100 GBT

CLINICAL CASESGBT PROTOCOL NEW WAYS IN PREVENTION AND PROPHYLAXISRDear Clinician,AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE.
Guided Biofilm Therapy focuses not only on prevention and maintenance of periodontal
and peri-implant diseases in adults but is also the only proven protocol to manage
biofilm around orthodontics and in non-surgical periodontal treatment. Through thisbook, we are able to show the implementation of GBT with regard to:Children: GBT not only enhances motivation but has also
proven effective to counter the fear felt by many.
Implants: GBT shows how versatile and efficient it can be.
Maintenance: GBT is the ultimate prevention tool.
Orthodontics: GBT is a complete, efficient and predictable method for biofilm removal.
Non-Surgical periodontal treatment: GBT is perfect to restore great periodontal health.
The simplicity of usage combined with the versatile clinical applications has beenhighlighted in this Vol.2 for you to share and enjoy.
“The doctor of the future will give no medicine but will instruct his patients in the care of
the human frame, in diet, and the cause and prevention of disease” – Thomas A. Edison
Favored by patients and clinicians worldwide, state-of-the-art prophylaxis is showcased inthis collection of 100 GBT clinical cases from around the globe. Join the GBT movement!

Your Swiss Dental Academy TeamNyon/Switzerland, November 10, 2022​
Celso Da Costa
Global Director
Swiss Dental Academy(SDA)

Dr Neha Dixit
Global Lead,
Clinical Affairs andMedical Education

PS: If you want to be featured in the next GBT Clinical Cases volume,
please submit your clinical case to the email address: gbtclinicalcases@ems-ch.com

WHY GBT?
1 A GAME CHANGER FOR BETTER ORAL PROPHYLAXIS
2 GOOD ORAL HEALTH = HEALTHY PATIENT
3 BEST CLINICAL PROTOCOL = BEST CLINICAL RESULTS.
GBT REDUCES THE RISK OF CARIES, GINGIVITIS ANDPERIODONTAL DISEASE.
“We can be sure only when biofilm has been completely removed.”

	 Nicole Einemann and Manuela Cordes, Dental Hygienists, Dr. Arendt Dental, Bremerhaven, Germany

4 PATIENTS WANT GBT. NOTHING ELSE.
NO MORE FEAR OF PAIN. NO MORE DISCOMFORT.
ONCE EXPERIENCED, PATIENTS LOVE GBT,ESPECIALLY CHILDREN.
5 SATISFIED CLINICIANS,
RELAXED PATIENTS. EFFICIENT, SYSTEMATIC
WORKFLOW WITH ERGONOMIC INSTRUMENTS.
BYE-BYE STRESS, BYE-BYE CARPAL TUNNEL S., BYE-BYE BIOFILM.
6 SUCCESSFUL DENTAL PRACTICES GOOD MONEY FOR GOOD WORK. ENTHUSIASTIC PATIENTS WILLRECOMMEND THE GBT-CERTIFIED PRACTICE.
7 ORAL MEDICINE AND PREVENTION ARE THE FUTURE OF
DENTISTRY. GBT IS THE FUTURE OF PREVENTION.
8 GBT IS A SURPRISING “I FEEL GOOD EXPERIENCE”.
STATE-OF-THE-ART IS FAVORED BY PATIENTS.
AND BY CLINICIANS.

Reserve a free GBT Demo: gbt-dental.com/GBT-DEMO-ENG
6

HOW TO DO GBT?
01 ASSESSMENT AND INFECTION CONTROL

Protect your patients and your practice team from infections. Start GBT by rinsing
40 seconds with BACTERX® PRO. Diagnosis and documentation of the individual
supra- and subgingival status for each patient.

02 DISCLOSE

Make the oral biofilm visible by disclosing and explain
the WHY to the patient. Scientific evidence confirms thatoral biofilm causes 95 % of all dental problems: caries,
gingivitis and periodontitis.

03 MOTIVATE

Emphasize the importance of oral home care and professional
prevention. Instruct your patients in oral hygiene.

04 AIRFLOW® MAX

Eliminate the disclosed biofilm supra- and subgingivally up to 4mm with
AIRFLOW® MAX and AIRFLOW® PLUS Powder. The original AIR-FLOWING®
is minimally invasive and pain-free.*05 PERIOFLOW®

Remove oral biofilm in deep pockets up to 9mm with PERIOFLOW® NOZZLEand AIRFLOW® PLUS Powder.*06 PIEZON® PS

Gently remove calculus with the original PIEZON® NO PAIN PS Instrument.*

07 CHECK

Check whether oral biofilm and calculus have been removed completely andwhether previously hidden caries is now visible. Conventional professional
teeth cleaning removes only 50 % of oral biofilm in areas that are difficult toreach. Source: Stiftung Warentest 7/2015. NO MORE POLISHING. Polishingand grinding with abrasive pastes is truly no longer necessary. Why produce
unnecessary smear layers?

08 RECALL

Would your patient like to answer the GBT questionnaire?
This is helpful for a successful GBT treatment.
Schedule the next prophylaxis appointment.

*
Learn more about how GBT works in practice, how to avoid dust when AIR-FLOWING ®,how to use PERIOFLOW® correctly or how to minimize the risk of emphysema at
the Swiss Dental Academy (SDA): sda.dental/Contact-GBT-Expert

A REGULAR GBT RECALL GUARANTEESLASTING ORAL HEALTH FOR YOUR PATIENTS.
We recommend a free GBT Demo: gbt-dental.com/GBT-DEMO-ENG
7

THE GBT COMPASS AND
08 RECALLHEALTHY PATIENT = HAPPY PATIENT
Schedule recall frequency
according to risk assessment
Ask your patient if heor she liked the treatment

07 CHECK

MAKE YOUR PATIENT SMILE
Do a final check for remaining biofilm
Ensure calculus is fully removed
Accurately diagnose caries
Protect with fluoride
No polishing anymore

06 PIEZON® PS

REMOVE REMAINING CALCULUS
Use the minimally invasive EMSPIEZON® PS Instrument supra- andsubgingivally up to 10 mm
Clean > 10 mm pockets with mini curette
Use EMS PIEZON® PI MAX
Instrument around implants
up to 3 mm subgingivallyand on restorations

05 PERIOFLOW®

REMOVE BIOFILM IN >4 TO 9 MM POCKETS
Use AIRFLOW® PLUS Powder
on natural teeth in deep pockets and root
furcations and on implants
Use new and slimmer PERIOFLOW ® Nozzle
8

ITS 8-STEP PROTOCOL
01 ASSESSMENT AND
INFECTION CONTROLASSESS EVERY CLINICAL CASE AND
IMPLEMENT HYGIENE MEASURES
Start by rinsing with BacterX® Pro
mouthwash Assess teeth, gingiva andperiodontal tissues Assess implants andperi-implant tissues

02 DISCLOSE

MAKE BIOFILM VISIBLE
Highlight to patients the disclosed
biofilm and their problematic areas
with EMS Biofilm Discloser
The color will guide biofilm removal
Once biofilm is removed,
calculus is easier to detect

R

03 MOTIVATERAISE AWARENESS AND TEACH
Emphasize the importance ofprevention Instruct your patientsin oral hygiene EMS recommends
interdental brushes or dental floss
as well as electric or manual toothbrushes and AIRFLOW® erythritol
toothpaste for daily home care

04 AIRFLOW® MAX

REMOVE BIOFILM, STAINSAND EARLY CALCULUS
Use AIRFLOW® MAX for natural teeth,
restorations and implants Remove
biofilm supra- and subgingivally up to
4 mm using AIRFLOW® PLUS 14 μm Powder
Also remove biofilm from gingiva,
tongue and palate
9CHILDREN AND GBTCASE 1
CLINICIAN

Leyla Bakirova
DentistAzerbaijan

PATIENT INFORMATION
Age 18, female.

BACKGROUND INFORMATIONFirst professional prophylaxis. Worried about procedure. No relevant habits.

CLINICAL FINDINGS

Poor oral hygiene, large amounts of biofilm present.

TREATMENTGBT with AIRFLOW® PLUS Powder and PIEZON® PS Instrument + fluoride
application. Instructions for proper oral hygiene.

PATIENT FEEDBACK“I NEVER FELT MY TEETH SO SMOOTH, THANK YOU VERY MUCH!”
10

BEFORE GBTAFTERDISCLOSINGAFTER GBT

11

CHILDREN AND GBTCASE 2
CLINICIAN

Adolfová Jitka SmržDental hygienist
Czech Republic

PATIENT INFORMATION
Age 11, male.

BACKGROUND INFORMATION

Patient has never been to a dental hygienist. He had bad experience with a previous
treatment at the dentist. It was necessary to communicate with the patient and hisolder sister because parents do not speak Czech. No relevant habits.

CLINICAL FINDINGS

Poor oral hygiene, gingivitis caused by biofilm. Generalized bleeding on probing.
Presence of supragingival and subgingival calculus, periodontal pockets under 4 mm.

TREATMENTGBT done with AIRFLOW® PLUS Powder and PIEZON® PS Instrument to remove
all residual biofilm and calculus. Initial therapy comprised of 3 appointments every
two weeks. Next recall is in 3 months.

PATIENT FEEDBACK“IT’S SO COOL! IT’S THE FIRST TIME THAT I’M NOT AFRAID TO COME BACK.”
12

BEFORE GBTAFTERDISCLOSINGAFTER GBT

13

CHILDREN AND GBTCASE 03
CLINICIAN

Bessy Georgaris
Dental hygienist
United States

PATIENT INFORMATION
Age 14, male.

BACKGROUND INFORMATION

Patient had a bad experience in the past during prophylaxis. Very sensitive andscared when he entered. No relevant habits.

CLINICAL FINDINGS

Bleeding on probing positive. Presence of interdental calculus.

