Apatzidou Danae Anastasia
Department of Preventive Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Front Oral Biol. 2012;15:99-116. doi: 10.1159/000329674. Epub 2011 Nov 11.
The subgingival dental plaque is a microbial biofilm consisting of highly variable bacterial microcolonies embedded within a self-produced matrix of extracellular polymeric substance. In contrast to microorganisms growing in a planktonic state, the inhabitants of a biofilm are effectively protected within this dense structure from host defense mechanisms and from therapeutic agents, including antimicrobials. The mechanical removal of the microbial biofilm and the establishment of meticulous plaque control measures comprise the key elements for the success of non-surgical periodontal treatment. Ultrasonic devices are effective in disrupting the biofilm, and carefully remove soft and hard deposits from a root surface with minimal trauma to the tooth structure. Controversies and modern trends in non-surgical periodontal therapy - such as quadrant-wise treatment modalities versus full-mouth approaches, hand-versus power-driven instrumentation, and the time frame of non-surgical periodontal therapy - are discussed here in depth in order to provide an insight into modern approaches to non-surgical biofilm management. Clinical, microbiological and immunological findings following different treatment protocols, in addition to cost-effective benefits of these clinical modalities, are discussed.
龈下牙菌斑是一种微生物生物膜,由嵌入自身产生的细胞外聚合物基质中的高度可变的细菌微菌落组成。与以浮游状态生长的微生物不同,生物膜中的微生物在这种致密结构中受到有效保护,免受宿主防御机制和包括抗菌剂在内的治疗剂的影响。机械去除微生物生物膜和建立细致的菌斑控制措施是非手术牙周治疗成功的关键要素。超声设备能有效破坏生物膜,并以对牙齿结构造成最小创伤的方式仔细清除根面上的软硬沉积物。本文深入讨论了非手术牙周治疗中的争议和现代趋势,如象限治疗模式与全口治疗方法、手动器械与动力驱动器械以及非手术牙周治疗的时间框架,以便深入了解非手术生物膜管理的现代方法。还讨论了不同治疗方案后的临床、微生物学和免疫学发现,以及这些临床模式的成本效益。
Front Oral Biol. 2012
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