Periodontology

A healthy periodontium is the biological foundation for the long-term preservation of natural teeth and for the stability of subsequent restorative, orthodontic, surgical and prosthetic treatment.

At Laser Dental Clinic, periodontal treatment is not regarded as a single procedure or merely as “tartar removal”. It is a structured therapeutic process that begins with assessment of the periodontal tissues and the patient’s individual risk, continues with control of infection and inflammation, and aims to achieve and maintain long-term biological and functional stability.

How does periodontal disease develop?

Periodontal diseases are multifactorial inflammatory diseases in which disruption of the balance within the bacterial biofilm around the teeth and the individual inflammatory and immune response of the body play a central role.

In susceptible patients, persistent inflammation may gradually affect not only the gingiva, but also the periodontal attachment and the bone supporting the teeth. The development and rate of progression vary between individuals and may be influenced by genetic susceptibility, general health, smoking, metabolic factors, oral hygiene and other risk factors.

For this reason, periodontal treatment is not limited to removing calculus. Our aim is to control the bacterial biofilm and inflammation, assess the patient’s individual risk and response, and preserve the periodontal tissues and supporting bone as much as possible.

Understanding the condition and individual risk

Periodontal diagnostics include a clinical examination, probing and charting of periodontal pockets, assessment of bleeding, plaque control, gingival recession, tooth mobility, clinical attachment loss and bone changes, supplemented when necessary by appropriate imaging diagnostics.

When indicated, salivary flow, pH and buffering capacity may also be assessed.

In selected clinical cases, diagnostics may be supplemented by comprehensive microbiological and molecular-genetic testing. After a sample is collected from the periodontal pockets, it is analysed in a specialized laboratory for the presence and quantity of 12 periodontally significant microorganisms, as well as genetic markers associated with the individual inflammatory response and susceptibility to progression of periodontal disease.

The results are not interpreted in isolation, but together with the clinical and imaging findings. They may support individualization of treatment, risk assessment and determination of the frequency of subsequent supportive periodontal therapy.

Controlling infection and inflammation

Initial control of bacterial biofilm, infection and inflammation is carried out within the Initial Therapy – Biological Stabilization phase.

This is not limited to the mechanical removal of calculus. Depending on the individual condition, professional biofilm and deposit removal, ultrasonic and gentle instrumentation, AirFlow/AquaCare approaches and treatment of difficult-to-access areas may be combined.

An essential part of this phase is individualized instruction in daily oral care – correct cleaning not only of the teeth and interdental spaces, but also of the gingiva, tongue and accessible mucosal surfaces, using methods and aids appropriate for the individual patient.

When periodontal pockets and the relevant clinical indications are present, specialized therapy may include treatment of root surfaces and periodontal pockets, laser decontamination and laser curettage, as well as individually selected laser protocols.

Treatment may be supplemented with photobiomodulation (PBM), low-level laser therapy, magneto-laser therapy and laser acupuncture according to the specific therapeutic indications.

Reassessing the achieved result

After the therapeutic phase, a follow-up periodontal assessment is performed.

Inflammation and bleeding, periodontal pocket depth, tissue response, the quality of daily oral care and the achieved stability are monitored.

Only after this reassessment is the need for additional non-surgical treatment or progression to surgical and/or regenerative therapy determined.

Surgical and laser periodontal therapy – when necessary

When clinical indications remain after non-surgical therapy, conventional, minimally invasive and laser-assisted periodontal surgical approaches may be applied.

Depending on the specific clinical problem, these may include surgical access for treatment of periodontal tissues and root surfaces, laser periodontal surgery, corrective soft-tissue procedures, gingivectomy and gingivoplasty, clinical crown lengthening and other mucogingival procedures when indicated.

Surgical treatment is not an automatic next step – it is undertaken after reassessment and only when required by the individual clinical situation.

Supporting natural regenerative processes

When clinical conditions are appropriate, regenerative approaches may be used to support the recovery of damaged periodontal tissues.

Depending on the type and morphology of the defect, bone substitute materials, collagen materials and membranes, as well as autologous biological products including PRP/PRF, may be used when indicated.

Preserving stability, function and aesthetics

For periodontally compromised teeth that can be preserved but require additional stabilization, adhesive fibre-reinforced splinting may be used.

When a tooth has an unfavourable prognosis and cannot be predictably preserved, extraction is considered as part of the overall restorative plan.

The extraction site is managed carefully and, according to the specific indications, collagen material, bone substitute material and/or PRP/PRF may be used, followed by adaptation and stabilization of the soft tissues with sutures.

During subsequent soft-tissue and bone healing, the patient is provided with an individually planned temporary solution to preserve function and aesthetics.

Depending on the clinical situation, this may be an adhesive fibre-reinforced temporary restoration or a Kemeny-type temporary partial denture, which allows subsequent adaptation and relining as the tissue contours change.

In other cases, after suture removal and when the tissue condition permits, the abutment teeth may be prepared and a conventional impression or digital scan taken for the fabrication of a chairside, laboratory-made or provisional test bridge.

This allows restoration and monitoring of function and aesthetics during tissue and bone remodelling until the appropriate time for definitive prosthetic rehabilitation.

Assessing functional loading

When functional loading is relevant to the condition and prognosis of the periodontium, periodontal therapy is integrated with assessment of occlusion and neuromuscular function and, when necessary, with the other clinical disciplines of Laser Dental Clinic.

The aim is to preserve the achieved periodontal stability under real functional loading.

Maintaining the result over time

Active treatment does not end when inflammation has been controlled.

After the final assessment, the patient enters an individualized supportive periodontal programme.

The frequency of visits is determined by periodontal status, individual risk profile, response to treatment, quality of daily oral care and changes observed during follow-up.

At follow-up visits, periodontal parameters and biological and functional stability are monitored, and supportive therapy is adapted when necessary.

Our goal

Periodontal treatment is not a single procedure, but a structured process:

Diagnostics → control of infection and inflammation → reassessment → specialized therapy → surgical and regenerative therapy when indicated → functional stabilization → individualized long-term maintenance.

The goal is disease control, the greatest possible preservation of natural teeth, and the creation of a stable biological and functional environment for long-term oral health.