Clinical efficacy of Guided Biofilm Therapy in the management of periodontal disease - a systematic review

Professional scaling and root debridement (SRD) is traditionally considered a gold standard in non-surgical periodontal therapy. However, Guided Biofilm Therapy (GBT) offers a possible alternative, utilizing a disclosing agent and air abrasive powder. Despite its potential benefits, the comparative clinical outcomes of GBT versus SRD remain underexplored. Hence, this systematic review was conducted to evaluate the effectiveness of Guided Biofilm Therapy compared to conventional methods in managing periodontal disease. A systematic review was conducted following the PRISMA guidelines, including studies retrieved from PubMed, Cochrane, LILACS, Scopus, Web of Science, Google Scholar, OpenGrey and Clinical Trials registry. Studies comparing GBT with SRD for routine non-surgical therapy or periodontal maintenance were included. To evaluate the methodological quality of included studies, the Cochrane RoB-2 tool for randomized controlled trials (RCTs) and GRADE assessment was used. A total of five studies, involving 231 participants in total, were included in this review. GBT demonstrated advantages over SRD through improved patient satisfaction, reduced pain perception and reduced treatment time. However, its effect on clinical outcomes like bleeding on probing (BOP), clinical attachment level (CAL), and probing pocket depth (PPD) were inconsistent across studies. GBT showed promise in reducing pain and improving operator comfort but did not consistently outperform SRD in primary clinical outcomes. GBT demonstrated favorable patient-centered outcomes, including reduced treatment time and improved patient comfort, compared with conventional non-surgical periodontal therapy. However, the evidence regarding its effects on primary clinical periodontal outcomes was heterogeneous and limited. Therefore, the current evidence does not support the clinical superiority of GBT.