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Periodontal maintenance – overcoming the barriers

From Volume 38, Issue 1, January 2011 | Pages 38-48

Authors

Øystein Fardal

BDS, MDS, PhD, DipPerio, MRCD(C)

Private practice, Egersund, Norway

Articles by Øystein Fardal

Abstract

Periodontal maintenance therapy is the most important stage of periodontal treatment, yet compliance is low. Overcoming the barriers associated with the low compliance involves a complex set of problems relating to the patient, the clinician and the interactions between them. It is therefore important to create a periodontal maintenance treatment programme which takes into consideration the needs of each individual patient. In addition, regional variations and differences in practice profiles are also factors to be accommodated in a maintenance programme.

Clinical Relevance: Good co-operation between the referring dentist and the specialist is required when recommendations are made to the patient regarding maintenance therapy.

Article

Chronic periodontal disease is a microbial disease that triggers the host's inflammatory responses, resulting in the destruction of tooth-supporting structures.

The initial definitive periodontal treatment or cause related therapy (CRT) aims to control the infection. The treatment consists initially of oral hygiene instruction and the non-surgical removal of sub- and supra-gingival calculus and bacterial deposits. Periodontal surgery may be required to access areas beyond the reach of non-surgical treatment. Surgery may also be used in attempting to regenerate lost tissue.

Owing to the chronic nature of periodontal disease, continuous monitoring and therapy are required to prevent recurrence. The follow-up treatment is usually life-long and referred to as supportive periodontal therapy (SPT) or periodontal maintenance treatment (PM). The frequency of SPT visits may be from one to six times per year. SPT includes the following:

Re-treatment usually includes some stages of the initial periodontal therapy. Strategic extraction(s), root resection, stabilization of the occlusion, antibiotic therapy and modification of systemic factors are sometimes carried out during CRT, but are usually parts of the SPT.

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