Nonsurgical Treatment of Periodontitis
Abstract Context. Scaling and root planing (SRP) is the gold standard treatment for most patients with chronic periodontitis. Nevertheless, in the last years, different therapeutic strategies have been proposed to improve the results of SRP and hence to avoid the need of periodontal surgical interve...
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Veröffentlicht in: | The journal of evidence-based dental practice 2012-09, Vol.12 (3), p.76-86 |
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creator | Sanz, Ignacio, DDS Alonso, Bettina, DDS, Dr Odont Carasol, Miguel, MD, DDS Herrera, David, DDS, Dr Odont Sanz, Mariano, MD, DDS, Dr Med |
description | Abstract Context. Scaling and root planing (SRP) is the gold standard treatment for most patients with chronic periodontitis. Nevertheless, in the last years, different therapeutic strategies have been proposed to improve the results of SRP and hence to avoid the need of periodontal surgical interventions in some patients with advanced periodontitis. They are based on modifications of standard therapies (such as enhancement of instrument tip designs), on development of new technologies (such as lasers), or development of alternative treatment protocols (eg, full-mouth disinfection). The purpose of this review is, therefore, to update the scientific evidence based on randomized clinical trials (RCT) evaluating these advanced nonsurgical therapies that have been published between January 2010 and March 2012. Evidence Acquisition. RCTs published between January 2010 and March 2012 have been selected. Previous systematic reviews were used as a start point. Three distinct aspects were evaluated independently: the modification of conventional instruments, the advent of new technologies, and the development of new treatment protocols. Evidence Synthesis. Twenty-two publications were selected: 4 were related to modifications of standard therapies (new tip designs and local anesthetics), 14 to new technologies (new ultrasonic devices, air abrasive systems, endoscope and lasers), and 4 to new treatment protocols. Conclusions. These technological advances and the development of new protocols may improve patient-related outcomes and cost-effectiveness, although they have not shown significant differences in efficacy when compared with conventional SRP. |
doi_str_mv | 10.1016/S1532-3382(12)70019-2 |
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Scaling and root planing (SRP) is the gold standard treatment for most patients with chronic periodontitis. Nevertheless, in the last years, different therapeutic strategies have been proposed to improve the results of SRP and hence to avoid the need of periodontal surgical interventions in some patients with advanced periodontitis. They are based on modifications of standard therapies (such as enhancement of instrument tip designs), on development of new technologies (such as lasers), or development of alternative treatment protocols (eg, full-mouth disinfection). The purpose of this review is, therefore, to update the scientific evidence based on randomized clinical trials (RCT) evaluating these advanced nonsurgical therapies that have been published between January 2010 and March 2012. Evidence Acquisition. RCTs published between January 2010 and March 2012 have been selected. Previous systematic reviews were used as a start point. Three distinct aspects were evaluated independently: the modification of conventional instruments, the advent of new technologies, and the development of new treatment protocols. Evidence Synthesis. Twenty-two publications were selected: 4 were related to modifications of standard therapies (new tip designs and local anesthetics), 14 to new technologies (new ultrasonic devices, air abrasive systems, endoscope and lasers), and 4 to new treatment protocols. Conclusions. These technological advances and the development of new protocols may improve patient-related outcomes and cost-effectiveness, although they have not shown significant differences in efficacy when compared with conventional SRP.