Clinical Relevance of Different Time of Periodontal Re-evaluation

Treatment of periodontitis follows an incremental step approach in which the first step is aimed at modifying patient behavior with the goal of supragingival plaque reduction.

The second step is subgingival instrumentation, performed with different instruments and treatment timing and with or without additional therapies. However, in periodontitis patients, the complete removal of subgingival biofilm and calculus at teeth with deep probing depths (≥6 mm) or complex anatomical surfaces (root concavities, furcations, infra bony pockets) may be difficult, and hence, the endpoints of therapy may not be achieved, and further treatment should be implemented.

The third step of therapy is aimed at treating those areas of the dentition non-responding adequately to the second step of therapy (presence of pockets ≥4 mm with bleeding on probing or presence of deep periodontal pockets [≥5 mm]), with the purpose of gaining further access to subgingival instrumentation, or aiming at regenerating or resecting those lesions that add complexity in the management of periodontitis (intra-bony and furcation lesions).

Periodontal reevaluation is performed after step 2. The case reevaluation, executed after the completion of the first step of periodontal therapy, allows to assess the response to therapy, to specify the prognosis of the case and the possible need for further treatment and, consequently, to finalize and correct the case's periodontal treatment plan.

Many different time intervals, ranging from 2 weeks to 6 months, have been documented in periodontal literature to be the best time to perform reevaluation.