Periodontal follow-up and reevaluation

In order to assess the response to non-surgical periodontal therapy, a careful reevaluation and reassessment of all relevant parameters is required. If the periodontal follow-up status and control analysis indicate a satisfactory outcome, the patient can be transferred to the maintenance phase.

After non-surgical periodontal therapy, wound healing is monitored and clinical status assessed every 2 weeks. This is necessary because unforeseeable events such as abscess formation or the like can influence the healing process.

Periodontal follow-up status

The final reevaluation of the results of the non-surgical periodontal therapy takes place after 6-8 weeks. It is not until this point that a significant improvement in the clinical parameters can be expected. An evaluation of the periodontal follow-up status is carried out and the response to the treatment so far is assessed. Plaque and bleeding scores should have gone down along with a reduction in any tooth mobility, and pus discharge should no longer be present. There should have been a significant reduction in probing depths.

Control analysis

In addition, a microbiological control analysis with micro-IDent®/micro-IDent®plus is useful as part of this reevaluation. This testing helps to verify the effectiveness of the treatment measures in reducing bacteria numbers and to document the response to treatment. The results of the control analysis together with the clinical findings form the basis for decision-making regarding whether further treatment measures are necessary. If the critical review of the treatment results is positive overall, the patient can be discharged into the maintenance phase. If the results of this review are unsatisfactory, on the other hand, further measures are needed.

Further therapy

Surgical treatment options should be considered if pockets ≥ 5.5 mm are present on specific teeth both at baseline and at follow-up. In particular, if a microbiological control analysis shows a persistent bacterial load after non-surgical treatment, removal of the subgingival biofilm under direct vision is indicated.

Individual risk of inflammation

If the clinical parameters are persistently poor despite a marked reduction in the numbers of bacteria, an analysis of the individual risk of inflammation with GenoType IL-1 is recommended at this point if not before. Because the immune system of patients with interleukin-1 gene mutations can be very sensitive even to small quantities of bacteria. In the presence of a genetic predisposition, the treatment is adapted to the patient’s risk profile, e.g. by shortening the recall intervals. Unlike a marker bacteria analysis, human genetic testing only has to be carried out once in a person’s lifetime, because a person’s genetic background does not change.