal oral hygiene to achieve periodontal health. A number of treatment procedures, such as gingival curettage and aggressive removal of contaminated root cementum, have been unlearned. Lang NP, Attstrom R, Loe H. 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Some of the aforementioned modalities have been found to offer statistical significant benefit in clinical outcomes than the scaling and root planing alone. Cochrane Database Syst Rev. At 3 and 6 months after treatment, there were no statistically significant differences between the groups with regard to CAL, PD, FMPS, or microbiologic changes. Periodontol 2000. The comparative effect of propolis in two different vehicles; mouthwash and chewing gum on plaque accumulation and gingival inflammation. An analysis of factors affecting compliance with tooth-cleaning recommendations. Mechanical debridement of supra-gingival and subgingival biofilms, together with adequate oral hygiene measures is the standard periodontal therapy. Nonsurgical periodontal therapy. 2011;17:450–561. The primary goal of periodontal therapy is to preserve the natural dentition by achieving and maintaining a healthy functional periodontium. rootdebridementinmolarteeth.JClinPeriodontol1987;14:231‑6. The specimens were evaluated for histologic description (H&E), histochemical study (Masson trichrome), and histomorphometric study, to evaluate the area % of newly formed tissues. Material and Methods: J Periodont Res. 1980;7(4):289–99. Recent preclinical and clinical data have suggested a potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. Slot DE, Dorfer CE, van der Weijden GA. Reduced efficacy in molar furcation defects, the reduction of anaerobes was only 2‑fold. Periodontol 2000. Three months after mechanical treatment, the mean probing depth changed in the test group from 4.16±0.45 mm to 2.80±0.42 mm, and in the control group from 4.16±0.30 to 2.69±0.19. The cornerstone of management of chronic periodontitis is the non-surgical periodontal treatment. 2008;6(4):265–79. Tonetti MS, Greenwell H, Kornman KS. Community Dent Oral Epidemiol. However, over the last 30 years or so, it has become apparent that calculus does not cause disease, cementum does not become significantly infected and bacteria and their toxins are only loosely adherent to the diseased root surface. Petit C, Batol F, Bugueno IM, Schwinte P, Benkirane-Jessel N, Huck O. J Dent Res. The concept of critical probing depth was consistently found to be greater for the surgical approach than for the nonsurgical treatment. following three modalities of periodontal therapy. J Periodontol, periodontal tissues following different techniques of periodontal, Healing following surgical/nonsurgical treatment of periodontal. Effect of nonsurgical periodontal therapy. Metronidazole alone or with amoxicillin as adjuncts to non-surgical treatment of chronic periodontitis: a 1-year double-blinded, placebo controlled, randomized clinical trial. Anauate-Netto C, Anido-Anido A, Leegoy HR, et al. 2005;76(8):1227–36. 2017;52(3):574–81. treatment of periodontal intraosseous defects IV, resective versus a partially resective approach. J Clin Periodontol. The minimum inhibitory concentration and minimum bactericidal concentration of curcumin for both ATCC and clinical strains of P. gingivalis were found to be 62.5 and 125 µg ml−1 respectively. 2018;53:267–87. Report of the Cancer Assessment Review Committee (CARC). intraosseous defects. II Effect of citric acid conditioning of the root. Objectives: The aim of this systematic review was to assess the study design and reporting of studies on periodontal regeneration, with respect to the effect of the provision of non-surgical periodontal therapy (NSPT) before surgery. instruments or ultrasonic instruments were used. 2013;92:694–701. This work describes a systematic review of literature from 2010 to 2018 evaluating current strength of evidence of periodontal treatment and its effects on various systemic conditions and diseases. J Periodontol. Owing to its beneficial biological properties including antimicrobial and immune-stimulating effects, ozone therapy has opened new vistas in treatment modalities of dental pathologies for patients of all ages. This has led to the development of less invasive instrumentation principles which may be better for patients, more cost-effective and more easily applied in different clinical settings. The primary goal of periodontal therapy is to preserve the natural dentition by achieving and maintaining a healthy functional periodontium. Materials and Methods. OBJECTIVE: This paper studied the therapeutic effects and holding time of hyperbaric oxygen (HBO) on human severe periodontitis. Flemmig TF, Rumetsch M, Klaiber B. Efficacy of systemically administered acetylsalicylic acid plus scaling on periodontal health and elastase-alpha-1-proteinase inhibitor in gingival crevicular fluid. The included studies had to have two groups: smokers (S) and non… Oral Hyg Health. 