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Step 2 of periodontal therapy primarily aims at the non-surgical, mechanical disruption of the subgingival biofilm and removal of plaque-retentive factors, allowing a shift from disease to health. Numerous therapeutic agents have been proposed as adjuncts to non-surgical periodontal therapy, generally through either aiding disruption of the dental plaque biofilm, or though alteration of the host immune response. This article reviews the British Society of Periodontology's implementation of the S3-level guidelines in relation to adjunctive therapies.
CPD/Clinical Relevance: Recommendation to use adjunctive therapies in the treatment of periodontitis requires careful consideration of the available evidence as well as the wider effects of the proposed therapy.
Article
The desired outcome of periodontal treatment is disruption of a dysbiotic dental plaque biofilm, including bacteria and bacterial metabolites and toxins, leading to a return to healthy, non-pathogenic biofilm, and resolution of dysbiosis-induced inflammation.
Step 2 of periodontal therapy primarily aims at the non-surgical, mechanical disruption of the subgingival biofilm, as well as removal of plaque retentive factors (PRFs), allowing the shift in the microbiome–host interaction, leading to disease resolution.1 This stage is conditional on patient engagement with improvements in oral hygiene and risk-factor control as part of the first step of periodontal therapy. There are a number of potential adjunctive therapies that can be administered, alongside mechanical plaque removal, to facilitate the disruption of the subgingival biofilm or to alter the host immune response. In this article, the present authors discuss the use of therapies adjunctive to non-surgical subgingival instrumentation, as part of step two of periodontal therapy.
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