Page 50 - DP Vol 22 No 1

PERIODONTICS

TRANSLATING BIOFILM SCIENCE INTO

PERIODONTAL PRACTICE

Ejya Mathur

ABSTRACT INSIGHT INTO GUIDED BIOFILM THERAPY
Guided Biofilm Therapy (GBT) is a modern, evidence-based approach At the heart of GBT is the EMS AIRFLOW® Prophylaxis Master
to professional mechanical plaque removal that focuses on the (Figure 3), a state-of-the-art device that integrates AIRFLOW®,
identification, targeted elimination, and long-term control of dental PERIOFLOW®, and PIEZON® technologies developed and patented
biofilm. As biofilm is the primary etiological factor in periodontal by EMS (Electro Medical Systems), Switzerland.
and peri-implant diseases, its effective management is fundamental This system is the only one scientifically designed and approved
to periodontal therapy. GBT follows a structured clinical protocol for the full 8 step clinical GBT protocol that emphasizes biofilm
that integrates biofilm disclosure, patient motivation and biofilm disclosure, motivation, and targeted removal for better results. (Figure
elimination without any pain thereby minimizing tissue trauma while 4) The protocol shifts the focus from aggressive instrumentation to
maximizing clinical efficiency. precision based, minimally invasive therapy.
Keywords: Guided Biofilm Therapy; Dental biofilm; Periodontitis; Air
flow; Minimally invasive periodontology THE 8 STEPS OF GBT
1. Assessment and diagnosis- A thorough initial diagnosis and
INTRODUCTION periodontal charting of oral cavity, gums, and implants / prosthesis if
Periodontal diseases are chronic inflammatory conditions initiated present to identify the problem areas and customize treatment.
and sustained by dysbiotic dental biofilm (Figure 1). Traditional non- 2. Biofilm disclosure- A special dye colours the invisible biofilm
surgical periodontal therapy has largely focused on calculus removal revealing mature biofilm as blue coloured and new as pink coloured
using hand and ultrasonic instruments. However, growing scientific and guiding us exactly where it’s located for targeted cleaning and also
evidence indicates that biofilm, rather than calculus alone, is the aids in patient education.
primary driver of periodontal inflammation and disease progression. 3. Patient motivation and education- Revealing the biofilm helps
This paradigm shift has led to the development of treatment concepts in educating and motivating patients. Clinician can formulate
that emphasize biofilm management while preserving hard and soft personalized instruction on brushing and flossing techniques, using
tissues. the stained areas as a guide for better home care.
Guided Biofilm Therapy (GBT), patented technology by EMS 4. AIRFLOW® therapy- A gentle spray of warm water, air, and a fine
(Electro Medical Systems, Switzerland), represents a systematic and Erythritol powder of only 14 µm particle size to remove biofilm, stains,
minimally invasive approach to biofilm control. For periodontists, and early tartar supra gingivally and up to 3-4mm sub gingivally. It
GBT offers a predictable, efficient, and patient-centred method that also helps in removing biofilm from tongue and palate. (Figure 5)
complements both non-surgical and surgical periodontal therapy. 5. PERIOFLOW® therapy- A specialized flexible tip made of PEEK
material cleans deep pockets of 4-9mm, furcation, root concavities
DENTAL BIOFILM AND PERIODONTAL PATHOGENESIS and around implants with the same powder-water-air mix (Figure 6 )
Dental biofilm is a highly organized, three-dimensional microbial 6. PIEZON® NO PAIN ultrasonic scaling (if calculus is present)-
community embedded within an extracellular polymeric matrix Piezon tips working in linear fashion are used if any hard calculus
adherent to tooth and root surfaces. (Figure 2) is left, in this minimally invasive EMS Piezon PS instrument is used
In periodontal pockets, the anaerobic environment favours the to clean supragingival and up to 10mm subgingival. It uses PI Max
proliferation of pathogenic microorganisms associated with tissue instrument to clean around implants and restorations supragingival
destruction and alveolar bone loss. and 3mm subgingival. (Figure 7)
Mature biofilm exhibits increased resistance to host immune 7. Final control and evaluation- Re-examine to ensure all biofilm and
responses and antimicrobial agents, making mechanical disruption calculus are removed, diagnose any issues and apply fluoride for long
essential for disease control. lasting maintenance.
Effective periodontal therapy therefore depends on complete 8. Recall and maintenance planning- Schedule next personalized
and atraumatic disruption of biofilm within periodontal pockets, maintenance appointment based on your individual risk assessment
particularly in anatomically complex areas such as furcation and analysis.
interproximal root surfaces.

50 Dental Practice I January-February 2026 I Vol 22 No 1