Modern approach of periodontal treatment

The World Health Organization has described 3 levels of prevention: primary prevention of the healthy carrier, secondary prevention of our gingivitis and tertiary prevention for periodontal diseases. During this conference, we will see how the mastery of the ultrasonic technology will allow us to respond to all the different levels of prevention without using analgesia and antiseptics. We will speak about different ultrasonic technology to respect the therapeutic gradient and provide the best care to our patient in surgical and non surgical treatment. I suggest to dive into the world of periodontics in order to offer our patients ever less invasive therapy and secure treatment during implantology.

Periodontal diseases are inflammatory pathologies whose etiology is infectious. They are initiated in response to a dysbiosis between the organism and the microbiota. By overflowing the body's defenses, microbiota allows to initiate and then continue the development of the pathology.
These resolutely chronic diseases cannot be cured, however, it is now possible for us to prevent them and stop their evolution.
Various tools have been proposed to regain control of the infection by allowing disorganization of the bacterial biofilm. While many of these tools will allow healing, some will be more harmful than others to the periodontal tissues and in particular the cementum.
The respect of the therapeutic gradient, both in terms of biological cost for the preservation of the tissues but also monetary for the practitioner and the patient, directs us towards a reasoned and evidence-based management in the context of the treatment of periodontal diseases.
If manual curettes will be banned because of their aggressiveness and their complete lack of therapeutic objective, we will see how to master the potential of ultrasound to set up treatments that are less invasive, painless, without anesthesia and perfectly meeting the need for tissue preservation. and periodontal healing.
The decontamination capacity of ultrasound thanks to cavitation, allows us to do without chemical supplementation.
If the Erbium-Yag laser has shown in the literature its ability to remove subgingival calculus and perform subgingival decontamination superior to ultrasonic system, the material and biological cost ranks it after ultrasonic technology. It will be placed secondarily if necessary in order to perfect the result and to minimize the need for surgery or limit the extent of the flap. Finally, we will see that minimal invasive surgery retains all its appeal in the management of intraosseous defects, in order to restore a bone architecture compatible with the healing of periodontal tissues. The contribution of regeneration materials will also be discussed to simplify the protocols and strengthen the connective tissue, which guarantees clinical success for our patients.
Controlling the therapeutic gradient will prevent the incidence of periodontal diseases and offer a reasoned choice in the treatment of our patients.