Guided biofilm therapy: A novel approach in professional dental biofilm management

Abstract

There are many different kinds of microorganisms that live in the oral cavity, from good ones to those that could be harmful. It is a well-established fact that periodontal diseases are linked to dental plaque. A biofilm is a community of microcolonies of microorganisms in an aqueous solution that is surrounded by a glycocalyx matrix. This matrix also binds the bacterial cells to a solid substratum (surface), which can be hard or soft tissues or inanimate surfaces such as clear aligners, prosthetics, or orthodontic bands of the oral cavity. Although scaling and root planing (SRP) is considered the gold standard for mechanical plaque debridement, it also has some drawbacks, such as inaccessibility to deeper areas on the root surfaces and patient discomfort, including root hypersensitivity. To overcome these disadvantages, minimally invasive nonsurgical approaches have been introduced. One such novel alternative is guided biofilm therapy (GBT), which uses a disclosing agent to visualize the biofilm before removing it with a specialized air-abrasive powder and removing supra- and subgingival calculus with specialized instruments. Biofilm can be effectively removed around an implant or tooth with GBT. As a component of either supportive periodontal therapy or nonsurgical periodontal therapy, GBT was found to have a lower perception of pain and better patient compliance than SRP. GBT, as a monotherapy, can be advised as a basic treatment plan for teeth and implants. The various aspects of GBT in the management of periodontal and peri-implant diseases will be highlighted in this review.

Keywords

• air polishing
• biofilm
• disclosing agents
• guided biofilm therapy