Harrel Stephen K, Cobb Charles M, Sheldon Lee N, Rethman Michael P, Sottosanti John S
Department of Periodontics, Texas A&M College of Dentistry, 3302 Gaston Avenue, Dallas, TX 75246, USA.
Department of Periodontics, School of Dentistry, University of Missouri-Kansas City, 650 East 25th Street, Kansas City, MO 64108, USA.
Dent J (Basel). 2022 Oct 20;10(10):195. doi: 10.3390/dj10100195.
Based on the 2018 classification of periodontal disease, a series of articles have been published describing the decision points of periodontal therapy and how the findings collected at those decision points can be used as guidelines for periodontal therapy. The articles are reviewed with a focus on the finding of inadequate calculus removal at the decision points and how that finding impacts treatment outcomes.
A narrative review of the literature discussing the influence of calculus on inflammation was performed and the effects of inadequate removal of calculus during periodontal therapy were analyzed in light of the 2018 classification of periodontal disease, the decision points of periodontal therapy, and the guidelines of periodontal therapy.
The published literature supports that calculus is a major risk factor for periodontal inflammation. Recent studies indicate that the pathologic risk of calculus goes beyond the retention of biofilm and may represent a different pathophysiologic pathway for periodontal disease separate from the direct action of biofilm. The inadequate removal of calculus is a factor in the failure of periodontal therapy.
The inadequate removal of calculus plays an important role in the frequent failure of non-surgical periodontal therapy to eliminate inflammation.
基于2018年牙周疾病分类，已发表了一系列文章，描述了牙周治疗的决策点以及在这些决策点收集的结果如何用作牙周治疗的指导方针。本文对这些文章进行综述，重点关注决策点处牙石清除不充分的发现以及该发现如何影响治疗结果。
对讨论牙石对炎症影响的文献进行叙述性综述，并根据2018年牙周疾病分类、牙周治疗的决策点和牙周治疗指南，分析牙周治疗期间牙石清除不充分的影响。
已发表的文献支持牙石是牙周炎症的主要危险因素。最近的研究表明，牙石的病理风险超出了生物膜的留存，可能代表了与生物膜直接作用不同的牙周疾病病理生理途径。牙石清除不充分是牙周治疗失败的一个因素。
牙石清除不充分在非手术牙周治疗频繁无法消除炎症中起重要作用。
