Periodontal therapeutics – a viable option?

Abstract

Research in recent years in periodontology has seen a shift from surgery towards medicine. While surgery, particularly regenerative, and including implants, continues to form an important element of periodontal treatment, the volume of treatment required and the results of recent and ongoing non-surgical studies clearly show that most future periodontics will be based on a physician-type approach. Improved diagnostics based on more precise periodontal disease classification, simplification of mechanical oral hygiene equipment and procedures, and the development of conventional and non-conventional chemical and physical adjuncts may be expected to reduce the rate of common periodontal disease advance, resulting in less complex treatments, and more of the latter coming to lie within the competence of the generalist and the hygienist working together. The rationale for non-surgical adjunctive therapy is extensive, far beyond the usual antimicrobial logic. It will also be important to control the oral microflora for systemic reasons, since increasingly strong links are being established between focal infection of oral origin, much of it periodontal, and a range of systemic diseases, including coronary heart disease, stroke, gastrointestinal disorders, and low birth weight, apart from severe, overt systemic infections. All these developments derive from a greatly improved understanding of the fundamentally ecological nature of the natural microbial biofilm that is dental plaque, and of its interactions with its human host.

Therapeutic Efficacy of Subgingivally Delivered Doxycycline Hyclate as an Adjunct to Non-surgical Treatment of Chronic Periodontitis

“…The adjunctive use of locally delivered antibiotics can provide additional benefit when compared to the conventional therapy [3,14]. The present study demonstrated significantly greater PPD reductions in the both groups.…”

Viscoelastic Properties of a Mixed Culture Biofilm from Rheometer Creep Analysis

“…Prevention of this phenomenon is also important in the field of medicine. For example, the growth of biofilm on medical devices can result in persistent infections (Costerton et al, 1999) and the detachment of dental biofilms associated with periodontal disease has been linked to a range of systemic diseases (Newman, 1998).…”

Utilisation of locally delivered doxycycline in non‐surgical treatment of chronic periodontitis

“…Such treatment approaches have been demonstrated to be successful in arresting disease progression in most patients (for reviews, see Cobb (1996), Palcanis (1996)). Utilisation of chemical antimicrobial agents is another treatment approach that has been evaluated rather extensively in recent years (for reviews, see Drisco (1996), Tonetti (1997), Greenstein & Polson (1998), Killoy (1998), Newman (1998)). The most promising results so far have been achieved with the use of various antibiotics administrated either systemically or locally.…”