Нехірургічні методи лікування генералізованого пародонтиту (огляд літератури)

E. Danko; V. Pantyo

doi:10.33295/1992-576X-2025-5-9

Authors

E. Danko Uzhhorod National University, Uzhhorod, Ukraine https://orcid.org/0000-0002-3997-9311
V. Pantyo Uzhhorod National University, Uzhhorod, Ukraine https://orcid.org/0000-0002-0207-3372

DOI:

https://doi.org/10.33295/1992-576X-2025-5-9

Keywords:

generalized periodontitis, periodontal tissue diseases, periodontitis, non-surgical treatment methods, periodontal pocket, periodontal therapy, scaling and root planning, guided biofilm therapy

Abstract

Topicality. Periodontal diseases are among the most common pathologies in dental practice and have a significant impact on patients’ quality of life. Generalized periodontitis is a multifactorial dystrophic-inflammatory disease, which is accompanied by progressive loss of soft and bone tissues of the periodontium. Untimely diagnosis and lack of adequate therapy lead to complications and tooth loss, which disrupt the chewing function and aesthetics, reducing the social and psychological adaptation of patients. In this regard, it is relevant to thoroughly study modern methods of treating periodontitis, in particular non-surgical approaches that effectively halt the inflammatory process, preserve periodontal tissues, and prevent complications. It is also essential to analyze and assess the effectiveness of the stages of periodontal treatment, their complexity, individualization, and adaptation to each patient’s clinical picture.
This work aimed to analyze scientific literature on methods of non-surgical treatment of periodontal tissue diseases, including generalized periodontitis, to examine the current stages of periodontal therapy, their application across varying degrees of periodontal tissue disease severity, and their associated complications.
Materials and methods. An analysis of scientific literature sources on methods of treating periodontal tissue diseases was conducted using the search engines PubMed, Google Scholar, ResearchGate, and Wiley Online Library. The search keywords were periodontitis, periodontal therapy, non-surgical treatment of periodontitis, Guided Biofilm Therapy, and scaling and root planing.
Results of the study and their discussion. According to the clinical recommendations of the European Federation of Periodontology (EFP), the treatment of periodontitis stages I–III comprises four stages. The first stage is the removal of supragingival biofilm from tooth surfaces and the prevention of its reappearance. The second stage is the removal of subgingival dental deposits and the use of drug treatment. The third stage is repeated periodontal curettage and surgical flap operations. The fourth stage is supportive therapy. The primary method of periodontal therapy is non-surgical periodontal treatment (NSPT), which includes the scaling and root planing (SRP) method using ultrasonic and manual periodontal instruments. A modern trend in periodontology is the use of the Guided Biofilm Therapy (GBT) protocol, which uses dyes to visualize the biofilm and its subsequent removal with air-abrasive systems that minimize tissue trauma.
Systemic antibiotics are used as adjuvant therapy, but their use should be considered due to the risk of antibiotic resistance. The use of probiotics is necessary to restore the oral microflora, reduce the levels of periodontal pathogens and pro-inflammatory cytokines, and prevent complications of periodontal tissue diseases.
Physiotherapy methods are an addition to the complex treatment of periodontitis and, due to their anti-inflammatory and analgesic effects on periodontal tissues, improve blood supply to the gums. The use of platelet concentrates (PRF, I-PRF) plays a vital role in the regenerative treatment of periodontitis, particularly by stimulating cell proliferation and restoring damaged tissues. In turn, the use of hyaluronic acid in the treatment of periodontal diseases has anti-inflammatory, antibacterial, and osteoconductive effects.
Thus, the modern concept of periodontitis treatment is based on a stepwise approach combining mechanical, antibacterial, probiotic, physiotherapeutic, and regenerative methods to eliminate biofilm, control inflammation, and restore periodontal tissues.
Conclusions. Modern treatment of generalized periodontitis should be based on the principles of comprehensiveness, stagedness, and individualization of therapy. This approach involves diagnostics, elimination of biofilm and risk factors, professional hygiene, curettage of periodontal pockets, surgical interventions, rational use of antibacterial drugs, and supportive therapy. Particular attention should be paid to the problem of antibiotic resistance, which can arise from unjustified or uncontrolled antibiotic use. The introduction of modern treatment methods, such as Guided Biofilm Therapy, physiotherapy (laser therapy, ozone therapy, electrophoresis), and biotechnological means (PRF, hyaluronic acid), allows us to improve clinical outcomes, promote tissue regeneration, and ensure long-term stabilization of periodontal status.

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