Badersten A, Nilveus R, Egelberg J. Effect of non surgical periodontal therapy. II. Severely advanced periodontitis. J Clin Periodontol. 1984; 11:63-76
Segelnick SL, Weinberg MA. Reevaluation of initial therapy: when is the appropriate time?. J Periodontol. 2006; 77:1598-1601
König J, Plagmann H-C, Rühling A Tooth loss and pocket probing depths in compliant periodontally treated patients: a retrospective analysis. J Clin Periodontol. 2002; 29:1092-1100
Gjermo PE, Grytten J. Cost-effectiveness of various treatment modalities for adult chronic periodontitis. Periodontology 2000. 2009; 51:269-275
Eickholz P, Kaltschmitt J, Berbig J Tooth loss after active periodontal therapy. 1: Patient-related factors for risk, prognosis, and quality of outcome. J Clin Periodontol. 2008; 35:165-174
Axelsson P, Lindhe J. Effect of controlled oral hygiene procedures on caries and periodontal disease in adults. J Clin Periodontol. 1978; 5:133-151
Axelsson P, Lindhe J. The significance of maintenance care in the treatment of periodontal disease. J Clin Periodontol. 1981; 8:281-294
Rosling B, Serino G, Hellström MK Longitudinal periodontal tissue alterations during supportive therapy. Findings from subjects with normal and high susceptibility to periodontal disease. J Clin Periodontol. 2001; 28:241-249
Dridi SM, Lallam-Laroye C, Viargues P Les réévaluations et l'orientation thérapeutique en parodontie. Rev Odonto Stomato. 2002; 31:193-210
Avila G, Galindo-Moreno P, Soehren S. A novel decision-making process for tooth retention or extraction. J Periodontol. 2009; 80:476-491
Matuliene G, Pjetursson BE, Salvi GE Influence of residual pockets on progression of periodontitis and tooth loss: results after 11 years of maintenance. J Clin Periodontol. 2008; 35:685-695
Cosyn J, De Bruyn H. Interclinician disparity in periodontal decision making: need for consensus statements on surgical treatment. J Periodontal Res. 2007; 42:311-317
Nyman S, Lindhe J, Rosling B. Periodontal surgery in plaque-infected dentitions. J Clin Periodontol. 1977; 4:240-249
Heitz-Mayfield LJA, Trombelli L, Heitz F A systematic review of the effect of surgical debridement vs. non-surgical debridement for the treatment of chronic periodontitis. J Clin Periodontol. 2002; 29:92-102
Heitz-Mayfield LJA. How effective is surgical therapy compared with non surgical debridement. Periodontology 2000. 2005; 37:72-87
Graziani F, Gennai S, Cei S Clinical performance of access flap surgery in the treatment of the intrabony defect. A systematic review and meta-analysis of randomized clinical trials. J Clin Periodontol. 2012; 39:145-156
Baehni P, Giovannoli JL. Patient profile and decision-making in periodontal practice. Periodontology 2000. 2004; 36:27-34
Ingber JS. Forced eruption. Part I. A method of treating isolated one and two wall infrabony osseous defects – rationale and case report. J Periodontol. 1974; 45:199-206
Decision-making for residual periodontal pockets after aetiological treatment Amal Bouziane Latifa Benrachadi Oumkeltoum Ennibi Dental Update 2024 42:5, 707-709.
Authors
AmalBouziane
DMD Specialist in Periodontology, Associate Professor, Department of Periodontology, Faculty of Dental Medicine, Biostatistical, Clinical and Epidemiological Research Laboratory. Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
The practitioner may have difficulties making decisions regarding the most appropriate therapeutic approach in the case of the persistence of periodontal pockets after initial periodontal treatment. Several options may be considered: aetiologic retreatment, maintenance, surgery of the pocket or extraction of the tooth for strategic reasons or when the conservation of the tooth is impossible. There are no clear guidelines for the treatment decision. The aim of this article is to present the main factors involved in making a treatment decision. An algorithm and its background rationale are presented to help the practitioner make a decision about residual periodontal pockets after aetiological treatment.
CPD/Clinical Relevance: Many factors need to be considered in making a treatment decision for residual periodontal pockets: depth of the pocket, presence of signs of infection, difficulty of access to deposits and the type of periodontal lesion.
Article
Non-surgical mechanical debridement is the first therapeutic option of periodontal pockets during the initial phase to eliminate local aetiological factors of periodontitis, namely the bacterial biofilm (plaque) and calculus. In many cases, the aetiological periodontal treatment alone is a sufficient treatment for the improvement of clinical parameters.1
There is no consensus on the clinical criteria to guide therapeutic decisions in the case of residual periodontal pockets after initial periodontal treatment. Decision-making is an important aspect of everyday clinical practice. Definition of therapeutic goals is an important step in this process:
The aim of this article is to present the criteria that can guide the clinician in his/her decision when dealing with residual periodontal pockets.
There must be a proper time interval between initial treatment and re-evaluation of residual periodontal pockets. Different periods have been reported to reassess the pocket depth after initial treatment. Based on the rate of healing, 3 months after treatment is a proper interval for evaluation of initial non-surgical treatment. Healing seems to be complete 3–6 months after non-surgical treatment.2 A limited and gradual healing can even occur over 9 months or more after treatment.3 Too short a time interval can lead to an overtreatment.4
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