Eduard Aghasyan1, Lazar Yessayan DMS, PhD2, Boyapati Ramanarayana BDS, MDS3, Curd Bollen DDS, PhD, MSc4, Hakob Khachatryan DDS5 and Gagik Hakobyan DMS, PhD6*

Background
Periodontitis is a chronic multifactorial inflammatory disease that is widespread worldwide and, when advanced, leads to tooth loss and reduced quality of life. The etiology of periodontitis is due to the occurrence of pathogenic lesions, inflammatory and immune states of the host and systemic risk factors. For effective prevention and treatment of periodontitis, a thorough diagnosis, elimination of causes and reduction of modifiable risk factors are of primary importance.

Objective
The objective this review is to provide current concepts of periodontitis treatment.

Materials and Methods
Inclusion Criteria: included clinical trials that evaluated the effects of using new approaches to periodontitis therapy and written in English.
Data Extraction: A comprehensive electronic literature search was performed in the following databases: PubMed, PMC, Science Direct, and Scopus using the Medical Subject Heading (MeSH) terms: biofilm, oral microbiome, new treatments, essential oils, oral care products, and periodontitis.156 articles were found and 100 full-text articles of high methodological quality were selected.

Results
This review focuses on non-surgical periodontal therapy (NSPT) (subgingival treatment, laser therapy and photodynamic therapy) and adjunctive chemotherapeutic approaches such as systemic and topical antibiotics and antiseptics, subgingival pocket irrigation.

Studies have demonstrated the effectiveness of non-surgical periodontal therapy in reducing clinical parameters such as probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PI). For successful prevention and treatment of periodontitis, the following are of primary importance: Careful diagnosis, elimination of causes and reduction of modifiable risk factor.

Conclusions
The long-term success of periodontal therapy depends on maintaining good oral hygiene and adhering to regular periodontal maintenance visits. This highlights the need for ongoing periodontal care even after initial treatment.

Keywords: periodontal disease, biofilm, dental plaque, oral hygiene, non-surgical periodontal therapy.

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