Non Surgical Treatment of Periodontal Disease

Periodontitis is an infectious disease caused by a set of bacteria. The microorganisms invade the support structure of the teeth causing a chronic inflammation. The affected tissue (boney tissue, gums, periodontal ligament) suffers damage that could be different with stimulus being equal, and is dependent on the different immune responses of each individual. The development of periodontitis could cause a loss of teeth with time.

The first visible signs are generally: the bleeding of the gums, recession of the gums (uncovered roots), the movement of one or more teeth, and their change of position.

Thanks to the systemic use and combination of the operating microscope and laser, it is possible to cure the periodontitis without resorting to surgery.

The microscope allows for the treatment of roots avoiding opening the gums. The laser permits the elimination of pathogens bacteria even in areas which cannot be reached with drugs.

Traditional surgical treatment

• It does not radically eliminate pathogen bacteria, healing incomplete with the possibility of relapse.
• It assumes the execution of endodontic and prosthetic treatments (devitalization, bridges and crowns).
• It may leave the teeth's roots uncovered, creating noticeable esthetic damage and problems of sensitivity;
• It difficulty controls the following types of periodontitis: juvenile, aggressive, and particularly those defined as resistant to therapy.

Advantages of non surgical treatment

• Anesthesia is not needed
• It immediately eliminates the bleeding of the gums
• It eliminates the discomfort of surgery
• It reduces and/or eliminates movement of teeth
• It seals surgical pockets
• It regenerates periodontal tissues: bones and ligaments
• It has a greater index of success
• It allows for an easy solution in cases of relapse
• It reduces biological costs
• It reduces economic costs

The New Diagnostic Approach Today, in the tradition of clinical diagnosis and radiography, sophisticated molecular biological analyses are collaborating. It is therefore possible to plan out an effective treatment based on objective data from the laboratory.

The new Therapeutic Approach:

1. The entire treatment is executed with the microscope
2. Thorough decontamination without administration of systemic antibiotics in periodontal pockets
3. Objective validation of the results obtained: pre and post-operation tests
4. Maintenance of the results obtained: simple and immediate treatment of the relapse

Periodontitis and sistemic diseases

Recent and accredited researches shows the existence of a strong correlation between periodontal disease and important sistemic pathologies. The risk of worsening cardiovascular pathologies, diabetes, and premature childbirth is increased in patients with untreated periodontitis.

How samples for the tests are done

The taking of the sample is, in both cases, quick and painless. In the case of the microbiological testing, small absorbent paper cones are inserted in the periodontal pockets. For the genetic testing, a swab is wiped across the inside of the cheek.

Microbiological testing Microbiological tests allow us to characterize, from a qualitative as well as quantitative point of view, the bacterial population present during different phases of the treatment. This represents an indispensable instrument for a proper treatment

Genetic testing

Genetic testing provides information on the immune response of the patient, indicating a hereditary predisposition. In this way different risk profiles are defined for the development of periodontitis or of serious and unresponsive to the theray forms. In candidates for implantation it marks an increased risk for failure. For recovering patients, genetic testing is important in order to formulate a maintenance plan.

Clinical Evaluation of the Healing Process

The first phase of the healing process is easily recognizable by the patients themselves who see: pus from the lesion disappears, blood from the gums disappears (both spontaneous and provoked), the movement of the elements that will be mantained decreases or disappears. These effects are evident during the first weeks of the treatment (2-3 months).
During the middle 6-24 month period, along with the stabilization and successive slow improvement of the first clinical results, that which could be considered the real periodontitis healing phase takes place; this consists of the closing of the pockets, with consequent reformation of the periodontal attack, and the partial regeneration of tissues destroyed during the inflammatory process.
The regeneration of support tissues, especially boney tissue, is generally very evident with radiographic, and proceeds along with a decrease in the deepness of the periodontal pockets.
The rapidity of regeneration of tissues and the stabilization of the periodontitis, like the maintenance protocol, is defined based on genetic analysis which is done in order to evaluate each person's individual risk profile for the disease.
Within the first 36 months of treatment, the periodontal disease becomes eradicated, if the patient strictly follows the maintenance protocol at home as well as the professional maintenance with the hygienist.
The final phase of the healing process could bring about the spontaneous repositioning of the teeth that were previously dislocated and causing serious esthetic and functional damage.