TREATMENT

Performed GBT. He was « petrified » to see all the biofilm he leaves behind andwas more motivated than ever during the hygiene instructions! He thought he wasgoing to suffer during his treatment and was positively surprised of how comfortable
it was and how clean he felt after erythritol powder was used with AIRFLOW® MAX
to remove all the biofilm. PIEZON® PS Instrument was also used supragingivally toremove hard calculus in a few areas.

PATIENT FEEDBACK“I AM VERY SURPRISED WITH THE RESULTS OF DISCLOSING, VERY
MOTIVATED FOR HYGIENE INSTRUCTIONS AND GBT IS VERY COMFORTABLE
DURING CLEANING”
14

BEFORE GBTAFTERDISCLOSINGAFTER GBT

15

CHILDREN AND GBTCASE 04
CLINICIAN

Rosaria Cataneo
Specialist
Italy

PATIENT INFORMATION
Age 17, male.

BACKGROUND INFORMATION

Poor oral hygiene, no relevant medical history. Patient with no relevant habits.

CLINICAL FINDINGS

Very poor oral hygiene, large amounts of biofilm in both jaws, calculus in frontal
part in lower jaw, no interdental hygiene, formation of acidic biofilm.

TREATMENTGBT done with AIRFLOW® PLUS Powder, PIEZON® PS Instrument.

PATIENT FEEDBACK“BEFORE THE TREATMENT I WASN’T EXPECTING MUCH FROM IT BUT IT
REALLY DID CHANGE MY ORAL HYGIENE AND NOW I FEEL LIKE I HAVE A
NEW MOUTH.”
16

BEFORE GBTAFTERDISCLOSINGAFTER GBT

17

CHILDREN AND GBTCASE 05
CLINICIAN

Petra Janáková
Dental hygienist
Czech Republic

PATIENT INFORMATION
Age 13, female.

BACKGROUND INFORMATION

Young patient with good general health. Very diverse eating habits. Brushes teeth
twice a day with manual toothbrush. Visits a dentist and orthodontist for checkups
periodically once a year. Patient was advised to see a dental hygienist because of
bleeding and receding gums. No relevant habits.

CLINICAL FINDINGS

Gingivitis (inflammation of the gums). BOP +. Poor oral hygiene. Insufficientdental care in lateral part of the teeth and cervical area.
Intact teeth with local demineralization. Thin vestibulum and recessions in frontal
area of lower jaw.

TREATMENTGBT protocol was done using AIRFLOW® PLUS Powder. Supragingival calculus
removed by using PIEZON® PS Instrument. Fluoridation with Varnish Profluorid.
Motivation and education of patient about regular dental care. Patient was shownhow to use interdental brushes and appropriate aids for home care. First recall
after 12 weeks, then every 6 months. Recommendation to see a periodontal surgeon
because of thin vestibulum.

PATIENT FEEDBACK“I DID NOT WANT TO GO TO THE DENTAL HYGIENIST AT FIRST BUT AFTERWARDS I
WAS QUITE IMPRESSED HOW MY TEETH WERE CLEAN AND SHINY.”
18

BEFORE GBTAFTER DISCLOSINGAFTER GBT

19

CHILDREN AND GBTCASE 06
CLINICIAN

Li beng Wong
Periodontist
Singapore

PATIENT INFORMATION
Age 13, male.

BACKGROUND INFORMATION

Never visited a dentist before for prophylaxis due to dental phobia, not motivatedto maintain good oral hygiene. No relevant habits.

CLINICAL FINDINGS

Poor oral hygiene. Generalized gingival inflammation with heavy biofilm deposit.

TREATMENT

Use of pre-rinse mouthwash, followed by biofilm disclosure and motivation (chairside
brushing and flossing demonstration). AIRFLOW® treatment was carried out using
AIRFLOW® PLUS Powder. Calculus removal at certain interproximal areas was
performed using PIEZON® PS Instrument without need for local anesthesia. Finalcheck for any residual biofilm, calculus and caries. Patient was placed on recall
every 6 months.

PATIENT FEEDBACK“TREATMENT IS MUCH MORE COMFORTABLE THAN WHAT I IMAGINED IT
TO BE. I WILL DEFINITELY ASK MY MOTHER, WHO IS ALSO SCARED TO SEE
DENTIST, TO TRY OUT GBT TREATMENT.”
20

BEFORE GBTAFTERDISCLOSINGAFTER GBT

21

CHILDREN AND GBTCASE 07
CLINICIAN

Chrissy Ford
Dental hygienist
CanadaPATIENT INFORMATION
Age 10, male.

BACKGROUND INFORMATION

Bad previous dental experience due to sensory processing disorder. Anxiety overtextures and taste in the dental office. Poor oral hygiene and compliance issues
using toothpaste due to flavoring.

CLINICAL FINDINGS

Generalized gingivitis with moderate biofilm and bleeding at maxillary anterior
crowding.

TREATMENT

Full GBT treatment was completed with AIRFLOW® PLUS Powder and localized
early calculus removed with the PIEZON® PI Instrument.

PATIENT FEEDBACK“I SURE LIKED THE TOOTH SHOWER BETTER THAN MY LAST CLEANING!”
22

AFTER DISCLOSINGAFTER GBT

23

CHILDREN AND GBTCASE 08
CLINICIAN

Patricia Spazierer
Dental hygienist
Germany

PATIENT INFORMATION
Age 17, male.

BACKGROUND INFORMATION

Habits: consumes many soft drinks, Does not use interdental care, uses oscillating
toothbrush. Patient is stubborn. Poor oral hygiene in general.

CLINICAL FINDINGS

Average oral hygiene, gingivitis, BOP +, PBI 66%, API 62%.

TREATMENTThe patient was treated according to the GBT protocol after detailed oral hygiene
instructions, AIRFLOW® PLUS Powder, PIEZON® PS Instrument, UK Front lingual
in the gaps, M23 scaler and explorer probe were used for control. The recall was set
at 6 months. In-depth demonstration with TePe interdental space brushes (red andblue), demonstration handling oscillating toothbrush was given. Advised to lower
soft-drink consumption in order to reduce biofilm and disease.

PATIENT FEEDBACK“TREATMENT WAS EXTREMELY PLEASANT. I AM HAPPY THAT I WILL BE ABLE TO
FIGHT CARIES AND GUM DISEASE. BUT I WILL CONTINUE MY SOFT DRINKS.”
24

BEFORE GBTAFTERDISCLOSINGAFTER GBT

25

CHILDREN AND GBTCASE 09
CLINICIAN

Adina Mauder
Dental hygienist
Germany

PATIENT INFORMATION
Age 6, female.

BACKGROUND INFORMATION

Healthy smiling girl, visited the dental office for the 2nd time. Good eating habits.
Wanted to change her hygienist as she had heard about a new modern teeth cleaning
method. Biofilm was never disclosed to this patient.

CLINICAL FINDINGSGood oral hygiene, brushes teeth regularly twice a day. No BOP, no calculus.

TREATMENT

Patient was shown where the biofilm is through disclosure. Tooth brushing witha manual brush was shown. GBT with AIRFLOW® MAX and erythritol PLUS
Powder. Patient scheduled for regular recall.

PATIENT FEEDBACK“I AM SURPRISED TO SEE BACTERIA IN MY MOUTH, GBT FELT LIKE A MOUTH
SHOWER. I WILL COME BACK, GBT IS FUN.”
26

BEFORE GBTAFTER DISCLOSINGAFTER GBT

27

CHILDREN AND GBTCASE 10
CLINICIAN:

Gleb Aseev
DentistRussiaPATIENT INFORMATIONAge 8, male.

BACKGROUND INFORMATION

Bilateral cleft palate and lip. Restricted opening of the mouth. Bad oral hygiene.
We did GBT before the surgical treatment, then treated the teeth and completed
the GBT treatment again. Previously, there were 3 operations on the palate andlips. The child is preparing for the next operations.

CLINICAL FINDINGSType of condition: generalized gingivitis, very high level of bleeding on probing.

TREATMENT

Standard GBT protocol using only AIRFLOW® PLUS Powder. Emphasis on patient
motivation.

PATIENT FEEDBACK“PARENTS NOTED AN INCREASE IN THE CHILD’S INTEREST IN HOME
CLEANING OF TEETH. THE CHILD NOTED A DECREASE IN THE LEVEL OF
ANXIETY AND FEAR OF DENTAL TREATMENT.”28

BEFORE GBTAFTERDISCLOSINGAFTER GBT

29

CHILDREN AND GBTCASE 11
CLINICIAN:

Gleb Aseev
DentistRussiaPATIENT INFORMATION
Age 6, male.

BACKGROUND INFORMATION

Routine visit of the patient for hygiene and preventive examination. The patient
is in the mixed dentition stage. Presence of sensitivity in many areas.

CLINICAL FINDINGSType of condition: gingivitis, low level of bleeding on probing.

TREATMENTWe did standard GBT protocol without PERIOFLOW® technology. In the areaof teeth that are just erupting, it is necessary to work very carefully. The use oferythritol powder allows us to clean the biofilm surface around the soft tissues
without causing damage.

PATIENT FEEDBACK“I LOVE THE TASTE OF THE POWDER USED IN GBT!”
30

BEFORE GBTAFTER DISCLOSINGAFTER GBT

31

CHILDREN AND GBTCASE 12
CLINICIAN

Sara Bågvik Börjesson
Dental hygienist
SwedenPATIENT INFORMATION
Age 11, female.

BACKGROUND INFORMATION

The mother called clinic and was worried about the black stains her daughter has.
She was also concerned that the stains would cause teasing in school.
Patient claims she brushes twice a day. The mother was not so sure about that.

CLINICAL FINDINGSBlack stains, mainly on the buccal and lingual surfaces. Most visible up front.
The stains are thin, but firmly attached to the teeth. Mixed dentition.

