Surgical Versus Nonsurgical Treatment of Periodontitis

The treatment of periodontal disease is divided in four steps: initial diagnosis and patient motivation, cause-related nonsurgical therapy, optional surgical intervention, followed by supportive periodontal care. Central aspect of all these stages is the aim to remove (or control) pathogenic biofilm to establish a favorable environment. This chapter focuses on the relative effectiveness and related issues of surgical versus nonsurgical periodontal therapy. Antczak-Bouckoms et al. was one of the first publications relating to investigation of relative effectiveness of surgical versus nonsurgical methods of treatment of periodontal disease. This meta-analysis included the results of five randomized controlled trials deemed suitable by the authors. Tooth loss is one tangible endpoint relevant to periodontal therapy, and based on common sense and clinical experience, one may argue that attachment levels and probing depth are valid surrogate endpoints for assessing the effect of periodontal therapy on tooth loss risk.