Nonsurgical periodontal therapy aims to eliminate bacteria from tooth surfaces and gums through scaling and root planing to remove plaque, calculus, and endotoxins. This leads to reduced inflammation and clinical improvements like decreased pocket depth and stabilization of bone loss. Systemic and local antibiotic therapies can further reduce the bacterial load, while lasers kill bacteria without creating a smear layer to improve conditions for tissue reattachment.

1. NON SURGICAL
PERIODONTAL THERAPY

2. • Nonsurgical therapy aims to eliminate both living bacteria in the
microbial biofilm and calcified biofilm microorganisms from the tooth
surface and adjacent soft tissues.
• However, a reduction in inflammation of the periodontium due to a
lesser bacterial load leads to beneficial clinical changes.
• In addition, nonsurgical therapy aims to create an environment in
which the host can more effectively prevent pathogenic microbial
recolonization using personal oral hygiene methods
INTRODUCTION

3. Scaling and Root Planing
The primary objective of (SRP) is to regain gingival health by
completely removing elements that are responsible for the gingival
inflammation (i.e., plaque, calculus, and endotoxins) in the oral
environment

4. Effects of Nonsurgical Therapy on the
Periodontal Tissues
Changes in gingival inflammation

5. Changes in probing pocket depth and clinical attachment level

6. Changes in alveolar bone structures

7. Reduced efficacy in molar furcation defects

8. Chemotherapeutic Agents
Systemic anti-infective therapy (oral antibiotics) and local anti-infective
therapy (placing anti-infective agents directly into the periodontal
pocket) can reduce the bacterial challenge to the periodontium

9. Four generations of antiseptics that includes:
• I generation: Antibiotics, phenols, quaternary ammonium compounds,
and sanguinarine
• II generation: Bisbiguanides, bipyridines, quaternary ammonium
compounds, phenolic compounds, metal ions, halogens, enzymes,
surfactants, oxygenating agents, natural products, urea, amino
alcohols, saliflour, and agents that increases the redox potentials
• III generation: Effective against specific periodontogenic organisms
• IV generation: Probiotics are incorporated in mouthwashes

10. Antibiotics in Periodontics
• Periodontium usually harbors a constellation of putative pathogens
rather than a single species.
• Any effect produced in the sulcus, a systemically administered
antibiotic will produce antimicrobial effects in other areas of the oral
cavity.
• This additional effect will reduce bacterial counts on the tongue and
other mucosal surfaces

11. Most commonly used antibiotics for periodontal organisms are
• Metronidazole
• Amoxicillin
• Tetracycline
• Clindamycin
• Azithromycin
• Ciprofloxacin
• Augmentin.

12. Lasers in Nonsurgical Periodontal Therapy
Laser irradiation has been reported to exhibit bactericidal, and
detoxification effects without producing a smear layer and root surface
treated with laser may, therefore, provide favorable conditions for the
attachment of periodontal tissue.

13. The different types of lasers used are
• CO2
• Neodymium-doped yttrium aluminum garnet (Nd:YAG)
• Erbium-doped yttrium aluminum garnet laser
• Diode laser
• Argon laser

14. Hyperbaric Oxygen Therapy
• HBOT is a method of administering pure oxygen at greater than
atmospheric pressure to a patient to improve or correct conditions.
• HBOT should be used to compliment conventional therapies and
treatments.