Treatment options in periodontics: non-surgical therapy
In Periodontics, the fundamental goal is to assess the correct diagnosis in order to plan a custom treatment schedule. Different treatment plans can be drawn according to the final result to be achieved: the non-surgical therapeutic option can achieve extraordinary results and guarantee maintenance of natural dentition in the long term.
A 55 years old male patient presented with class 1 occlusion, tooth mobility, horizontal and angular bone defects with furcation involvement and signs of gingival inflammation.
Img. 3 Radiographic examination was carried out at the beginning of therapy and followed-up for 16 years. At time zero, the patient had intact dentition, meaning no caries, BOP at many sites, considerable mobility of all dental elements, deep pockets, angular and horizontal bone defects and furcation involvement. In images 1, 2 and 3 we can see the evolution through the follow-up time for the different oral sextants.
Img. 4 – Frontal picture. Clinical pictures show how in non-surgical therapy dedication, recalls can make a difference in the patient’s health while preserving dentition. After 16 years of nonsurgical therapy and periodontal maintenance alone, the patient has an intact dental arrangement, no caries, and has gained stability of the teeth despite furcation involvement and considerable bone resorption.
Img. 5 – Posterior areas. Clinical pictures after 16 years of non-surgical therapy show gingival recessions, loss of papillae, abrasions, chipping and discoloration of the tooth surfaces, and presence of diastemata. Slight bleeding of the gingival margin is due to the fact that the photograph was taken right after a session with the dental hygienist. The patient is satisfied with the treatment and has no esthetic concerns. Health and function have been restored and maintained over the course of the years while the esthetic appearance remained practically unchanged.
Though the non-surgical treatment is apparently the simplest therapeutic modality, it requires the greatest dedication, meaning time, focus and specific skills of the operator and the whole dental team.