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Periodontitis treatment has come a long way, but dental professionals still debate which approach works best for deep pocket reduction and long-term oral health. A recent randomized trial by Cyris et al. (2024) sheds new light on how Guided Biofilm Therapy (GBT) compares to conventional protocols for non-surgical periodontal therapy (NSPT) in patients with advanced periodontitis—using inexperienced operators under supervision.
The study was set up with 60 patients suffering from generalized stage III/IV periodontitis. In a split-mouth RCT, quadrants were randomly assigned to either:
Treatments were performed by dental students under supervision, with close calibration, and outcomes were measured five months post-therapy. Key variables included pocket probing depth (PPD), bleeding on probing (BOP), gingival recession (GR), clinical attachment loss (CAL), treatment time, and patient pain scores.
Cyris et al. found no significant difference in clinical attachment gain, pocket closure rates, or pain between GBT and conventional therapy in advanced periodontitis cases when standardized operator training is provided. The only meaningful difference was shorter treatment times for GBT—a small but potentially valuable advantage in busy clinics or educational settings.
The trial ran for five months—longer-term studies could reveal deeper differences in clinical outcomes or recurrence rates. Split-mouth designs control for patient variables but aren’t perfect; future research may clarify microbial shifts or protocol efficacy in smokers and patients with systemic disease.
Bottom Line: For stage III-IV periodontitis, GBT and conventional NSPT both deliver strong results. GBT offers a slightly faster workflow, but clinical gains are comparable—suggesting protocol choice can be tailored to patient and practice needs.
Cyris M, Festerling J, Kahl M, Springer C, Dörfer CE, Graetz C. Guided biofilm therapy versus conventional protocol-clinical outcomes in non-surgical periodontal therapy. BMC Oral Health. 2024 Sep 18;24(1):1105. doi: 10.1186/s12903-024-04898-z. PMID: 39294663; PMCID: PMC11409476.
