Guided Biofilm Therapy provides a two stages clinical protocol that is able to ensure complete cleaning of teeth while preserving tooth substance.
The previous protocol for the removal of hard and soft deposits, which begins with hand instruments, continues with an ultrasonic device and ends with classical polishing (rubber cups, brushing, polishing pastes), is today still widely used in dentistry. However, recent clinical studies show that this method is obsolete. It leaves distinct marks on hard tooth structure and is aggressive on soft tissue.
EMS has developed a new systematic approach for professional prophylaxis under the name of Guided Biofilm Therapy. This prophylaxis procedure focuses not only on the removal of hard and soft deposits, but also on a different treatment sequence. The procedure guarantees complete cleaning, even in the most difficult-to-reach areas and at the same time preserves tooth substance and natural tissue.
The final polishing with a polishing paste can now be avoided.
The Procedure
For optimal results, it is first necessary to make a diagnosis of the soft tissue and mucous membranes, to raise patient awareness for the benefits of good oral hygiene, and to motivate them.
Because, professional prophylaxis always has to be supported by individual prophylaxis. The primary common and widespread technique for the preparation of the tooth surfaces is brushing your teeth. It causes the disorganization of the biofilm.
Professional tooth cleaning then ensures the removal of biofilm in areas that are also difficult for patients to reach.
The Advantages of The New Concept of Guided Biofilm Therapy
This procedure guarantees efficient cleaning and a complete removal of biofilm, even in hard-to-reach areas, and preserves the tooth structure and natural tissue. The final polishing procedure using a polishing paste can thus be avoided. Furthermore, patients very much appreciate this gentle and totally painless form of treatment and are thus happy to come to prophylaxis sessions.
Fig. 1: Checking the attachment and the depth of the pocket
Fig. 2: Professional diagnosis to raise patient awareness with a plaque test (GC)
Fig. 3: AIR-FLOW® Powder PLUS
Fig. 4: Removal of supragingival biofilm and stains, also in contact with the gingiva
Fig. 5: Removal of biofilm under the gingiva (sulcus
Fig. 6: The optimal positioning of the AIR-FLOW® handpiece
Fig. 7: The optimal positioning of the suction tube
Fig. 8: Probing the pocket
Fig. 9: Removal of biofilm with the PERIO-FLOW® handpiece
Fig. 10 and 11: Calculus removal from natural teeth with PS attachment by EMS. This very fine instrument allows thorough cleaning even in hard-to-reach areas, below and above the gingiva (up to 10 mm depth). Recommendation: Set the power to 30-60%, water flow to 70-100%.
Fig. 12: Calculus removal on an implant with PI attachment by EMS. The tip enables cleaning of implant, implant post and crown surfaces without damaging titanium or zirconium surfaces.
The Protocol
STAGE 1 (Fig. 3 to 9)
1 – Removal of Soft Deposits, Discolourations And Biofilm
This stage is carried out using the AIR-FLOW® method by EMS in combination with the AIR-FLOW® Powder PLUS. It is based on erythritol, a natural component, together with 0.3% chlorhexidine. Thanks to its fine grain size (14 μm), the tooth surface and the soft tissues are not affected. This powder enables the removal of biofilm and soft deposits in both supragingival as well as subgingival areas on natural teeth or implants. It is recommended to not eat any chromogenic food for 3 hours after the treatment.
2 – Rehabilitation of Deep Pockets
In the 5-9 mm deep pockets, biofilm is removed with the PERIO-FLOW® handpiece with vertical movements back and forth for 5 seconds per pocket. This technique is four times as fast as with a curette. Thanks to its soft disposable plastic attachment, the handpiece does not damage the surface of the root or the implant and adapts perfectly to the anatomic shape.
STAGE 2 (Fig. 10 to 12)
Removal of Hard Deposits with the Piezon® No Pain Technology
The linear vibrations, which are aligned to the treatment area, stand in the center of the original PIEZON® method to ensure super smooth tooth surfaces. In combination with the intelligent No Pain technology, which automatically regulates the power and speed of the EMS attachments, this method provides maximum protection of the gingiva. Soft deposits, discoloration and biofilm are eliminated with the AIR-FLOW® technology and the hard deposits are now clearly visible.
The combination of the PIEZON® No Pain technology and the PS attachment guarantees effective, quick, tissue-sparing and virtually painless treatment. Since calculus removal is carried out only in the areas where it is really necessary, final polishing is not required. However, dental professionals can still quickly carry out air polishing with AIR-FLOW® Powder PLUS in the areas where calculus has been removed.
After the prophylaxis treatment, it is recommended to apply a fluoride solution for efficient protection against caries.
Disclaimer
Published in the magazine Dentoscope special edition No. ADF 2016
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