SEMINAR – SUPPORTIVE PERIODONTAL

THERAPY

GUIDED BY-
Dr. P.V Sunil Reddy (Professor & Hod)
Presented By-
Dr. Shailendra S. Chaturvedi (Reader)
Dr. Palak Sharma
Dr. Pramod V.(Reader)
PG Student
Dr. Hiroj Bagde(Reader)
Dr. Abhilasha Singh
 CONTENTS
 INTRODUCTION
 RATIONALE OF PERIODONTAL THERAPY
 GOALS OF SPT
 OBJECTIVES OF PERIODONTAL THERAPY
 TYPES OF MAINTENANCE PROGRAM
 POST TREATMENT MAINTENANCE PROGRAM
 MERINS CLASSIFICATION
 EFFECTIVENESS OF SPT IN GINGIVITIS
 EFFECTIVENESS OF SPT IN PERIODONTITIS
 COMPLAINCE AFFECTING SPT
 MAINTENANCE OF IMPLANT
 COMPLICATION OF SPT
 CONCLUSION
 REFRENCES
 Introduction

Definition
Procedures performed at selected intervals to assist
the periodontal patient in maintaining oral health.
-GPT 2001.

Therapeutic measures to support the patient’s own

efforts to control and to avoid re‐infection. - Jan
Lindhe.
Correct sequence of treatment
 Rationale for SPT

1. Limitation of mechanical subgingival debridement

2. Recolonization of pocket

3. Long JE (weak attachment)

4. Subgingival scaling alters the microflora of periodontal

pockets

5. To prevent interception
 Goals Of SPT

3 main goals according to the AAP position paper

(1998)

1. To prevent or minimize the recurrence and

progression of periodontal disease in patients
who have been previously treated for gingivitis,
periodontitis and for peri-implantitis.
2. To prevent or reduce the incidence of tooth
loss by monitoring the dentition.

3. To locate and treat other diseases or

conditions found in the oral cavity in a
timely manner
 Objectives of SPT
periodontal
Preservatio
n of bone
support

Reinforceme
nt of proper
home care.

Maintenan
ce of stable
CAL

Maintenance
of a healthy
and functional
oral
environment
 Objectives of SPT
General

Assessment
of the general
health status

Encouragemen
t of patients
oral hygiene
efforts

Establishment
of the future
maintenance
regime

Continuatio
n of patient
education
 Schallhorn and Snider (1981)
1. Preventive maintenance therapy

Periodontally healthy individuals.

2. Trial maintenance therapy

Mild to moderate periodontitis.

3. Compromised maintenance therapy

Medically compromised patients where active therapy is not

possible.

4. Post-maintenance treatment therapy

Maintenance for prevention of recurrence of disease

Maintenance Program (Carranza)
 Examination and Evaluation
• Patient greeting
• Medical history changes
• Oral hygiene status
• Gingival changes
• Pocket depth changes
• Mobility changes
• Occlusal changes
• Dental caries
• Oral pa Restorative, prosthetic, and implant
status thologic examination
Microbial testing
 Part-2: Maintenance treatment and
Oral hygiene reinforcement

• Oral hygiene reinforcement

• Scaling

• Polishing

• Chemical irrigation or site-specific

antimicrobial placement
 Part-3: Report, Cleanup, and Scheduling
Write report in chart.

 Discuss report with patient.

 Clean and disinfect operatory.
 Schedule next recall visit.
 Schedule further periodontal treatment.
 Schedule or refer for restorative or
SPT programme (Lindhe)
Whom to refer to periodontist?

A B C
Effectiveness of SPT (for patients with Gingivitis)

Axelsson
and Lindhe
(1974-
1976)
Lovdal Baderste
et al. n et al.
1961 (1990)

Lisrgard Suomi et
en 1982 al. 1971
Effectiveness of SPT (for patients with Periodontitis)

Bragger et al

Axellson et al

Nyman et al
 Periodontal Risk Assessment (PRA) for Patients in
Supportive Periodontal Therapy (SPT)

Tonetti – model
 Subject level risk
assessment
 Tooth level risk assessment
 Site level risk assessment
 Compliance affecting SPT
Wilson stated that
“Patients who comply to suggested recall visits are
periodontally healthy and keep their teeth
longer.”
 Improving compliance

• Wilson suggests:

• Counseling them about their condition, the role of

treatment and the importance of compliance

• Simplify instructions to patients

• Teach them self performed plaque control
• Accommodating patient needs

• Positive reinforcement
Maintenance of Implants
Procedures for maintenance of
implant is similar to teeth except
1. Special instrument not to scratch
●

implant for calculus removal.

2. Acidic fluroide prophylactic is

●

avoided

3. Nonabrasive porphypaste is
●

used
 Maintenance intervals for implant patients

1. Patients with both teeth and implants should

see the periodontist as often as necessary to
keep the periodontium and peri-implant
tissues healthy.
2. Totally edentulous patients with implants
should be seen at least once per year
 Complication of SPT
 Root caries
 Endodontic lessions- periapical lessions
 Periodontal abscess
 Root senstivity
 Conclusion

Supportive periodontal therapy or maintenance

program is key of success for periodontal

treatment in long term with least reoccurrence and

progression of periodontal problem and long term

satisfactory results for future.

 References:
 Newman MG,Takai HH, Kookkevold PR, Carranza FA. Supportive

Periodontal Therapy. In: Merin RL. Carranzas Clinical Periodontology,11th

Edi.Mosby,saunder:elsevier:2011 P.G. 1188-1192.

 American Academy of Periodontology. Glossary of Periodontal Terms. 4th

ed. Chicago: American Academy of Periodontology; 2001. p. 39.

 Kerry GJ. Supportive periodontal treatment. Periodontology 2000, vol. 9,

1995, 176-185.

 Renvert S. Supportive periodontal therapy. Periodontology 2000, vol. 36,

2004, 179–195.
 Hancock EB. Preventive strategies and supportive treatment.

Periodontology 2000, vol. 25, 2001, 59–76. • Wilson TG Jr.

Supportive periodontal treatment introduction - definition, extent

of need, therapeutic objectives, frequency and efficacv.

Periodontology 2000, vol. 12, 1996, 11-15.

 Slots J. Microbial analysis in supportive periodontal treatment.

Periodontology 2000. Voz. 12, 1996, 56-59.

 FarooqiAO. Appropriate recall interval for periodontal

maintenance: A systematic review. J evid base dent pract

2015;15:171-181.