Treatment
Phase 1 — Cause-Related Therapy
Non-surgical periodontal therapy
- • Oral hygiene instruction: individualised technique (modified Bass, interdental brushes, floss)
- • Full-mouth scaling and root planing (SRP) — ultrasonic + hand instruments
- • Remove plaque-retentive factors (calculus, overhangs)
- • Smoking cessation counselling; diabetes optimisation
Re-evaluation (6–8 weeks post-SRP)
Reassess periodontal response
- • Repeat full-mouth periodontal charting
- • Residual pockets ≥5mm with BOP → surgical referral
- • Assess patient compliance
Corrective Phase (Surgery if indicated)
Periodontal surgery for residual disease
- • Resective surgery: osseous resection, pocket reduction flap
- • Regenerative surgery: bone grafts + GTR membranes + EMD (Emdogain) for vertical defects
- • Mucogingival surgery: CTG for recession coverage
Supportive Periodontal Therapy (SPT)
Lifelong maintenance
- • Quarterly for high-risk patients; 6-monthly for well-controlled cases
- • OHI reinforcement, targeted SRP, radiographic monitoring