Normal turnover of cells in the junctional epithelium, which migrate from the apical end to the coronal end, takes about 5 days. 26302 La Paz Rd Suite 207 â¢ Periodontics: Home | Meet Our Staff | Patient Information | Periodontal Disease | Dental Implants The purpose of prophylaxis is to assist the patient in maintaining and preserving periodontal health. Specific definitions accepted in the dental hygiene community, The American Academy of Periodontology (AAP) defines scaling as “instrumentation of the crown and root surfaces of the teeth to remove plaque, calculus, and stains from these surfaces.”, Scaling may be accomplished with sharp hand instruments or with, Root planing is defined by the AAP as “a treatment procedure designed to remove cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms.”. In these instances, root planing, commonly referred to as âdeep cleaningsâ, becomes necessary. The specific plaque hypothesis was proposed by Loesche in the 1970s.15 This classic study has increased the understanding of periodontal disease and the use of appropriate antimicrobial agents to improve treatment results. Synopsis. Repair after disruption of the junctional epithelium during scaling procedures (not removal, which occurs with surgical excision) is similar to the normal course of events in tissue turnover.25, Inflammatory activity occurs in the underlying connective tissue during the disease process and is also a result of treatment. Studies evaluating plaque biofilm formation on rough root surfaces are equivocal. • Rough surfaces mechanically irritate gingival tissues. In its broadest sense, nonsurgical therapy defines all of the procedures performed to treat gingival and periodontal diseases up to the time of reevaluation, which is when patients begin maintenance care and the need for periodontal surgery to enhance results is determined. The cornerstone of management of chronic periodontitis is the non-surgical periodontal treatment. Armitage presented the following information regarding root surface roughness8: 1. It works by mechanical abrasion using a slurry of sodium bicarbonate and water. These reasons are. Thus, the rationale for root planing to remove root roughness and achieve glassy, smooth root surfaces is no longer valid. Most importantly, no surfaces should feel rough, as if calculus is still present. Plaque biofilm must also be dislodged from all accessible surfaces. Material and methods: Fourteen CP cases received full-mouth non-surgical treatment and, after 6 months, at least two surgical sessions. Other concerns include the possibility of creating bacteremia in the patient and possibly damaging the tooth pulps by heat generated from the power-driven prophylaxis angle. Healing of inflamed connective tissue is complex, requiring many cells and mediators. Treatment frequently requires the use of pain control measures. One size fits all grit paste ignores the science of abrasion, can cause sensitivity, and damage aesthetic restorations. With the following innovative techniques, we are able to achieve periodontal health for many of our patients in a simple, non- invasive and affordable manner. In addition, the microbial composition of dental plaque changed from one of gram-positive microbiota to one dominated by gram-negative organisms. These products are not effective as standalone treatment and are also not effective for long term control of advanced periodontal disease or with patients who have chronically deep gum pockets. Animal studies, the landmark study on human experimental gingivitis, and much additional evidence prove that plaque biofilm removal is a major part of nonsurgical periodontal therapy. Laser periodontal therapy is one of the latest and most exciting techniques being developed for the treatment of periodontal disease. Subgingival bacterial plaque biofilm will regrow but, at least initially, it will consist of a younger, less pathogenic bacterial biofilm than that associated with untreated periodontal pockets. Dental hygiene procedures with hand instruments or powered scalers adequately accomplish subgingival plaque biofilm removal. Categories: Target Audience: Dental Assistants, Dental Students, Dentists. Explain the benefits and indications of antimicrobial adjuncts to nonsurgical therapy. After periodontal debridement is performed (unless there are systemic complications) periodontal pockets, alveolar bone, periodontal ligament, and epithelium will heal. If the non-surgical therapy effectively eliminates the gum disease, the only further requirement will be periodic maintenance every 3-4 months. 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