TREATMENTGBT removed the black stains and biofilm completely. The patient could follow theprocess in the mirror. GBT done with AIRFLOW® PLUS Powder.

PATIENT FEEDBACK“THANK YOU FOR SHOWING MY DAUGHTER HOW TO PREVENT NEW STAINS.”
32

BEFORE GBTAFTERDISCLOSINGAFTER GBT

33

CHILDREN AND GBTCASE 13
CLINICIAN

Bianca Maria Messina
Dental hygienist
Italy

PATIENT INFORMATION
Age 11, female.

BACKGROUND INFORMATIONFirst visit to dental hygienist, before orthodontic therapy.
Uses only manual toothbrush.

CLINICAL FINDINGS
Visible biofilm.

TREATMENT

Biofilm disclosed using the Biofilm Discloser from EMS. Patient motivation throughthe use of electric toothbrush. GBT performed with only AIRFLOW® PLUS Powder
to remove biofilm.

PATIENT FEEDBACK“I’M VERY HAPPY, I DON’T HAVE DIRTY TEETH.”
34

BEFORE GBTAFTER DISCLOSINGAFTER GBT

35

CHILDREN AND GBTCASE 14
CLINICIAN

Katarzyna Ostrowska
Dental hygienist
PolandPATIENT INFORMATION
Age 12, male.

BACKGROUND INFORMATION

Uses a manual toothbrush, 1550 ppm fluoride toothpaste.
Neurological patient: epilepsy, treated pharmacologically with Depakine chronosphere(valproic acid).

CLINICAL FINDINGS

Poor hygiene, no cavities, numerous mineralized deposits, abundant biofilm,
occasional dry mouth (due to medications taken).

TREATMENT

Professional hygiene according to GBT protocol, fluoride varnishing with FluoroDose.
Recommendation: ORP electric toothbrush, SPLAT oral foam, increased water
intake. Next visit in 2 months.

PATIENT FEEDBACK“I FEEL SUPER CLEAN. I UNDERSTAND BETTER HOW TO BRUSH.”
36

BEFORE GBTAFTERDISCLOSINGAFTER GBT

37

CHILDREN AND GBTCASE 15
CLINICIAN

Seo- yeon Han
Dental hygienist
South Korea

PATIENT INFORMATIONAge 8, male.

BACKGROUND INFORMATION

The patient has a habit of drinking cola since he was 1 year old. There was an
overall black stain that appeared from infancy. Oral health had not improved evenafter the patient entered elementary school, so the parent decided to introduce him
to an oral care program. Currently, the patient enjoys sweets.

CLINICAL FINDINGS

General black stain. Checked the biofilm formed along the black stain around thegingival margin. In general, the anterior region was not self-managed any better
than the posterior region.

TREATMENTThe patient was usually afraid of dental treatment and was less cooperative, sochecked and explained all treatment processes with a mirror and proceeded with
GBT. Depending on the overall stain and the patient’s level of cooperation andcondition, the procedure was divided into 2 sessions with an interval of one week.
GBT protocol was conducted with a focus on improving patient motivation and selfmanagement ability.

PATIENT FEEDBACK“I THOUGHT DENTAL TREATMENT WOULD BE SCARY BUTI WAS ABLE TO EXPERIENCE PAIN-FREE TREATMENT.”38

BEFORE GBTAFTER DISCLOSINGAFTER 1 WEEK

39

CHILDREN AND GBTCASE 16
CLINICIAN

Andrii Voroshylov
Dental hygienist
Ukraine

PATIENT INFORMATION
Age 15, male.

BACKGROUND INFORMATIONFirst visit to dental hygienist, never been before. High-sugar diet.

CLINICAL FINDINGS

Very poor oral hygiene, large amounts of biofilm in both jaws, calculus in frontal
part in lower jaw, no interdental hygiene, formation of acidic biofilm.

TREATMENT

Plaque removed with AIRFLOW® Prophylaxis Master using AIRFLOW® PLUS
Powder. During check, all the demineralized areas could be seen clearly. The patient
was advised to continue using a toothpaste twice per day and apply a remineralizing
agent (GC Tooth Mousse Plus) after brushing.

PATIENT FEEDBACK“I LIKE IT, IT IS QUICK, THERE IS NO PAIN. I WILL TRY BETTER TO BRUSH MY
TEETH AT HOME IN THE MORNING AND EVENING.”
40

BEFORE GBTAFTERDISCLOSINGAFTER GBT

41

CHILDREN AND GBTCASE 17
CLINICIAN

Lauren Smith Woodel
Dental hygienist
United States

PATIENT INFORMATION
Age 12, male.

BACKGROUND INFORMATION

Patient drinks mostly water, occasional soda, juice. Patient breathes mostly throughthe mouth at night. Asperger’s, high functioning. Pre Diabetic. Vitamin D deficiency.
No medications. Patient states that he brushes 0-2 times per day with a manual
toothbrush. He is a not a highly motivated patient.

CLINICAL FINDINGS

Patient has generalized moderate plaque at the gumline, most of the enamelsurfaces and interdental spaces, generalized gingivitis with rolled, bulbous gingiva.

TREATMENT

Patient pre-rinsed with Ora Care mouthwash for 60 seconds before application of
GC Tri Plaque ID. We removed the plaque and debris using the AIRFLOW® Master
unit utilized AIRFLOW® PLUS Powder.

PATIENT FEEDBACK“I AM HAPPY!”42

BEFORE GBTAFTER DISCLOSINGAFTER GBT

43

CHILDREN AND GBTCASE 18
CLINICIAN

Ney Acurcio Cruz
Dental hygienist
Brazil

PATIENT INFORMATION
Age 5, male.

BACKGROUND INFORMATION

The patient has a low sugar intake. Need of prophylaxis with fluor application.

CLINICAL FINDINGS

Preventive treatment.

TREATMENTGBT was performed with emphasis on patient motivation and home teeth cleaningeducation.

PATIENT FEEDBACK“WOW, IT WAS FAST AND PAINLESS!!! I’M NOT AFRAID OF THE DENTISTANYMORE!”44

BEFORE GBTAFTER DISCLOSINGAFTER GBT

45

CHILDREN AND GBTCASE 19
CLINICIAN

Henrietta Vass
Dental hygienist
Hungary

PATIENT INFORMATIONAge 8, female.

BACKGROUND INFORMATION

Patient’s first prophylaxis visit. She regularly takes medication for epilepsy. That
medication is also a cause for altered oral bacterial flora. Patient brushes her teeth
twice a day with electronic toothbrush. No relevant habits

CLINICAL FINDINGS

Visible biofilm present on teeth and on tongue. Supragingival calculus present.
Minimal BOP+.

TREATMENT

After discussion with her regular GP, Guided Biofilm Therapy sessions started
weekly for 1 month; using AIRFLOW® PLUS Powder and PIEZON® PS Instrument.
Since then, regular monthly recalls. Bacterial flora, plaque index and overall resultshow significant improvement.

PATIENT FEEDBACK“I AM NOT AFRAID TO GO TO THE DENTAL PRACTICE. THE TREATMENTTICKLES A BIT BUT IS NEVER PAINFUL.”
46

BEFORE GBTAFTERDISCLOSINGAFTER GBT47

IMPLANTS AND GBTCASE 20
CLINICIAN

Andrea Sales do Prado Godoy
Endodontist, Prosthodontic, Dental Aesthetics
Brazil

PATIENT INFORMATION
Age 58, male.

BACKGROUND INFORMATION

The patient had an implant due to tooth extraction with endodontic and periodontal
involvement. Patient is motivated and willing to have the most conservative treatment
possible. No relevant eating habits but patient with high level of bruxism.

CLINICAL FINDINGS

Patient with peri-implantitis. This motivated us to do a GBT (conservative treatment)
through the PERIOFLOW® technique in an attempt to maintain the compromised
element.

TREATMENT

Detailed assessment with radiographs was done. The GBT protocol was initiated,starting with the disclosing biofilm followed by the sub- and supragingival AIRFLOW®
jet at a maximum of 4mm. In the sequence we introduced the PERIOFLOW® up
to power 8 and finished with a new AIRFLOW® jet. Post 30 days, there was an
improvement in bone growth.

PATIENT FEEDBACK“I AM EXTREMELY HAPPY WITH THE CONSERVATIVE APPROACH
IN ORDER TO SAVE MY IMPLANT.”48

BEFORE GBTAFTER GBT

30 DAYS AFTER GBT

49

IMPLANTS AND GBTCASE 21
CLINICIAN

Dr. Augusto Andre Baptista
Exclusive Practice Oral Surgery,
Periodontology and aesthetic dentistry
Luxembourg

PATIENT INFORMATION
Age 55, male.

BACKGROUND INFORMATION

Bad initial oral hygiene with inflammations, history of aggressive periodontitis,
young toothless patient, treated with a double ALL on 6. Big former smoker.

CLINICAL FINDINGS

Pain, mucositis, halitosis.

TREATMENT

Global oral hygiene teaching session and periodontal probing, small periodontal
maintenance every 6 months without removing the prosthesis, cleaning and sanitation
without anesthesia. Major maintenance session with removal of the prosthesis
is scheduled after every 3 minor maintenance sessions. GBT session starts withprobing, disclosing, cleaning with AIRFLOW® PLUS Powder with AIRFLOW MAX®
handpiece then with PERIOFLOW® handpiece for the abutments, the biological
width around implants and all the narrow areas with difficult access. Recall every
6 months: Good oral hygiene from the patient and suppression of symptoms.

PATIENT FEEDBACK“I HIGHLY RECOMMEND THIS TREATMENT BY THE GBT PROTOCOL TO ALL
PATIENTS WITH IMPLANTS, NO PAIN FEELING, VERY COMFORTABLE AND
PERFECT DEEP CLEANING !”50

BEFORE GBTAFTER DISCLOSINGAFTER AIRFLOW®

AFTER PERIOFLOW®

AFTER GBT

51

IMPLANTS AND GBTCASE 22
CLINICIAN

Dr. Jacques Hassid
Periodontist and Implantologist
FrancePATIENT INFORMATION
Age 54, female.

