Guided Biofilm Therapy as a Paradigm Shift in Periodontal and Peri-Implant Care: An Integrative Review

Abstract

Background: Dental biofilm is a primary etiological factor in the development of periodontal and peri-implant diseases. Traditional methods of plaque removal, such as scaling and root planing (SRP) and toothbrushing, exhibit certain limitations. Guided Biofilm Therapy (GBT) integrates visual disclosure, air-polishing, and ultrasonic instrumentation for effective biofilm management. 
Objectives: This review aims to assess the evidence supporting GBT as a therapeutic modality, evaluate its clinical efficacy in comparison to conventional methods, and explore its applications in the management of periodontal and peri-implant diseases. 
Methods: A comprehensive literature search was conducted using PubMed  and Google Scholar from  2016 to  2024. Search terms included "guided biofilm therapy," "air-polishing," "erythritol," and related terms. Inclusion criteria encompassed randomized controlled trials, clinical trials, and peer-reviewed research published in English. Data extraction focused on clinical efficacy, microbiological outcomes, patient perception, and comparative effectiveness. 
Key Findings: GBT demonstrates a 49-60% greater reduction in plaque on gingival surfaces compared to conventional methods and requires 15% less chairside time than SRP while achieving equivalent outcomes. It enhances patient education and is applicable in both periodontal and peri-implant disease management. 
Conclusions: GBT represents a paradigm shift in biofilm management, offering superior efficacy and improved patient satisfaction. Long-term trials and health economic analyses are necessary to establish its definitive role in dental practice.

Bangladesh Journal of Dental Research & Education 

official publication of Bangladesh Academy of Dentistry International (BADI)®