Drisko Connie L
GRU & GRHS Leadership Academy (GLA), Georgia Regents University, Augusta, GA 30912, USA.
J Evid Based Dent Pract. 2014 Jun;14 Suppl:33-41.e1. doi: 10.1016/j.jebdp.2014.02.007. Epub 2014 Feb 15.
Periodontal debridement (PD) remains a gold standard for the treatment of inflammatory periodontitis.
BACKGROUND/PURPOSE: The evidence base regarding the causal relationship between oral biofilm and the host inflammatory response to the etiology of periodontal disease has substantially increased over the years. What has not changed significantly during that time is the conservative manner in which the disease can be treated with periodontal debridement (PD). Since dental hygienists, in particular, specialize in providing these procedures it is important to evaluate the evidence that supports periodontal debridement as a primary and fundamental treatment modality.
An extensive narrative literature review that included systematic reviews, examined traditional PD, the use of adjuncts to enhance PD and newer PD procedures to determine what are the best practices for achieving optimal clinical outcomes.
Compared to surgical therapy, PD results in maintenance of attachment levels over time, but is not as effective in the initial reduction of probing depths in deep pockets. Sustained release local drug delivery agents have some modest adjunctive effects when used with PD, as do systemic antibiotics in aggressive periodontitis cases. Reported analyses of the long term effects of chemotherapeutic agents usually do not extend beyond a few months to a year. While laser therapy is still under investigation it remains as a potential PD therapy. New instruments being refined to better visualize the root surface either non-surgically or with mini papilla reflection flaps, hold promise for the future when they become more affordable and accessible. Despite the development of new technology, it still appears that periodontal debridement (PD) remains the gold standard for the treatment of inflammatory periodontitis.
牙周洁治术（PD）仍是治疗炎症性牙周炎的金标准。
背景/目的：多年来，关于口腔生物膜与宿主对牙周病病因的炎症反应之间因果关系的证据基础有了大幅增加。在此期间没有显著变化的是用牙周洁治术（PD）治疗该疾病的保守方式。由于特别是牙科保健员专门从事提供这些程序，评估支持牙周洁治术作为主要和基本治疗方式的证据很重要。
进行了广泛的叙述性文献综述，包括系统评价，研究传统的PD、增强PD的辅助手段的使用以及更新的PD程序，以确定实现最佳临床结果的最佳做法。
与手术治疗相比，PD随着时间推移能维持附着水平，但在最初减少深牙周袋探诊深度方面效果不佳。缓释局部给药制剂与PD联合使用时有一些适度的辅助作用，在侵袭性牙周炎病例中全身使用抗生素也有同样效果。报道的对化疗药物长期效果的分析通常不超过几个月到一年。虽然激光治疗仍在研究中，但它仍是一种潜在的PD治疗方法。正在改进的新器械能更好地非手术可视化根面或通过微小乳头反射瓣可视化根面，当它们变得更经济实惠且易于获得时，未来有望发挥作用。尽管新技术不断发展，但牙周洁治术（PD）似乎仍然是治疗炎症性牙周炎的金标准。
