Prof. Dr. Bülent Kurtiş

Biofilm-Centered Changing Algorithms in the Treatment of Periodontal and Peri-implant Diseases. “Guided Biofilm Therapy”

The main cause of the periodontal and peri-implant diseases is biofilm which contains lots of pathogenic microorganisms formed and accumulated on the natural teeth and dental implant surfaces. Following with the understanding of the biofilm related destruction mechanism of the supporting periodontal and peri-implant tissues, therapies of periodontal and peri-implant diseases have begun with primarily removing the biofilm and non-surgical phase I periodontal treatment approaches. Although scaling and root planing (SRP) is regarded as a gold standard for mechanical plaque and calculus debridement, it has also some disadvantages such as time consuming procedure, technically demanding and uncomfortable to the patients. Nowadays, various other new techniques oriented to the management of biofilm and debridement have been introduced in the literature. A new concept has emerged known as “Guided Biofilm Therapy” (GBT) and comparable clinical outcomes have been documented with SRP. Main idea of GBT is to enhance and optimize the long term patient motivation and homecare protocols as well as more effective and non-invasive biofilm therapy with both patient and clinician together. Application of disclosing solution as part of GBT workflow is an essential step in identifying biofilm and is quite beneficial for both patient and clinician to see where biofilm is accumulating on the visible portion of the dentition. Other parts of GBT are the systematic professional prophylaxis using air abrasives and ultrasonic technologies for biofilm management. GBT is also provide individual treatment protocols for each patients based on differential diagnosis and risk assessments in order to achieve optimal clinical results. In this lecture, methodical algorithm changes that have emerged in the center of more effective and predictable biofilm removal both in the clinic and home care to increase the effectiveness of phase 1 periodontal treatment will be discussed.