Periodontics

Otherwise known as conventional periodontal therapy, non-surgical periodontal therapy, or deep cleaning, is the process of removing or eliminating the etiologic agents – dental plaque, its products, and calculus – which cause inflammation, thus helping to establish a periodontium that is free of disease.

Scaling and root planing is considered the basic treatment of periodontal diseases and may be the only treatment required to treat mild cases of periodontitis. However, it may also be the initial therapy prior to future surgical needs. For the procedure to be considered effective, the patient must be able to be maintained at a level of periodontal health that will prevent reinfection with periodontal pathogens. This requires optimal home care and ongoing periodontal maintenance therapy, usually every three to four months to sustain health.

It is effective only when certain conditions are fulfilled. A complete removal of calculus from the periodontal pockets using hand and ultrasonic instruments is not totally effective. The depth of the pocket, when identified by the probe, exceeds more than 3mm then calculus removal becomes more insufficient. The maximum access of a probing instrument is up to 6mm, any calculus beyond that can’t be reached. If there is calculus exceeding more than 6mm, then scaling and root planing are ineffective and the best treatment option in such cases will be surgical access for complete pathogen and calculus free area.

The probing depth and methods affects the success of the procedure, and factors like root grooves, concavities, and furcation involvement may limit visibility of underlying deep calculus and debris. In severe periodontal disease where there is a systemic involvement, scaling and root planing are insufficient and surgery is required. Scaling and root planing are ineffective in cases where tooth mobility is severe; such conditions require periodontal surgery and placement of bone grafts.

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