Effectiveness of Non-Surgical Periodontal Therapy in the Management of Chronic Periodontitis

Abstract

Background: Non-surgical periodontal therapy, comprising oral hygiene instruction, risk-factor control and subgingival instrumentation, is the first-line treatment for periodontitis. Its effectiveness varies between patients and sites, and identifying the factors that influence outcome can guide treatment planning. Aim: To evaluate the clinical effectiveness of non-surgical periodontal therapy in adults with chronic periodontitis (stage II–III periodontitis under the 2017 classification) and to identify patient- and site-level factors associated with pocket closure. Materials and methods: In this prospective interventional study, [n] adults with stage II–III periodontitis attending [institution] received oral hygiene instruction, supragingival cleaning and quadrant-wise subgingival instrumentation completed within [two weeks]. Plaque Index, Gingival Index, bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline and at [6 weeks] and [3 months] after therapy. Pocket closure was defined as PPD ≤ 4 mm without BOP. Changes were analysed with repeated-measures ANOVA, and factors associated with pocket closure were assessed with multilevel logistic regression. Results: Mean PPD decreased from [X.XX ± SD] mm at baseline to [X.XX ± SD] mm at 3 months, and mean CAL improved by [X.XX] mm (p [< 0.001]). Full-mouth BOP fell from [XX]% to [XX]%. Pocket closure was achieved in [XX] % of sites with initial PPD ≥ 5 mm. [Smoking (OR [X.XX]), poorly controlled diabetes (OR [X.XX]), initial PPD ≥ 7 mm (OR [X.XX]) and molar furcation sites (OR [X.XX])] were associated with a lower likelihood of pocket closure. Conclusion: [Non-surgical periodontal therapy produced significant clinical improvements and closed most moderate pockets.] Outcomes were poorer in smokers, patients with uncontrolled diabetes, deep pockets and molar sites, which should be considered in treatment planning and in deciding the need for further therapy.