</description><identifier>ISSN: 1532-3382</identifier><identifier>EISSN: 1532-3390</identifier><identifier>DOI: 10.1016/S1532-3382(12)70019-2</identifier><identifier>PMID: 23040340</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Anti-Infective Agents, Local ; Clinical Protocols ; curettes ; Dental Instruments ; Dental Scaling - instrumentation ; Dental Scaling - methods ; Dentistry ; Humans ; laser ; nonsurgical therapy ; Periodontal Index ; Periodontitis ; Periodontitis - therapy ; power-driven ; Root Planing - instrumentation ; Root Planing - methods ; Treatment Outcome</subject><ispartof>The journal of evidence-based dental practice, 2012-09, Vol.12 (3), p.76-86</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c335t-2a72cd168d8e13b5f0cffadf179bd99380851889fb56977eebe6bfb2f1450f4d3</citedby><cites>FETCH-LOGICAL-c335t-2a72cd168d8e13b5f0cffadf179bd99380851889fb56977eebe6bfb2f1450f4d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S1532-3382(12)70019-2$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23040340$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sanz, Ignacio, DDS</creatorcontrib><creatorcontrib>Alonso, Bettina, DDS, Dr Odont</creatorcontrib><creatorcontrib>Carasol, Miguel, MD, DDS</creatorcontrib><creatorcontrib>Herrera, David, DDS, Dr Odont</creatorcontrib><creatorcontrib>Sanz, Mariano, MD, DDS, Dr Med</creatorcontrib><title>Nonsurgical Treatment of Periodontitis</title><title>The journal of evidence-based dental practice</title><addtitle>J Evid Based Dent Pract</addtitle><description>Abstract Context. Scaling and root planing (SRP) is the gold standard treatment for most patients with chronic periodontitis. Nevertheless, in the last years, different therapeutic strategies have been proposed to improve the results of SRP and hence to avoid the need of periodontal surgical interventions in some patients with advanced periodontitis. They are based on modifications of standard therapies (such as enhancement of instrument tip designs), on development of new technologies (such as lasers), or development of alternative treatment protocols (eg, full-mouth disinfection). The purpose of this review is, therefore, to update the scientific evidence based on randomized clinical trials (RCT) evaluating these advanced nonsurgical therapies that have been published between January 2010 and March 2012. Evidence Acquisition. RCTs published between January 2010 and March 2012 have been selected. Previous systematic reviews were used as a start point. Three distinct aspects were evaluated independently: the modification of conventional instruments, the advent of new technologies, and the development of new treatment protocols. Evidence Synthesis. Twenty-two publications were selected: 4 were related to modifications of standard therapies (new tip designs and local anesthetics), 14 to new technologies (new ultrasonic devices, air abrasive systems, endoscope and lasers), and 4 to new treatment protocols. Conclusions. These technological advances and the development of new protocols may improve patient-related outcomes and cost-effectiveness, although they have not shown significant differences in efficacy when compared with conventional SRP.</description><subject>Anti-Infective Agents, Local</subject><subject>Clinical Protocols</subject><subject>curettes</subject><subject>Dental Instruments</subject><subject>Dental Scaling - instrumentation</subject><subject>Dental Scaling - methods</subject><subject>Dentistry</subject><subject>Humans</subject><subject>laser</subject><subject>nonsurgical therapy</subject><subject>Periodontal Index</subject><subject>Periodontitis</subject><subject>Periodontitis - therapy</subject><subject>power-driven</subject><subject>Root Planing - instrumentation</subject><subject>Root Planing - methods</subject><subject>Treatment Outcome</subject><issn>1532-3382</issn><issn>1532-3390</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LAzEQhoMotlZ_gtKT1MNqJtnPiyLFLygqWM9hN5lI6nZTk12h_97dbu3Bi6cZhneeYR5CToFeAoX46g0izgLOUzYBdpFQClnA9shwO87o_q5P2YAceb-glEUQhodkwDgNKQ_pkJw_28o37sPIvBzPHeb1Eqt6bPX4FZ2xyla1qY0_Jgc6Lz2ebOuIvN_fzaePwezl4Wl6Owsk51EdsDxhUkGcqhSBF5GmUutcaUiyQmUZT2kaQZpmuojiLEkQC4wLXTANYUR1qPiITHruytmvBn0tlsZLLMu8Qtt4AQAsTmII4zYa9VHprPcOtVg5s8zdWgAVnSKxUSS6_wUwsVEkWLt3tj3RFEtUu61fJ23gpg9g--i3QSe8NFhJVMahrIWy5t8T138IsjRVp_gT1-gXtnFVa1GA8EzQHtIxgG0IjP8ATOqJgQ</recordid><startdate>201209</startdate><enddate>201209</enddate><creator>Sanz, Ignacio, DDS</creator><creator>Alonso, Bettina, DDS, Dr Odont</creator><creator>Carasol, Miguel, MD, DDS</creator><creator>Herrera, David, DDS, Dr