BACKGROUND INFORMATION

By the age of 30, this patient had stage 3, grade C periodontitis (formerly calledaggressive periodontitis). Several periodontal treatments (non-surgical and surgicalperiodontal debridement and then periodontal maintenance) have been performed forseveral years. Despite regular follow-up, it was decided to extract all the maxillaryteeth and keep some mandibular teeth, then to carry out an implant treatment anda removable prosthesis on the mandible. Non-smoker, no health problems.

CLINICAL FINDINGSOn clinical examination, the patient does not present periodontal pockets, nosigns of peri-implantitis but superficial inflammation of the gingival tissues due totartaric deposits.

TREATMENT

After a complete periodontal examination, the GBT peri-implant maintenancesession takes place as follows: used a disclosing agent, recommendations for oral
hygiene. AIRFLOW® MAX handpiece with AIRFLOW® PLUS Powder, PERIOFLOW®
and PIEZON® PS Instrument for cleaning tartaric concressions. Control reminderscheduled at 4 months.

PATIENT FEEDBACK“PAINLESS TREATMENT, A REAL FEELING OF HAVING A HEALTHY
AND CLEAN MOUTH”
52

BEFORE GBTAFTER DISCLOSINGAFTER GBT53

IMPLANTS AND GBTCASE 23
CLINICIAN

Lauren Smith Woodel
Dental hygienist
USA

PATIENT INFORMATION
Age 35, male.

BACKGROUND INFORMATION

Patient drinks energy drinks and Coke Classic daily, doesn’t “enjoy” drinking water.
Patient snores, breathes mostly through the mouth, undiagnosed sleep apnea. Healthhistory includes asthma, daily Symbicort, Albuterol as needed. Patient also has
seasonal allergies. Patient states that he brushes 1-2 times per day with a Sonicare
toothbrush. He does not use dental floss, but uses a Waterpik every morning.
He is a moderately motivated patient with caries. 3-month recall.

CLINICAL FINDINGS

Patient has generalized old, sticky plaque at the gumline of the natural teeth,
generalized gingivitis with rolled, bulbous facial gingiva. The Zirconia All on Fourhas generalized light plaque, heavier on the upper right, debris between the prosthesis
and boney ridge. There are no exposed implant threads visually or radiographically.
All periodontal pockets were <5mm, no exudate, light BOP.

TREATMENT

Patient pre-rinsed with Ora Care mouthwash for 60 seconds before applicationof GC Tri Plaque ID Gel. We removed the biofilm with AIRFLOW® PLUS Powder
and hand scaled any remaining hard deposit which was inaccessible for ultrasonics.

PATIENT FEEDBACK“I ALWAYS FEEL BETTER AFTER BEING HERE, I FEEL CLEAN AND
FRESH AND MY TEETH LOOK WHITER.”54

BEFORE GBTAFTER DISCLOSINGAFTER GBT

55

IMPLANTS AND GBTCASE 24
CLINICIAN

Pascale Hemelrijk
Dental hygienist
Netherlands

PATIENT INFORMATIONAge 73, male.

BACKGROUND INFORMATION

He lost his teeth at the age of thirty because of caries and bad financial situation.
The implants were placed due to poorly fitting prosthesis 15 years ago. Last visit todentist and dental hygienist was two years ago due to a range of various illnesses. No
smoking, under and upper jaw prosthesis held by implants. No oral hygiene habits.

CLINICAL FINDINGS

Implants in upper and lower jaw prosthesis. The patient presented a peri-implantmucositis with a pocket depth of 4mm and BOP+ (bleeding on probing). Generalized
sub- and supragingival plaque, stains and tartar. Poor oral hygiene.

TREATMENT

Upon disclosing, biofilm was eliminated from the prosthesis and the implants
supra- and subgingivally with the AIRFLOW® MAX and AIRFLOW® PLUS Powder.
Use of the PIEZON® PI Instrument on generalized supra- and subgingival tartar
on the mandibular implants. Despite the blood thinners taken by the patient, thebleeding during the non-invasive GBT treatment was low in contrast to traditional
treatment.

PATIENT FEEDBACK“I AM SO HAPPY, I DID NOT FEEL ANYTHING. MY IMPLANTS ARE SHINING
AGAIN AND LOOK SO CLEAN. I AM COMING BACK IN 3 MONTHS. ”
56

BEFORE GBTAFTERDISCLOSINGAFTER GBT57

IMPLANTS AND GBTCASE 25
CLINICIAN

Roxanne Rigter
Dental hygienist
Netherlands

PATIENT INFORMATIONAge 77, female.

BACKGROUND INFORMATION

Implant 23 has been removed on 03-04-22 due to peri-implantitis. Poor oral health.
No significant habits.

CLINICAL FINDINGS

4 to 6 mm peri-implant sulcus depth
The mandible pockets 4-5mm, bleeding on probing (BOP)

TREATMENT

Examination of the implants and the tooth surfaces in the lower jaw. Cleaning theimplants and the tooth surfaces GBT. First disclosing the implants and the dental
surfaces with EMS Biofilm Discloser. Patient motivated and instructions given.
Using Airflow handpiece with AIRFLOW® PLUS Powder for the implants and tooth
surfaces. Removed calculus in the mandibular using the PIEZON® handpiece and
PIEZON® PS Instrument. Used PERIOFLOW® to clean the 4 to 6mm sulcus depth
at the implants (GBT).

PATIENT FEEDBACK“FINE PAINLESS TREATMENT.”58

BEFORE GBTPIEZON®

PERIOFLOW®

AFTER GBT

59

IMPLANTS AND GBTCASE 26
CLINICIAN

Serim Cho
Dental hygienist
Korea

PATIENT INFORMATION
Age 51, male.

BACKGROUND INFORMATION

Medicated for diabetes in the past but stopped it after being completely cured.
Self-care was poor. CC: chief compliant.

CLINICAL FINDINGS

Loss of multiple teeth, implant prosthesis with inflammation overall, BOP +(bleeding on probing), sub- and supragingival calculus and halitosis issue.

TREATMENTTo establish self-care, 4 sessions were performed in a weekly interval. On the first
visit, the oral bacteria test, the progression of periodontal disease, and the use ofinterdental toothbrushes and mouthwash were explained. On the second visit after
one week, introduced AIRFLOW® and PIEZON® and removed biofilm and stain using
PIEZON® PS Instrument. After that, AIRFLOW® and periodontal treatment werecombined in two maintenance sessions for the two following weeks..

PATIENT FEEDBACK“PREVIOUSLY, IT WAS PAINFUL AND UNCOMFORTABLE EVERY TIME WHEN I
RECEIVED SCALING OR PERIO TREATMENT, BUT GBT WAS COMFORTABLE. I
HAVE LESS BAD BREATH, SO I’M CONFIDENT TO TALK. I’M LOOKING FORWARD
TO THE FUTURE TREATMENT.”60

BEFORE GBTAFTER DISCLOSINGAFTER GBT

2-WEEK RECALL

61

IMPLANTS AND GBTCASE 27
CLINICIAN

Seonmi Park
Dental hygienist
Korea

PATIENT INFORMATION
Age 65, female.

BACKGROUND INFORMATION

Hyperlipidemia. #16 Implant after extraction. The patient was passive in recall
only to treat relapse of periodontitis. But the frequency of periodontitis recurrence
decreased through continuous co-therapy.

CLINICAL FINDINGS#16 Gingival crevicular fluid around implant +, BOP +, Biofilm ++.

TREATMENT

Explained to the patient that disease progresses faster around implant areas thanaround natural teeth, and healing is also slow. To enforce motivation, checked thegingival crevicular fluid –> checked the biofilm visually –> Homecare training ->GBT protocol –> Application of fluoride varnish to prevent root caries.

PATIENT FEEDBACK“THANKS, GBT PROTOCOL.”
62

BEFORE GBTAFTER DISCLOSINGAFTER GBT63

IMPLANTS AND GBTCASE 28
CLINICIAN

Beverley Watson RDH,
Hygienist
UAE

PATIENT INFORMATION
Age 49, male.

BACKGROUND INFORMATION

Has a difficult prosthesis design attached to implants. Motivated to care for his
bridge work and implants. Smoker.

CLINICAL FINDINGS

Suppuration visible and bone loss after taking radiographs around #11,12,13.
Upper right implants showed peri-implantitis.

TREATMENT

AIRFLOW® MAX was used to remove biofilm followed by PIEZON® PS Instrument
to remove calculus. No PERIOFLOW® at this appointment due to suppuration.

PATIENT FEEDBACK“I’M HAPPY THIS TYPE OF GBT CLEANING WAS ABLE TO HELP SAVE MY
IMPLANT. I REALLY DIDN’T WANT TO HAVE TO GET A NEW ONE PLACED.”
64

BEFORE GBTAFTERDISCLOSINGAFTER GBT

65

IMPLANTS AND GBTCASE 29
CLINICIAN

Manuela Netto
Pedro De Luca
Dentists
Brazil

PATIENT INFORMATION
Age 43, female.

BACKGROUND INFORMATION

Not very regular with professional teeth cleaning.

CLINICAL FINDINGS

Severe localized periodontitis, 6 mm and 7 mm deep pockets on the upper premolars
15 and 14, and mucositis on anterior upper implants.

TREATMENTThe GBT protocol was completed using AIRFLOW® MAX handpiece with PLUS
Powder around area of mucositis specifically.. In addition PERIOFLOW® Nozzle and
PIEZON® PS Instrument were used to clean deep periodontal pockets and remove
calculus around natural teeth.

