Slot-Based Antimicrobial Low-Cost Non-surgical Periodontal Therapy in the Management of Periodontitis: A Case Series and Narrative Review

Periodontitis is a chronic infectious and inflammatory disease characterized by progressive destruction of the periodontal ligament and alveolar bone. While scaling and root planing (SRP) remains the cornerstone of non-surgical periodontal therapy, mechanical debridement alone may be inadequate in cases with deep periodontal pockets and persistent microbial reservoirs. In the context of periodontitis, "slot-based therapy" refers to a comprehensive anti-infective treatment strategy based on pathogen-directed antimicrobial principles and low-cost periodontal care concepts, combining mechanical debridement with adjunctive antimicrobial measures in a simplified, cost-effective, and evidence-based approach, particularly suited to resource-limited clinical settings. This article presents a case series of three patients with localized and generalized periodontitis who were managed using non-surgical slot therapy protocols. All patients exhibited varying degrees of gingival inflammation, plaque accumulation, and compromised periodontal health at baseline. Treatment involved ultrasonic SRP supplemented with adjunctive antiseptic-based antimicrobial strategies, including povidone-iodine subgingival irrigation and dilute sodium hypochlorite rinses for maintenance, with systemic antimicrobials prescribed selectively based on clinical indication. Clinical follow-up demonstrated a consistent reduction in gingival inflammation, improved gingival contour, and enhanced periodontal health across all three cases. No adverse effects were observed during the treatment or follow-up periods. The outcomes observed in this case series support the clinical utility of slot therapy as a pragmatic adjunct to conventional non-surgical periodontal treatment, offering a viable alternative to technology-dependent modalities while achieving meaningful clinical improvement.