The impact of gingivitis control on the management of periodontitis

Abstract

The supragingival plaque control need has been sustained by the concept of the periodontal disease as an opportunistic infection. This concept relies on the fact that the supragingival biofilm has been proven to be essential for the establishment of the subgingival biofilm, this opportunity arising through a retro-feeding process between the supragingival biofilm formation and maturation and the inflammatory response. Since decades, the impact of the supragingival plaque control has been recognized as an important factor to modulate the subgingival response, regarding clinical, microbiological, and immunological indicators. These studies collectively underscore the supragingival control as essential not only for prevention of periodontal disease and maintenance of therapy results but also for the treatment of periodontitis, favoring subgingival inflammation reduction as well as the stability of attachment levels. Thus, it can be concluded that an adequate supragingival control is essential for the quality of periodontal therapy, migrating from a second-plan intervention to a unique unquestionable importance.