PATIENT FEEDBACK“VERY COMFORTABLE TREATMENT WITH NO PAIN AT ALL!” I FEEL AN
IMPROVEMENT AFTER GBT IN MY ORAL HEALTH.”
66

BEFORE GBTAFTERDISCLOSINGAFTER GBT

67

IMPLANTS AND GBTCASE 30
CLINICIAN

Marisa Cataneo
Dental hygienist
Italy

PATIENT INFORMATION
Age 60, female.

BACKGROUND INFORMATION

The patient smokes and not much motivated about dental hygiene. Patient withsevere inflammation. No relevant habits.

CLINICAL FINDINGSPain and functional discomfort. Presence of inflammation around the implants.
BOP +TREATMENT

Guided Biofilm Therapy session with AIRFLOW® PLUS Powder with AIRFLOW®
and PERIOFLOW® handpieces. Subsequently, removal of calculus using the PIEZON®
handpiece and PIEZON® PS Instrument. Prescription of antibiotic therapy ofamoxicillin 500 + metronidazole 500 mg and 0.20% Clx mouthwash for 7 days.

PATIENT FEEDBACK“FEW DAYS AFTER THE TREATMENT ALL SWELLING DISAPPEARED. I FELTREALLY RELIEVED AND ALL THE IRRITANTS WERE GONE. THANK YOU FOR
EVERYTHING.”
68

BEFORE GBTAFTER DISCLOSINGAFTER GBT

69

IMPLANTS AND GBTCASE 31
CLINICIAN

Nicole Stevanello
Dental hygienist
Italy

PATIENT INFORMATION
Age 62, female.

BACKGROUND INFORMATION

Poor oral hygiene. Non-smoker, no disease, no medication.

CLINICAL FINDINGS

Presence of plaque and BOP on all implants. The patient presented signs of periimplantitis with profuse bleeding on probing, a probing pocket depth (PPD) of ≥ 6
mm with level of bone loss of ≥ 3 mm to the implants in position (16; 26; 21; 23).

TREATMENT

AIRFLOW® with PLUS Powder used supra- and subgingivally followed by
PERIOFLOW® into the peri-implant pockets to implants (16;26;23;21). After hygiene
treatment the tissue compression was reduced through the removal of the buccal
resin prosthetic pontics (flange reduction) for proper self-maintenance.

PATIENT FEEDBACK“NO MORE PAIN AND INFLAMMATION.”
70

BEFORE GBTAFTERDISCLOSINGAFTER GBT

71

IMPLANTS AND GBTCASE 32
CLINICIAN

Riccardo De Angelis
General dentist
Italy

PATIENT INFORMATION
Age 55, female.

BACKGROUND INFORMATION

Low level of oral hygiene with poor compliance. Smoker.

CLINICAL FINDINGS

Presence of mucositis and deep probing depths around a few implants. BOP +TREATMENT

Prosthesis removed, disclosing done. Patient was motivated to maintain better
oral hygiene. Lecture on stopping smoking. Complete GBT treatment done withPERIOFLOW® Nozzle and PIEZON® PI Instrument.

PATIENT FEEDBACK“I AM HAPPY AND HAVE NO PAIN.”
72

AFTERDISCLOSINGPERIOFLOW®

PIEZON® PI

AFTER GBT73

MAINTENANCE - RECALL 			
CASE 33
CLINICIAN

Adina Mauder
Dental hygienist
Germany

PATIENT INFORMATION
Age 37, male.

BACKGROUND INFORMATION

Last treatment 2 years ago; ceramic bridge from teeth 34-37; missing tooth 32,
manual toothbrush; no interdental brushes or dental floss; oral habits, clench andgrind. No relevant habits.

CLINICAL FINDINGS

Redness, swelling; general gum bleeding; BOP 62%, calculus was found on teeth
13-23, 16,17,26, 27,36,37,46,47; generalized gingivitis; plaque index 80%.

TREATMENT

Biofilm removed with AIRFLOW® MAX handpiece and AIRFLOW® PLUS Powder.
Calculus removed with PIEZON® PS Instrument. After 1 month: BOP 10% ; API
8% ; better oral hygiene.

PATIENT FEEDBACK“ MY TEETH ARE SHINY AND FEEL VERY CLEAN!”
74

PATIENT MOTIVATIONBEFORE GBTAFTER DISCLOSINGAFTER GBT

75

MAINTENANCE - RECALL 			
CASE 34
CLINICIAN:

Allison Arendziak
Dental hygienist
USA

PATIENT INFORMATIONAge 73, male.

BACKGROUND INFORMATION

Patient is on a 3-month periodontal maintenance recall due to heavy soft plaqueand calculus accumulation and history of periodontal disease. Patient has multiple
restorations present and a fissured, geographic tongue. Oral hygiene is poor. Habit
of clenching and grinding.

CLINICAL FINDINGS

Patient diagnosed with generalized stage IV, grade B disease. Probing depths
range from 1-7mm with generalized bleeding points. 28% of teeth have a probing
depth of 6mm or greater. Localized recessive defects noted in the left posterior.
Generalized soft plaque and localized moderate calculus in the lower anteriors andupper posteriors.

TREATMENT

Patient was disclosed with a 3 tone dye – tri tone GC. After educating the patient
and reviewing oral hygiene instructions, the AIRFLOW® was used to remove thebiofilm on teeth, tongue, and soft tissues. PIEZON® PS was used to remove all hardcalculus and in a few areas hand instrument to remove inaccessible calculus.

PATIENT FEEDBACK“THIS WAS THE MOST COMFORTABLE TREATMENT. I AM SATISFIED!”76

PATIENT MOTIVATIONBEFORE GBTAFTER DISCLOSINGAFTER GBT

77

MAINTENANCE - RECALL 			
CASE 35
CLINICIAN

Bianca Maria Messina
Dental hygienist
Italy

PATIENT INFORMATION
Age 26, male.

BACKGROUND INFORMATION

No professional hygiene for at least 2 years. The patient came for a visit because of
gum bleeding when brushing his teeth and to remove smoking stains. Uses manual
toothbrushes, does not use floss. Smoker.

CLINICAL FINDINGSNo deep periodontal pockets, presence of gingival inflammation, BOP + (bleedingon probing), presence of calculus especially in the lower anterior region and on upper
canine.

TREATMENT

Used biofilm discloser to show biofilm and calculus condition and motivated patient
to use electric toothbrushes and dental floss. Performed GBT using AIRFLOW®
MAX with AIRFLOW® PLUS Powder to remove all biofilm and stains and used
PIEZON® PS Instrument to remove supragingival calculus.

PATIENT FEEDBACK“I’M SATISFIED AND HAPPY. I’LL BE BACK FOR RECALL.”
78

PATIENT MOTIVATIONBEFORE GBTAFTER DISCLOSINGAFTER GBT79

MAINTENANCE - RECALL 			
CASE 36
CLINICIAN

Boris Radenkov
DentistBulgaria

PATIENT INFORMATION
Age 22, male.

BACKGROUND INFORMATION

He is referred to us by his boss, who is our patient (GBT user). His boss called
us and said, “I’m sending you a young man. I can’t look at his teeth like that, youhave to do something.” The patient claims that the last cleaning was less than ayear ago - performed by the conventional method, without advice on better homeoral hygiene. Regularly falls asleep watching movies and eating junk food.

CLINICAL FINDINGS

Biofilm-induced gingivitis. There are no surfaces free of plaque. BOP+++. In thiscase the biofilm is visible to the naked eye, but the patient thought he had a goodhygiene… until the “disclose” step.

TREATMENTGBT with an emphasis on motivation - recommendations for proper brushing andelimination of the harmful habit of eating in bed. After the first procedure, thepatient was very happy because he did not feel any pain. At the recall one month
later, the patient again showed unsatisfactory oral hygiene. He was advised to use
disclosing tablets every evening for 2 weeks to better strengthen the habit of (proper)
brushing. Two months later the patient shows much better oral hygiene and the gums
look good - the papillae are not swollen and there is almost no bleeding on probing.

PATIENT FEEDBACK“ТHE FEELING IS TOTALLY DIFFERENT. I CAN COME EVERY WEEK!”80

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

2-MONTH
RECALL81

MAINTENANCE - RECALL 			
CASE 37
CLINICIAN

Claudia Elizalde Molina
Periodontist
MexicoPATIENT INFORMATION
Age 30, female.

BACKGROUND INFORMATION

History of orthodontics in the past and esthetic crown lengthening 18 weeks ago.
No relevant habits.

CLINICAL FINDINGS

Bleeding on probing and biofilm.
Orthodontic lingual retainer with the presence of biofilm and calculus.
Esthetic composite in superior incisors.

TREATMENT

Biofilm disclosure motivated the patient to understand the importance of biofilm
and good oral hygiene necessary for a healthy mouth. AIRFLOW® PLUS Powder
was used first using GBT protocol and then we used the PIEZON® PS Instrument
to remove the calculus. Patient recall every 6 months. Recall with GBT : every 6-8
weeks during the first year of treatment, later on every 3 months.

PATIENT FEEDBACK“I AM VERY HAPPY BECAUSE I HAVE MY TEETH CLEANED WITH THE NEWTECHNOLOGY WITHOUT PAIN BECAUSE I DON’T WANT ANYMORE THE OLD
FASHION WAY BECAUSE MY ESTHETIC COMPOSITE COULD BE DAMAGEDWITH THE ULTRASONIC SCALER.”
82

PATIENT MOTIVATIONBEFORE GBTAFTER DISCLOSINGAFTER GBT83

MAINTENANCE - RECALL 			
CASE 38
CLINICIAN

Dai Jinjing
Dental hygienist
China

PATIENT INFORMATION
Age 27, male.

BACKGROUND INFORMATION

Habit of smoking since the age of 23. Lazy in general. Heavy smoker, poor habit ofbrushing teeth, doesn’t know how to use dental floss. No professional oral cleaning
for a long time.

CLINICAL FINDINGS

Generalized gingivitis. BOP +. Oral hygiene average. Presence of interdental
calculus.

