Minimally Invasive Periodontology: A Treatment Philosophy and Suggested Approach

Abstract

Severe periodontitis is a highly prevalent dental disease. With the advent of implant dentistry, teeth are often extracted and replaced. Periodontal surgery, where indicated, could also result in increased trauma to the patient. This literature review discusses different treatment modalities for periodontitis and proposes a treatment approach emphasizing maximum preservation of teeth while minimizing morbidity to the patient. Scientific articles were retrieved from the MEDLINE/PubMed database up to January 2021 to identify appropriate articles that addressed the objectives of this review. This was supplemented with hand searching using reference lists from relevant articles. As tooth prognostication does not have a high predictive value, a more conservative approach in extracting teeth should be abided by. This may involve repeated rounds of nonsurgical periodontal therapy, and adjuncts such as locally delivered statin gels and subantimicrobial-dose doxycycline appear to be effective. Periodontal surgery should not be carried out at an early phase in therapy as improvements in nonsurgical therapy may be observed up to 12 months from initial treatment. Periodontal surgery, where indicated, should also be minimally invasive, with periodontal regeneration being shown to be effective over 20 years of follow-up. Biomarkers provide an opportunity for early detection of disease activity and personalised treatment. Quality of life is proposed as an alternative end point to the traditional biomedical paradigm focused on the disease state and clinical outcomes. In summary, minimally invasive therapy aims to preserve health and function of the natural dentition, thus improving the quality of life for patients with periodontitis.

[Retracted] Analysis of the Influence of Western Philosophy on the Development of Chinese Environmental Philosophy Theory and Its Future Direction

“…From the perspective of environmental philosophy, the world exists in a complex and complete ecological system of human, nature, and society [ 15 ]. Pure objective nature and pure human are not the origin of the world.…”

“…In the face of environmental problems, there are four changes, namely, from personal standard to class standard, from absolute subject consciousness to "limited subject" consciousness, from pleasure consciousness to survival consciousness, and from secularism consciousness to future consciousness. From the perspective of environmental philosophy, the world exists in a complex and complete ecological system of human, nature, and society [15]. Pure objective nature and pure human are not the origin of the world.…”

Cultural and Personal Practices with Unusual Oral Findings: Three Case Reports and a Literature Review

“… 36 At the same time, there is a risk of administering unnecessary treatments, which can be costly and, more importantly, harmful to patients if patients are misdiagnosed with diseases such as periodontitis. 37 …”

The Gaseous Ozone Therapy as a Promising Antiseptic Adjuvant of Periodontal Treatment: A Randomized Controlled Clinical Trial

“…Periodontal disease (PD) is one of the most common inflammatory illnesses affecting the individuals, and the global burden of periodontal disorders, as measured in prevalence, is between 20 and 50%, with severe periodontitis affecting 11.2% worldwide [ 1 , 2 , 3 ]. The term encompasses a wide spectrum of pathological conditions, ranging from reversible gingival inflammation to severe form, characterized by progressive destruction of alveolar bone [ 3 ].…”

“…Periodontal disease (PD) is one of the most common inflammatory illnesses affecting the individuals, and the global burden of periodontal disorders, as measured in prevalence, is between 20 and 50%, with severe periodontitis affecting 11.2% worldwide [ 1 , 2 , 3 ]. The term encompasses a wide spectrum of pathological conditions, ranging from reversible gingival inflammation to severe form, characterized by progressive destruction of alveolar bone [ 3 ]. All clinical manifestations have the same pathogenic pathway, with a dramatic increase in bacterial pathogens aggregation (bacterial plaque) as a mainly etiologic factor and important genetic and immunoregulatory individual determinants of the severity of the disease [ 4 , 5 , 6 , 7 , 8 , 9 ].…”