Odont</creator><creator>Sanz, Mariano, MD, DDS, Dr Med</creator><general>Mosby, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201209</creationdate><title>Nonsurgical Treatment of Periodontitis</title><author>Sanz, Ignacio, DDS ; Alonso, Bettina, DDS, Dr Odont ; Carasol, Miguel, MD, DDS ; Herrera, David, DDS, Dr Odont ; Sanz, Mariano, MD, DDS, Dr Med</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c335t-2a72cd168d8e13b5f0cffadf179bd99380851889fb56977eebe6bfb2f1450f4d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Anti-Infective Agents, Local</topic><topic>Clinical Protocols</topic><topic>curettes</topic><topic>Dental Instruments</topic><topic>Dental Scaling - instrumentation</topic><topic>Dental Scaling - methods</topic><topic>Dentistry</topic><topic>Humans</topic><topic>laser</topic><topic>nonsurgical therapy</topic><topic>Periodontal Index</topic><topic>Periodontitis</topic><topic>Periodontitis - therapy</topic><topic>power-driven</topic><topic>Root Planing - instrumentation</topic><topic>Root Planing - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sanz, Ignacio, DDS</creatorcontrib><creatorcontrib>Alonso, Bettina, DDS, Dr Odont</creatorcontrib><creatorcontrib>Carasol, Miguel, MD, DDS</creatorcontrib><creatorcontrib>Herrera, David, DDS, Dr Odont</creatorcontrib><creatorcontrib>Sanz, Mariano, MD, DDS, Dr Med</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of evidence-based dental practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sanz, Ignacio, DDS</au><au>Alonso, Bettina, DDS, Dr Odont</au><au>Carasol, Miguel, MD, DDS</au><au>Herrera, David, DDS, Dr Odont</au><au>Sanz, Mariano, MD, DDS, Dr Med</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nonsurgical Treatment of Periodontitis</atitle><jtitle>The journal of evidence-based dental practice</jtitle><addtitle>J Evid Based Dent Pract</addtitle><date>2012-09</date><risdate>2012</risdate><volume>12</volume><issue>3</issue><spage>76</spage><epage>86</epage><pages>76-86</pages><issn>1532-3382</issn><eissn>1532-3390</eissn><abstract>Abstract Context. Scaling and root planing (SRP) is the gold standard treatment for most patients with chronic periodontitis. Nevertheless, in the last years, different therapeutic strategies have been proposed to improve the results of SRP and hence to avoid the need of periodontal surgical interventions in some patients with advanced periodontitis. They are based on modifications of standard therapies (such as enhancement of instrument tip designs), on development of new technologies (such as lasers), or development of alternative treatment protocols (eg, full-mouth disinfection). The purpose of this review is, therefore, to update the scientific evidence based on randomized clinical trials (RCT) evaluating these advanced nonsurgical therapies that have been published between January 2010 and March 2012. Evidence Acquisition. RCTs published between January 2010 and March 2012 have been selected. Previous systematic reviews were used as a start point. Three distinct aspects were evaluated independently: the modification of conventional instruments, the advent of new technologies, and the development of new treatment protocols. Evidence Synthesis. Twenty-two publications were selected: 4 were related to modifications of standard therapies (new tip designs and local anesthetics), 14 to new technologies (new ultrasonic devices, air abrasive systems, endoscope and lasers), and 4 to new treatment protocols. Conclusions. These technological advances and the development of new protocols may improve patient-related outcomes and cost-effectiveness, although they have not shown significant differences in efficacy when compared with conventional SRP.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>23040340</pmid><doi>10.1016/S1532-3382(12)70019-2</doi><tpages>11</tpages></addata></record> |
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subjects | Anti-Infective Agents, Local Clinical Protocols curettes Dental Instruments Dental Scaling - instrumentation Dental Scaling - methods Dentistry Humans laser nonsurgical therapy Periodontal Index Periodontitis Periodontitis - therapy power-driven Root Planing - instrumentation Root Planing - methods Treatment Outcome |
title | Nonsurgical Treatment of Periodontitis |
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