TREATMENTFirst, carry out preoperative tooth staining examination, explain and communicate
the results and explain the precautions. According to inspection, first use AIRFLOW®
to clean plaque and heavy smoke stains, then use PIEZON® PS to remove the calculus.

PATIENT FEEDBACK“I NEVER THOUGHT MY TEETH COULD BE THAT CLEAN! THANKS GBT!”84

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT85

MAINTENANCE - RECALL 			
CASE 39

CLINICIAN

Dr. Hu Xiang,
Dr. Lv Da,
Dr.Wang Xiyu
Dr. Chen Gang
Dentists
China

PATIENT INFORMATION
Age 37, female.

BACKGROUND INFORMATION

Multiple teeth gradually loosened for a year. She rarely cleaned her teeth. Her gums
often bled. Lost a few teeth during pregnancy. She is healthy and has no smoking habits.

CLINICAL FINDINGSIntraoral examination. Poor hygiene, dark red and swollen gums, calculus ++.
Multiple periodontal pockets. Presence of periodontitis stage III, grade C.

TREATMENTGBT treatment oriented towards biofilm management using AIRFLOW® PLUS
Powder followed by surgical intervention (implant placement), orthodontic treatment
with regular professional plaque control. Follow up at 2, 8, 18 and 23 months.
Improvement in oral health.

PATIENT FEEDBACK“I CAN SEE ALL THE GOOD CHANGES. WILL COME BACKFOR REGULAR CHECKUPS.”86

PATIENT MOTIVATIONBEFORE

POST IMPLANT AND ORTHONDICS

GBT WITH AIRFLOW®

87

MAINTENANCE - RECALL 			
CASE 40
CLINICIAN

Manuela Netto
Pedro De Luca
Dentists
Brazil

PATIENT INFORMATION
Age 32, male.

BACKGROUND INFORMATION

Heavy smoker, no systemic diseases. His major complaint was the pigmentation
caused by nicotine. Brushes well.

CLINICAL FINDINGS

Diagnosed with gingivitis. No bleeding on probing. Good oral hygiene. Presenceof interdental calculus. Stains present in the palatal and lower anterior region.

TREATMENTGBT protocol was done, and all stains were removed with AIRFLOW® PLUS
Powder. PIEZON® PS was used to remove the calculus. Repair or replacement wererecommended because flaws and gaps were detected in the composite restoration
during the recheck phase.

PATIENT FEEDBACK“I’M REALLY HAPPY THAT THE WHOLE APPOINTMENT LASTED ONLY 40
MINUTES TO REMOVE ALL THE STAINS, WHILE IT TOOK AT LEAST 90 MINUTESBEFORE WITH THE CONVENTIONAL METHOD.”
88

PATIENT MOTIVATIONBEFORE GBTAFTER DISCLOSINGAFTER GBT89

MAINTENANCE - RECALL 			
CASE 41
CLINICIAN

Kim Eunae
Dental hygienist
South Korea

PATIENT INFORMATION
Age 52, male.

BACKGROUND INFORMATION

Non-smoker. “I think I got more stain because I was wearing a mask all the time
because of COVID-19”. He visited the clinic to inquire if he needed whitening his
teeth. No habits.

CLINICAL FINDINGS

Lack of plaque control causing stain. Found overall bleeding and swollen gingiva.

TREATMENT

After disclosing, showed the patient that biofilm was mostly found on where
stain was. Motivated the patient then performed tooth brushing instructions. It
was emphasized that not only tooth brushing but also Waterpik should be used to
manage the interproximal area. Removed all stains and biofilm using AIRFLOW®
PLUS Powder.

PATIENT FEEDBACK“I DIDN’T NEED TO GET WHITENING!
I WILL GET GBT NEXT TIME AGAIN FOR SURE.”
90

PATIENT MOTIVATIONBEFORE GBTAFTER DISCLOSINGAFTER GBT91

MAINTENANCE - RECALL 			
CASE 42
CLINICIAN

Francesca Gammino
Dental hygienist
Italy

PATIENT INFORMATION

Age 30, male. Pushes the lower lip against the teeth.

BACKGROUND INFORMATION

The patient had not realized the situation. I explained to him how to best use thetoothbrush.

CLINICAL FINDINGS
Gingival recession.

TREATMENTGBT done in the patient with AIRFLOW® PLUS Powder and PIEZON® PS Instrument
to remove all the biofilm. After 2 weeks, excellent tissue healing.

PATIENT FEEDBACK“I’M VERY VERY HAPPY!”92

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSING

AFTER
2 WEEKS93

MAINTENANCE - RECALL 			
CASE 43
CLINICIAN

Seo Gahye
Dental hygienist
South Korea

PATIENT INFORMATION
Age 56, male.

BACKGROUND INFORMATIONHigh blood pressure

CLINICAL FINDINGS

Biofilm accumulation around prosthetics. Mandibular anterior and #26 subgingival
calculus and BOP(+)

TREATMENT

Oral care was continuously performed every three months, and the ability for
self-management of mandible has improved compared to three months ago, but
periodontal condition was still poor. Performed a full arch with GBT. Repeatedteeth brushing instructions.

PATIENT FEEDBACK“I FEEL REFRESHED AFTER RECEIVING IT AND, I’M RELIEVED. ABOVE ALL,IT’S GREAT TO BE ABLE TO RECEIVE IT COMFORTABLY.”
94

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

95

MAINTENANCE - RECALL 			
CASE 44
CLINICIAN

Iva Zezulova
Dental hygienist
Czech Republic

PATIENT INFORMATION
Age 39, male.

BACKGROUND INFORMATION

Patient was detected with sideropenic anemia. Non-smoker, without medication,
healthy. Great oral care, exposed to psychological and physical issues since 10/21.

CLINICAL FINDINGSDue to usage of local anesthetics, rinsings and ointments during continuous periodof 6 months, huge amount of pigmentations from internal and external parts ofteeth was found. Aesthetic appearance of the teeth was unacceptable especially inthe case of dentist. No BOP during probing.

TREATMENTGBT done. In this case treatment was done with AIRFLOW® PLUS Powder
and AIRFLOW® Classic Comfort Powder followed by AIRFLOW® PLUS Powder.
Interdental calculus was removed with PIEZON® PS Instrument.

PATIENT FEEDBACK“I AM GLAD THAT STAINS AND AESTHETICS OF MY TEETH IS SOLVED.”96

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

97

MAINTENANCE - RECALL 			
CASE 45
CLINICIAN

Jana Krajčíková
Dental hygienist
Czech Republic

PATIENT INFORMATION
Age 33, male.

BACKGROUND INFORMATION

He visits his dentist every 6 months. For dental hygiene treatment he travels 100km
to my dental office because he loves GBT treatment and he prefers communicationin sign language. His last GBT treatment was 1,5 years ago. He visited other dental
hygiene offices when I was on maternity leave but he was not satisfied- without
disclosing, without AIRFLOW®, bad communication, insufficient quality and painful
treatment. Deaf, no medication, no diseases.

CLINICAL FINDINGS

Periodontitis, active periodontal pockets 4-5mm, bleeding gums, supra + subgingival
calculus, bruxism, erosion

TREATMENTGBT treatment with AIRFLOW® PLUS Powder and PIEZON® PS Instrument.
Deaf patients often have a problem with understanding, disclosing helps a lot tounderstand the importance of regular dental hygiene. Thanks to disclosing, teeth
cleaning instruction is easier. Patient brochure of all GBT processes is very helpful
for patient home study.

PATIENT FEEDBACK“VERY GENTLE AND QUALITY TREATMENT. I FEEL VERY GOOD. THANK YOU!”98

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT99

MAINTENANCE - RECALL 			
CASE 46
CLINICIANKateřina Jurenková
Dental hygienist
Czech Republic

PATIENT INFORMATION
Age 23, female.

BACKGROUND INFORMATION

Following orthodontic treatment, patient felt dissatisfied with her teeth after braces
were removed. With low motivation to brush teeth. No signifiant habits.

CLINICAL FINDINGS

Gingivitis, bleeding on probing positive, no interdental hygiene. Halitosis present.
After removing braces, patient´s enamel showed several small tiny scratches on all
vestibular parts of teeth. So it creates places where biofilm resists.

TREATMENTGBT done. Patient motivated and reinstructed how to take care about her interdental
places, which technique of cleaning teeth to do every day. Last but not least patient´steeth were professionaly polished. Scratches on enamel were better recognizedthanks to plaque detector. Patient recalled after 3 months for an evaluation.

PATIENT FEEDBACK“I AM VERY SATISFIED SINCE THE TREATMENT WAS VERY COMFORTABLE.”
100

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

3-MONTH
RECALL101

MAINTENANCE - RECALL 			
CASE 47
CLINICIAN

Khalid M Hannouneh
DentistUAE

PATIENT INFORMATION
Age 25, male.

BACKGROUND INFORMATION

Overall poor oral hygiene. History of a restorative aesthetic treatment.Different
types of smoking habits (cigar, pipe, dokha).

CLINICAL FINDINGSBOP +, supragingival calculus present. Moderate periodontitis around the veneers.
He doesn’t brush his teeth regularly and doesn’t use floss.

TREATMENT

Patient was educated about the proper brushing technique and the flossing
importance. GBT was done with emphasis on disclosing agent. He saw the biofilm
distribution and understood the importance of GBT, correct brushing and flossing
especially around the veneers. AIRFLOW® PLUS Powder was used to remove all
biofilm followed by PIEZON® PS Instrument.

PATIENT FEEDBACK“FINALLY MY EXPENSIVE VENEERS CAN BE SAVED
AND KEPT IN GOOD CONDITION.”
102PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

103

MAINTENANCE - RECALL 			
CASE 48
CLINICIAN

Leyla Bakirova
DentistAzerbaijan

PATIENT INFORMATION
Age 21, female.