1979;6:351–82. 2006;33:1–13. Sharma N, Charles CH, Lynch MC, et al. Dental hygienists’ experiences with motivational interviewing: a qualitative study. Resultsafteroneyear.JPeriodontol1988;59:351‑65. This meta-analysis assessed the advantages of full-mouth disinfection versus quadrant-wise ScRP. J Clin Periodontol. group revealed the best results in all intervals with significantly higher area % of newly formed tissues, followed by ADSCs and, finally, SRP. Antimicrobial action of minocycline microspheres versus 810-nm diode laser on human dental plaque microcosm biofilms. • Woelber JP, Spann-Algoe N, Hanna G, et al. Geisinger ML, Holmes CM, Geurs NC, Vassilopoulos PJ, Reddy MS. Electronic databases (PubMed, EMBASE, CENTRAL, CNKI, and WFPD) were searched for randomized controlled trials (RCTs) performed through July 2019. Adjunctive effects of a sub-antimicrobial dose of doxycycline on clinical parameters and potential biomarkers of periodontal tissue catabolism. Schwarz F, Derks J, Monje A, Wang H-L. Peri-implantitis. Enhanced patient compliance was noted with cyanoacrylate tissue adhesives. J Clin Periodontol. J Periodontol. In the cases presented, tetracyciine fibers were employed as a suppiement to mechanicai therapy and oral hygiene in a variety, Surgical pocket therapy entails raising a mucoperiosteal flap in order to carry out effective debridement so as to eliminate periodontal pockets and result in a healthy periodontium. Charcoal and charcoal-based dentifrices: a literature review. Scaling and root planing (SRP) is of limited value in many cases, so adjunctive treatment was applied to augment its outcome. J Clin Periodontol. Obesity is associated with an increased prevalence of periodontitis. OBJECTIVES: To evaluate the, In patients with chronic renal failure a primary disease is reflected also in the condition of hard dental tissues and periodontium. Physical disability, psychological discomfort and functional limitation were domains that improved significantly after … Successful periodontal management in patients with these associated systemic factors depends on the host tissue response and underlying disease mechanism. This systematic review assesses the current evidence regarding the safety and efficacy of such charcoal-containing dentifrices and finds that they may have high levels of abrasivity and the inclusion of charcoal may limit the availability of fluoride in such dentifrices. Tsouronakis I, Palaiologou-Gallis AA, Stoute D, Maney P, Lallier TE. Paquette D, Oringer R, Lessem J, Offenbacher S, Genco R, Persson GR, et al. Marjolein Van der Sluijs, Eveline Van der Sluijs, Fridus Van der Weijden, Dagmar Else Slot, The effect on clinical parameters of periodontal inflammation following non‐surgical periodontal therapy with ultrasonics and chemotherapeutic cooling solutions: a systematic review, Journal of Clinical Periodontology, 10.1111/jcpe.12613, 43, 12, (1074-1085), (2016). : Nonsurgical periodontal therapy: A review, studyofamagnetostrictiveandapiezoelectric, effectsofanEr:YAGlaser,aGaAlAsdiodelaserand, effect of photodynamic therapy on periodontal. Google Scholar. Introdution. 2004;31(9):749–57. Author information: (1)Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI. 2003;74:1395–401. Azaripour A, Mahmoodi B, Habibi E, Willershausen I, Schmidmann I, Willershausen B. • Fang H, Han M, Li Q-L. et al.Comparison of full-mouth disinfection and quadrant-wise scaling in the treatment of adult chronic periodontitis: a systematic review and meta-analysis. J Clin Periodontol. One year results of a randomized controlled clinical study evaluating the effects of non-surgical periodontal therapy of chronic periodontitis in conjunction with three or seven days systemic administration of amoxicillin/metronidazole. Supragingival pooled plaque samples were collected for analysis of total bacterial count at 1week follow up using lawn cultures in blood agar. 1988;15:116–22. https://doi.org/10.1007/s40496-019-00224-7, DOI: https://doi.org/10.1007/s40496-019-00224-7, Over 10 million scientific documents at your fingertips, Not logged in 2012;32(5):496–507. wall treatment effectively along with root surface debridement, laser, argon laser, an alexandrite laser, and an excimer laser, parameters and subgingival microora after Nd:Y, removal, and causes alteration of root surfaces such as grooves, single versus repeated instrumentation and demonstrated, microorganisms during healing phase may not be, Michigan study II was done in 1975 by Ramfjord, difference in PD reduction by surgical and NSPT. A clinical study, Effect of air–powder abrasive system on root surfaces in periodontal surgery, The nature of root surfaces after curette, cavitron and alpha-sonic instrumentation, The use of phase-contrast microscopy and chemotherapy in the diagnosis and treatment of periodontal lesions--an initial report (I), Results Following Three Modalities of Periodontal Therapy*. Ercan N, Erdemir EO, Ozkan SY, Hendek MK. J Periodontol. A systematic review. 