Department of Periodontology, University of Berne, Berne, Switzerland.
Periodontol 2000. 2019 Feb;79(1):15-21. doi: 10.1111/prd.12240. Epub 2019 Mar 19.
As periodontal and peri-implant diseases represent opportunistic infections, antiinfective therapy is the method of choice. Correctly performed, the treatment outcomes will include resolution of the inflammation concomitant with shrinkage of the tissues, reflected in reduced probing depths. Depending on the patient data obtained after initial antiinfective therapy, further - mostly surgical - treatment may be rendered to reach the goals of a healthy periodontium and peri-implant tissues. Patient compliance is as important as operator skills for optimal treatment outcomes. Regenerative therapy may be applied in compliant patients and for appropriate defects. This article depicts the historical development of periodontal therapy during the 20th century and addresses the various outcome parameters to be used in daily decision making. Obviously, nonsurgical therapy has gained clinical relevance, resulting in highly satisfactory treatment outcomes in many cases. The critical probing depth above which positive attachment gain is registered varies from one treatment modality to another. It is a concept that helps facilitate decision making for additional therapeutic measures after initial therapy. Treatment of peri-implant mucositis prevents development of peri-implantitis. Hence, nonsurgical treatment of mucositis is frequently performed during the continuous monitoring of oral implants. This chapter of Periodontology 2000 presents evidence for the prevention and therapy of peri-implant diseases.
由于牙周炎和种植体周围炎是机会性感染，抗感染治疗是首选方法。如果正确实施，治疗结果将包括炎症的消退以及组织的收缩，这反映在探测深度的减少上。根据初始抗感染治疗后获得的患者数据，可能需要进一步的——主要是手术的——治疗，以达到健康牙周组织和种植体周围组织的目标。患者的配合与医生的技能一样，对于获得最佳的治疗效果非常重要。在依从性好的患者和适当的缺损情况下，可以应用再生治疗。本文描述了 20 世纪牙周病治疗的历史发展，并介绍了各种用于日常决策的治疗结果参数。显然，非手术治疗已经获得了临床意义，在许多情况下都取得了非常满意的治疗效果。临界探诊深度是指在该深度以上可记录到附着体的正向获得，不同的治疗方法其临界探诊深度也不同。这一概念有助于在初始治疗后做出是否需要进一步治疗的决策。种植体周围黏膜炎的治疗可以预防种植体周围炎的发生。因此，在对口腔种植体进行持续监测时，通常会对种植体周围黏膜炎进行非手术治疗。《牙周病学 2000》的这一章介绍了预防和治疗种植体周围疾病的证据。