BACKGROUND INFORMATION

Poor oral hygiene. Underwent a gingivectomy, performed at two different clinics
in the last few months, so she did not believe in success. Doesn’t take any drugs.
No relevant habits.

CLINICAL FINDINGS

Spontaneous bleeding on probing present. Presence of gingival inflammation,
supra- and subgingival calculus, stains.

TREATMENT

Just one session GBT + 0.2% chlorhexidine mouthwash for 7 days was given.
Patient put on regular recall (3 months).

PATIENT FEEDBACK“IT’S A MIRACLE! I STILL CAN’T BELIEVE THAT EVERYTHING WILL RECOVER
WITHOUT SURGERY.”104

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

105

MAINTENANCE - RECALL 			
CASE 49
CLINICIAN

Marina Kamel
Periodontist
Australia

PATIENT INFORMATION
Age 50, male.

BACKGROUND INFORMATION

Non-smoker, no history of allergies, fit and healthy. He underwent periodontal
debridement 3 months prior. Has come to Westside Perio and Implants for the
management and ongoing maintenance of his periodontal disease for the past 6 months.

CLINICAL FINDINGS

Generalized periodontitis stage III, grade B. Generalized plaque and supragingival
calculus present. Periodontal charting revealed generalized 2-3mm PPD with 48.9%
BOP. He was diagnosed to be a stable periodontitis patient with a case of gingival
inflammation.

TREATMENTThe Guided Biofilm Therapy (GBT) protocol was followed with focus on disclosing
and motivation along with re-education. Using the AIRFLOW® MAX handpiece and
AIRFLOW® PLUS Powder biofilm removal was done. Calculus was removed with
PIEZON® PS Instrument at low power and max water. A periodontal risk assessment
tool was used to determine his recall period.

PATIENT FEEDBACK“IT IS VERY HELPFUL TO SEE THE AREAS THAT I AM MISSING WITH THE PINKAND PURPLE COLOURS. I WAS WORRIED THAT IT WILL BE SENSITIVE, BUT
THE PLEASANT TREATMENT WITH WARM WATER REALLY HELPED.”
106

PATIENT MOTIVATIONBEFORE GBTAFTER DISCLOSINGAFTER GBT

107

MAINTENANCE - RECALL 			
CASE 50
CLINICIAN

Marleen Goossen
Dental hygienist
Netherlands

PATIENT INFORMATION
Age 53, female.

BACKGROUND INFORMATION

Diet no details, Oral hygiene is reasonable, Always brushes with manual toothbrush,
since 2021 electric toothbrush, last advice was to place toothbrush right against thegingival margin. Many composite restorations present in the front. Culture taken
for candida, negative result. Healthy, no medicines, non-smoker.

CLINICAL FINDINGS

Gingivitis; many visible stains; little or no calculus.

TREATMENT

Just one GBT session. Patient put on regular recall (6 months).

PATIENT FEEDBACK“I FEEL CLEAN. TREATMENT WAS GREAT. THANK YOU!”108

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

109

MAINTENANCE - RECALL 			
CASE 51
CLINICIAN

Michal Herzina
Dental hygienist
Czech Republic

PATIENT INFORMATION
Age 43, female.

BACKGROUND INFORMATION

The patient regularly undertakes dental hygiene, but never tried the GBT protocol.
The patient is aware that due to unfavorable positioning of her teeth in the frontal
area, her oral hygiene is not completely perfect. She is constantly considering theoption of orthodontic treatment.

CLINICAL FINDINGS

Gingival recession on left central incisor, no periodontal pockets, very small
amounts of tartar present.

TREATMENT

Plaque disclosing with GC Tri-plaque ID gel. Then the patient showed areas which
she could not clean specifically the interdental areas. The patient was instructed withusage of dental aids. In addition to the classic dental aids that the patient already uses,
the patient was also shown how to use an expanding floss, which helps the patient clean
hard-to-reach places. AIRFLOW® PLUS Powder was used to remove stained deposits.
PIEZON® PS Instruments were used to remove small deposits of tartar. In addition,
recalls were recommended to the patient every 6 months hereafter.

PATIENT FEEDBACK“DENTAL HYGIENE HAS TAKEN ON A WHOLE NEW MEANING FOR ME. I’M
THRILLED. I THOUGHT I CLEANED BETTER THAN WHAT THE HYGIENE HASACTUALLY SHOWN. I HIGHLY RECOMMEND IT.”110

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT111

MAINTENANCE - RECALL 			
CASE 52
CLINICIAN

Míriam Torrejón Ayala
Dental hygienist
Spain

PATIENT INFORMATION
Age 35, male.

BACKGROUND INFORMATION

Poor oral hygiene. Never visited a dental clinic in the last 4-5 years because pastexperiences have horrified him. He was scared with the place and noise of a dental
clinic. No relevant habits present. Does not have dental hygiene habits.

CLINICAL FINDINGS

Generalized gingivitis. BOP+ >30% (Bleeding on Probing) with few 4mm pockets. Supraand subgingival calculus +++. Halitosis present. Inability to clean interproximal areas.

TREATMENT

Start by rinsing with BacterX® Pro mouthwash. Plaque disclosing and evaluation was
done using Discloser® and the patient was shown images of the teeth and the areas ofpoor plaque control. The patient was given additional instruction on the most appropriatetechniques for removing the plaque and this was demonstrated in the surgery. AIRFLOW®
MAX with the AIRFLOW® PLUS® Power removing biofilm, early calculus and stains.
Removing remaining calculus supra- and subgingivally with PIEZON® PS Instrument.
Do a final check for remaining biofilm and ensure calculus is fully removed. Applied
protection layer with fluoride. The patient will return every 6 months. I will ask him
if he liked the treatment.

PATIENT FEEDBACK“IT IS THE BEST TREATMENT I HAVE RECEIVED IN MY LIFE. IT IS VERYCOMFORTABLE AND PLEASANT. I WILL NEVER GO BACK TO AN OLD SYSTEM.”
112

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

6-MONTH
RECALL113

MAINTENANCE - RECALL 			
CASE 53
CLINICIAN

Neha Dixit
Periodontist
Switzerland

PATIENT INFORMATION
Age 65, male.

BACKGROUND INFORMATION

History of poor oral hygiene, lack of motivation, no time to brush.

CLINICAL FINDINGS

Bleeding on probing +. Presence of calculus. Lots of biofilm on disclosing.

TREATMENTGBT was performed with emphasis on each step. Patient was instructed, motivated,re-educated on oral hygiene. Recall showed drastic improvement in the plaque score.

PATIENT FEEDBACK“THANK YOU FOR THE TIME WITH ALL THE EXPLANATION. IT’S ONLY BECAUSE
OF THE TREATMENT YOU GAVE ME WHICH WAS SO COMFORTABLE THAT I
FEEL MOTIVATED TO BRUSH AND MAINTAIN MY ORAL HYGIENE.
WILL SEE YOU VERY SOON.”114

PATIENT MOTIVATIONFIRST APPOINTMENT

BEFORE GBTAFTER DISCLOSINGAFTER AIRFLOW®

AFTER GBTRECALL AFTER 1 YEAR

BEFORE GBTAFTER DISCLOSINGAFTER AIRFLOW®

AFTER GBT

115

MAINTENANCE - RECALL 			
CASE 54
CLINICIAN

Nicole Stevanello
Dental hygienist
Italy

PATIENT INFORMATION
Age 32, male.

BACKGROUND INFORMATION

Poor oral hygiene. Patient on a regular GBT recall every 3 months.
No relevant habits.

CLINICAL FINDINGS

Presence of light stains, plaque and calculus mostly in the lower anteriors.

TREATMENTGBT was done with AIRFLOW® PLUS Powder to remove all biofilm and stains
followed by PIEZON® PS Instrument to remove calculus.

PATIENT FEEDBACK“NO PAIN, HAPPY AND READY TO SMILE!!”116

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

117

MAINTENANCE - RECALL 			
CASE 55
CLINICIAN

Olga Grabowska
Dental hygienist
PolandPATIENT INFORMATION
Age 49, male.

BACKGROUND INFORMATION

Patient has hypothyroidism, open bite, mouth breather. Tense facial muscles
with a large tongue. The patient drinks large quantities of carbonated drinks andsweetened fruit juices.

CLINICAL FINDINGSInflammation of the gums, supragingival calculus, lack of subgingival calculus andpockets more than 4 mm, moderate bleeding when probing. Numerous decalcifications
on the cervical surfaces, resulting from insufficient home hygiene and incorrect
eating habits.

TREATMENTGBT protocol, using only AIRFLOW® PLUS Powder. The patient was instructedon the correct brushing technique (manual brush, soft alternating with an electric
toothbrush on a gentle mode). Another recall visit was scheduled in 4 months.

PATIENT FEEDBACK“GBT MADE ME REALIZE AREAS WHERE I NEED TO CLEAN BETTER. THE
WATER DURING THE PROCEDURE IS WARM, MAKING IT A PLEASANT
FEELING. I AM HAPPY TO RETURN TO THE DATES SET BY THE HYGIENIST. THE
CONDITION OF MY GUMS AND TEETH HAS IMPROVED A LOT.”
118

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

119

MAINTENANCE - RECALL 			
CASE 56
CLINICIAN

Rosario Maria Rodriguez Pichardo
Dental hygienist
Spain

PATIENT INFORMATION
Age 37, female.

BACKGROUND INFORMATION

Patient with gingivitis, she presents both subgingival and supragingival plaque.
Does not maintain good oral hygiene, does not use interproximal brushes or dental
tape. The patient has gingival overgrowth in the upper incisors but does not wantto undergo a gingivectomy. She lost molars a few years ago. She smokes and has
cardiovascular disease, in addition to being overweight. She visits the dentist every
3 or 4 years. Bleeding gums and halitosis.