1990;17:714–20. 2012;33:406–13. Inflammation present in the oral cavity can thus complicate general health status as being one of the sources of general inflammatory load. Curry-Chiu ME, Catley D, Voelker MA, Bray KK. Although considered the gold standard for dental biofilm associated periodontal disease, if the conditions second instrumentation decreased pockets to 4.9 mm. The present review showed that despite the transient duration of DH after non-surgical periodontal therapy, desensitizers are important to offer pain relief to patients. Drisko CL. 2016;7:254. J Am Dent Assoc. Adjunctive benefit of an essential oil containing mouthrinse in reducing plaque and gingivitis in patients who brush and floss regularly: a six-month study. Lang NP, Adler R, Joss A, Nyman S. Absence of bleeding on probing. 2014;17(1):11–5. Gingival crevicular fluid tissue/blood vessel-type plasminogen activator and plasminogen activator inhibitor-2 levels in patients with rheumatoid arthritis: effects of nonsurgical periodontal therapy. 2002;29(Suppl 3):72–81. Fifteen patients were selected for the study. This work reviews the microbial etiology of periodontitis and the over 700 bacterial species and 1500 putative periodontal pathogens present in the oral cavity that may contribute to periodontal disease. J Clin Periodontol. Basic periodontal examination was used for the grouping. Axelsson P, Nystrom B, Lindhe J. 2018;9:e12353. The results revealed that at baseline, 78.7% (48/61) of the subjects who had VSC concentration more than 250 parts per billion (ppb) were from the group with periodontal disease. Available at: https://www.mouthhealthy.org/en/az-topics/b/brushing-your-teeth Accessed April 12, 2019. J Dent Educ. May 23, 2009 www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/DevelopmentResources/Over-the-CounterOTCDrugs/StatusofOTCRulemakings/ucm096081.pdf Accessed April 12, 2019. group obtaining comparable histologic results to the normal, healthy tissues by 4 weeks. A novel therapeutic approach based on root planing tor debrldement local drug delivery for control of the pathogens, and oral hygiene for preventing recolonization is discusse. In addition, nonsurgical, therapy aims to create an environment in which the host can more effectively prevent pathogenic micr, oral hygiene methods. Bertl K, Steiner I, Pandis N, Buhlin K, Klinge B, Stavropoulos A. Statins in nonsurgical and surgical periodontal therapy. 2017;52:8–20. 2018;89(Suppl 1):S267–90. 2007;34:325–33. Google Scholar. Nevins M, Camelo M, Schupbach P, Kim S-W, Kim DM, Nevins M. Human clinical and histological evaluation of laser-assisted new attachment procedure. Join ResearchGate to find the people and research you need to help your work. 1986;12:590–6. Ren C, McGrath C, Jin L, Zhang C, Yang Y. histologicstudy.LasersSurgMed2003;32:359‑66.. It appears that there is no certain magnitude of initial probing pocket depth where nonsurgical periodontal therapy is no longer effective. Both treatments resulted in significant improvement in all clinical indices, except Approximal Plaque Index, which deteriorated significantly in both groups. Final report on the safety assessment of sodium metaphosphate, sodium trimetaphosphate, and sodium hexametaphosphate. Histologic methods were used to determine the composition of the surfaces following instrumentation. Cyanoacrylate tissue adhesives are slowly gaining popularity as wound closure agents. Changes in probing pocket depth and clinical attachment. J Clin Periodontol. This work describes the updated prevalence data for periodontitis and periodontal findings in adults based upon the NHANES III data from 2009 to 2014. Glavind L, Zeuner E, Attrstrom R. Evaluation of various feedback mechanisms in relation to compliance by adult patients with oral home care instructions. The results of this review seem to indicate that the CHX chip may serve as a useful adjuvant to non-surgical periodontal therapy. The GBF had a 1.8 folds increase after HBO exposure. Article In addition, nonsurgical therapy aims to create an environment in which the host can more effectively prevent pathogenic microbial recolonization using personal oral hygiene methods. 2002;29(Suppl 3):39–54. Effect of nonsurgical periodontal therapy. Ozone is an allotropic form of oxygen, which is effectively used in the treatment of different diseases for more than 100 years. Tabenski L, Moder D. Cieplik.F, et al. Stenman J, Lundgren J, Wennstrom JL, et al. 1 The use of the diode laser in non-surgical therapy does not replace treatment conventional, but can be associated and contribute to the success of therapy 2-3. Photomed Laser Surg. J Periodontol. 