Adjunctive Role of Supra- and Subgingival irrigation in Periodontal therapy

The primary purpose of irrigation is to nonspecifically reduce the bacteria and their by-products that lead to the initiation or progression of periodontal diseases. Supragingival irrigation allows for the disruption and dilution of marginal bacteria and their by-products which helps to prevent or treat gingivitis. Subgingival irrigation interferes with the complex ecosystem required for the initiation and continued destruction of the compromised periodontium in the susceptible host. The literature presented here exemplifies an important fact that, like all other therapeutic modalities, irrigation has both limitations and benefits. This review encompasses many new studies investigating various aspects of supragingival and subgingival irrigation including: new devices and methods of delivery by clinicians and patients; effect on plaque toxicity; depth of solution penetration; various chemotherapeutic agents employed; ultrasonics and antimicrobials; safety; and bacteremia associated with irrigation.