8. Conclusion

The nature of periodontal disease can be summarised as an imbalance in the host-parasite balance.
However, while individual susceptibility always plays a role, it is the bacterial factor that pulls the trigger.

Today, the understanding of the host's defence mechanisms is still insufficient to hope to interfere with the immune system. The success of the treatment therefore depends on the control of this bacterial factor.
We have seen that a number of risk factors are involved to varying degrees in the host response.
Most of these factors can be modulated and their management, in conjunction with periodontal cleaning, completes the therapeutic arsenal and increases the chances of success of our treatment and maintenance.

To conclude this article, it should also be remembered that periodontal disease is also a risk factor for other systemic diseases.
Indeed, periodontal pathogens, their products or the inflammatory response they provoke, can lead to systemic repercussions (cardiovascular, respiratory,...) (Mealey et al, 1999; Kinane et al, 2000).

Such hypotheses should force us to review our responsibility for the overall health of our patients. In this perspective, prevention must remain the cornerstone of our practice.
But to this end and to optimise this action, communication and coordination between doctors and dentists (general practitioners and specialists) must be further improved.

The focus of this article is essentially clinical, and each point can of course be discussed and qualified in the light of the abundant literature on the subject.

  1. Lindhe J., Niklaus L.. Clinical Periodontology and Implant Dentistry. Blackwell Munksgaard, 4ième edition, 2003.
  2. Bercy P., Tenenbaum H. – Parodontologie. Du diagnostic à la pratique. De Boeck Université, 1996.
  3. Genon P., Romagna Ch. Le traitement parodontal raisonné. Editions CdP, 1999.
  4. Didri S., Lallam C. Les réévaluations et l’orientation thérapeutique en parodontite. Rev Odont Stomat, 2002; 193-210.
  5. Herbert F. Wolf, Rateischak E. et K. Atlas de Parodontologie. Masson, 3ième édition, 2004.
  6. Danan M., Fontanel F. Parodontites sévères et orthodontie. Edition Cdp, 2004.
  7. Drisko CH. Nonsurgical periodontal therapy. Periodontol 2000, 2001 ; 25 :77-88
  8. Cobb CM. Clinical significance of non-surgical periodontal therapy: an evidence-based perspective of scaling and root planing. J Clin Periodontol, 2002 May ; 29 Suppl2 :6-16

Olivier FRANCOIS
Dentiste spécialiste en Parodontologie
D.E.S. Implatologie (ULg)
Pratique Privée

7. Treatment plan