2004;31:697–707. 2014;2:157. https://doi.org/10.4172/2332-0702,1000157. Badersten A, Nilveus R, Egelberg J. J Clin Periodontol. The oral-medical disease connection: pregnancy, cardiovascular disease, and diabetes. 2018;76(1):85–96. An increasing number of patients have become aware of the detrimental effects of periodontal disease and tooth-loss and they seek periodontal care. In this study none of the instrumentation methods consistently removed all of the cementum. Int J Dent Hyg. Pradeep AR, Karvekar S, Nagpal K, Patnaik K, Guruprasad CN, Kumaraswamy KM. Eur J Dent. This paper aims to describe and justify a minimally-invasive approach to the management of the diseased root surface in periodontitis, to clarify the terminology used and to suggest how these principles may be applied in general practice. J Periodontal Res. A clinical evaluation of anticalculus dentifrices. Training of dental professionals in motivational interviewing can heighten interdental cleaning self-efficacy in periodontal patients. 2015;146(7):525–35. 2016;34(4):137–49. Fundamental to all types of therapy is the patient's role in disease control, in the form of self-performed plaque control, and it is important that the patient understands this. Severely advanced periodontitis. Mechanical therapy requires a high level of operator skill and an understanding of expected results and the modifiers which may affect treatment outcomes. Periodontol 2000. Dental treatment should therefore be interdisciplinary with a close cooperation of dentist and nephrologist. SS. Clinical and microbiological features of subjects with adult, periodontitis who responded poorly to and root planing. J Clin, control and instrumentation on the clinical parameters of human. lesions‑aninitialreport.QuintessenceInternational1978;9:51‑6. whether the root surface was exposed or not. American Dental Association: Brushing your Teeth. 2017;8(Suppl 1):S7–S11. Additionally, it is estimated that up to 5 million dental implants are placed each year and, with the increasing number of implants comes increasing numbers of cases of peri-implant mucositis and peri-implantitis. The additional application of a single episode of PDT to scaling and root planing failed to result in an additional improvement in terms of PD reduction and CAL gain, but it resulted in a significantly higher reduction in bleeding scores compared to scaling and root planing alone. Straub AM, Salvi GE, Lang NP: Supragingival plaque formation in the human dentition. METHODS: Patients undergoing full mouth periodontal flap surgery were randomly selected for placement of cyanoacrylates or silk sutures using split mouth study design. As observed on extracted teeth. J Clin Periodontol. 2017;15:195–202. A single session of motivational interviewing as an additive means to improve adherence in periodontal infection control: a randomized controlled trial. Nonsurgical therapy aims to eliminate both living bacteria in the microbial biofilm and calcified biofilm microorganisms from the tooth surface and adjacent soft tissues. www.cdc.gov/biomonitoring/Triclosan_FactSheet.html Accessed April 12, 2019. This work outlines practice guidelines for the most effective use of adjunctive therapies with scaling and root planing. periodontaldisease.JClinPeriodontol1983;10:46‑56. Aim: The present literature review was carried out to apprehend and explore the various clinical aspects associated with diabetic and hypertensive patients following periodontal therapy. The SRP represents the basic procedure in periodontal treatment by elimination of the bacterial biofilm, leading to decrease in the bacterial load and creation of a more favorable environment for periodontal healing. Periodontol 2000. By using gene expression studies, we exploited the mechanism of anti-biofilm effects of curcumin on P. gingivalis. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. Dent Clin N Am. Oral inflammation and infection, an chronic medical diseases: implications for the elderly. The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. 2017;21:2253–64. Selection of the appropriate case and clinical competency in treatment modalities results in success in nonsurgical periodontal therapy. whereas there was a 100‑fold reduction at other sites. Periodontol 2000. Many adjunctive treatment modalities have been introduced lately to enhance the therapeutic outcome of periodontal treatment. Silva MP, Feres M, Sirotto TA, et al. Antibiotic therapy as an adjunct to scaling and root planing in smokers: a systematic review and meta-analysis. Author information: (1)University of College of Dentistry, Department of Periodontology, Gainesville, FL 32610-0434.
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