Cristian Cojocaru, Sorina Mihaela Solomon, Liliana Pasarin, Gabriel Rotundu, Răzvan Gradinariu, Oana Butnaru, Bogdan Vasiliu, Diana Hanu, Ionuț Luchian
ABSTRACT
Periodontal therapy aims to control bacterial infection, control disease progression, and restore the functional and esthetic integrity of the supporting periodontal structures. Over time, two major therapeutic modalities have been established: non-surgical therapy, focused on mechanical debridement and infection control, and surgical therapy, aiming to improve access for debridement, correct anatomical defects, and enhance regenerative outcomes. This review provides an educational overview of both approaches, summarizing their biological principles, clinical indications, techniques, advantages, and limitations. Evidence from recent literature confirms that non-surgical therapy remains the cornerstone of periodontal treatment, leading to significant improvements in inflammation control, pocket depth reduction, and clinical attachment gain. However, surgical interventions become necessary in advanced or non-responsive cases, particularly those involving intrabony defects, furcation involvement, or regenerative needs. The integration of minimally invasive surgical approaches, biomaterials, and patient-centered care further refines clinical outcomes. Understanding the complementary nature of both modalities is essential for evidence-based decision-making and for educating future practitioners in comprehensive periodontal care.
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