CLINICAL FINDINGSNo deep periodontal pockets. Heavy bleeding only when applying air. Generalized
supragingival and subgingival calculus.

TREATMENTGBT performed with AIRFLOW® PLUS Powder and PIEZON® PS Instrument toremove all biofilm and stains. After 1-month recall, excellent healing in the upperand lower incisors.

PATIENT FEEDBACK“THIS IS THE DENTAL CLEANING THAT HAS BOTHERED ME THE LEAST,I AM DELIGHTED!”
120

PATIENT MOTIVATIONBEFORE GBTAFTER DISCLOSINGAFTER GBT

121

MAINTENANCE - RECALL 			
CASE 57
CLINICIAN

Sarah Heuving
Dental hygienist
Germany

PATIENT INFORMATION
Age 42, male.

BACKGROUND INFORMATION

Periodontal treatment in 2021 under antibiotics. Recall at intervals of 12 weeks.
Currently smokes 15 cigarettes a day, works out.

CLINICAL FINDINGS

Probing depths generally at 4-5mm, BOP +, visible plaque in the cervical area,
tartar and extrinsic discoloration from smoking.

TREATMENT

Renewed detailed oral hygiene instruction with emphasis on the use of theappropriate interdental brush. Educational discussion about the negative effects ofsmoking on periodontal and holistic health. Professional teeth cleaning according
to the GBT® concept. Application of the AIRFLOW® MAX with AIRFLOW® PLUS
Powder. Periodontal pockets treated with PERIOFLOW®. Tartar removal with
PIEZON® PS and PI Instrument. Fluoridation and feedback discussion.

PATIENT FEEDBACK“I TOTALLY ENJOYED GBT AND WILL PLAN MY DATE SOON FOR
THE NEXT RECALL. I TAKE RESPONSIBILITY FOR ORAL HYGIENE AND
MY OVERALL HEALTH.”
122

PATIENT MOTIVATIONBEFORE GBTAFTER DISCLOSINGAFTER GBT

123

MAINTENANCE - RECALL 			
CASE 58
CLINICIAN

Simone Schwenke
Dental hygienist
Germany

PATIENT INFORMATION
Age 48, female.

BACKGROUND INFORMATION

Nothing relevant. The patient comes for a regular recall every 6 months. Her oral
hygiene is good. She uses a Philips Sonicare and dental floss. No relevant habits.

CLINICAL FINDINGS

Probing readings 1-3mm. No bleeding on probing. Recessions of 1-3mm by“scrubbing” with the manual toothbrush in the past. No calculus.

TREATMENT

Removal of existing biofilm with the AIRFLOW® MAX handpiece and AIRFLOW®
PLUS Powder.

PATIENT FEEDBACK“I LOVE THAT FRESH, CLEAN AND SMOOTH FEELING.”
124

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

125

MAINTENANCE - RECALL 			
CASE 59
CLINICIAN

Stephanie Günther
Dental hygienist
South Africa

PATIENT INFORMATION
Age 48, female.

BACKGROUND INFORMATION

The patient has been seeing me every 6 months since 2012 (10 years) for prophylaxis.
Her main concern is generalised gingival recession and sensitivity (especially during
hygiene visits) at the exposed tooth necks. This patient remembers the days of the“old fashioned, scale and polish” treatment and, though dedicated to her 6 monthly
visits, always came with a sense of dread in her heart due to the unpleasant scaling
sessions. I made the switch to GBT in 2017 and we have never looked back.
Non-smoker, nothing exceptional in the medical history, patient appears in good
health.

CLINICAL FINDINGS

Generalised, yet stable, gingival recession with moderate plaque (the interdental
areas being the patient’s weak spot) and calculus build-up mainly around the lower
anteriors.

TREATMENT

After disclosing, the AIRFLOW® MAX handpiece was used with AIRFLOW®
PLUS Powder for supra- and subgingival biofilm removal. Calculus was removed
with the PIEZON® PS Instrument. All tooth necks treated with Cervitec F varnish.

PATIENT FEEDBACK“HAVING MY TEETH CLEANED IS NOW AS EASY AS GOING TO THE
HAIRDRESSER... ALMOST!”126

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

127

MAINTENANCE - RECALL 			
CASE 60
CLINICIAN

Vanessa Borken
Dental hygienist
Germany

PATIENT INFORMATION
Age 27, female.

BACKGROUND INFORMATION

Bad experience in other dental office. Two weeks unpleasantries afterwards. Overall
good oral hygiene. Past of intensive home bleaching with over-the-counter products.
Since then, sensitivity problems. Bleaching toothpaste and Sonicare. Her level ofmotivation is very high. White and good-looking teeth are very important for her.

CLINICAL FINDINGS

Generalized sensitivity. First incisors partially transparent. Interdental plaque/mandibular incisors have calculus.

TREATMENT

Reeducation about bleaching and handling sensitivity problems. The goal is to
get the patient back to a healthy relationship between oral health and having thestress of a perfect look. GBT was done with AIRFLOW® PLUS Powder, minimal
PIEZON® NO PAIN, fluoride application.

PATIENT FEEDBACK“I NEVER EXPERIENCED A TEETH CLEANING AS COMFORTABLE AND
PLEASANT. BUT WITH GBT I HAD NO INCONVENIENCE. FOR THE FIRST TIME, IT
FELT LIKE I DID SOMETHING GOOD FOR MY TEETH.”
128

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT

129

MAINTENANCE - RECALL 			
CASE 61
CLINICIAN

Zeng Cuiying
Periodontist
China

PATIENT INFORMATION
Age 42, female.

BACKGROUND INFORMATION

Brushes teeth twice a day, 2min/ time, uses dental floss daily. Bleeding whenbrushing, loose teeth and bad breath for half a year. No smoking.

CLINICAL FINDINGS

Oral hygiene is ok. Soft deposit index: 2, dental calculus index: 2. Bleeding on
probing, bleeding index: 4. Gingival recession was moderate and severe, 17, 16, 46,
47 loss of attachment, PD 6-8mm in individual sites.

TREATMENTGBT combined with local medication. Focus on OHI.

PATIENT FEEDBACK“GBT IS AMAZING ! I THINK I NEED TO ASK ALL MY FAMILY MEMBERS TO DO
GBT AT LEAST ONCE A YEAR !”130

PATIENT MOTIVATIONBEFORE GBTAFTERDISCLOSINGAFTER GBT131

ORTHODONTICS
CASE 62
CLINICIAN

Adina Mauder
Dental hygienist
Germany

PATIENT INFORMATION
Age 37, female.

BACKGROUND INFORMATION

Poor oral hygiene. Orthodontic treatment since 1 year. The use of a mouth rinse
caused many stains.

CLINICAL FINDINGS

No periodontal pockets, BOP -, calculus ++, Difficulty in maintaining oral hygiene,
especially interdental care. After 3 months, patient shows good oral hygiene.

TREATMENTGBT performed using AIRFLOW® PLUS Powder. Time spent on patient motivationand cleaning orthodontic brackets together with the patient. Spoke about challenges
in keeping the areas clean. Calculus removed with PIEZON® PS Instrument without
touching the brackets.

PATIENT FEEDBACK“NEVER HAVE I EXPERIENCED PROPHYLAXIS TO BE SO THOROUGH, GENTLE
AND WITH SUCH GOOD RESULTS. THANK YOU GBT!”
132

& GBT
BEFORE GBTAFTER DISCLOSINGAFTER GBT133

ORTHODONTICS
CASE 63
CLINICIAN

Andrii Voroshylov
Dental hygienist
Ukraine

PATIENT INFORMATION
Age 13, male.

BACKGROUND INFORMATION

The patient believed he was cleaning teeth adequately and could not see any plaqueon the teeth. High sugar diet.

CLINICAL FINDINGS

Despite previously being provided with oral hygiene advice, plaque control aroundthe orthodontic brackets was not ideal.

TREATMENT

Plaque disclosing and evaluation were done using biofilm discloser and the patient was
shown images of the teeth and the areas of poor plaque control. Particular emphasis
was placed on the presence of the light blue stained plaque indicating the acid-producing
plaque which could potentially cause demineralization and white spot lesions on theteeth and thereby compromise the tooth structure and the final aesthetic result. The
patient was given additional instructions on the most appropriate techniques forremoving the plaque and this was demonstrated in the surgery. The residual plaque
was then removed with AIRFLOW® Prophylaxis Master (AFPM) using AIRFLOW®
PLUS Powder .The patient was advised to continue using a toothpaste twice a day
and apply a remineralizing agent GC Tooth Mousse Plus after brushing.

PATIENT FEEDBACK“THANK YOU FOR SHOWING ME MY BIOFILM.
IT WAS NOT SCARY AND DID NOT CAUSE ANY PAIN.”
134

& GBT
BEFORE GBTAFTERDISCLOSINGAFTER GBT

135

ORTHODONTICS
CASE 64
CLINICIAN

Beatrice Zvalčáková
Dental hygienist
Czech Republic

PATIENT INFORMATION
Age 13, male.

BACKGROUND INFORMATIONFirst visit to a dental hygienist, cleans only with toothbrush. Presence of orthodontic
brackets 2 years, consumes a lot of sweet food.

CLINICAL FINDINGS

Very poor oral hygiene, presence of a large amount of acidic dental plaque with therisk of demineralization, dental calculus around the orthodontic brackets in frontal
part in lower jaw, bleeding on probing (BOP).

TREATMENTGBT done with AIRFLOW® PLUS Powder, PIEZON® PS Instrument. Thoroughmotivation and practice of cleaning orthodontic brackets using toothbrush, interdental
brushes and tufted toothbrush. Regular recall every 3 months.

PATIENT FEEDBACK“I CANNOT BELIEVE THAT MY TEETH WERE THIS DIRTY. THE COLOR REALLY
MADE ME REALIZE THAT I HAVE TO BRUSH BETTER.”
136

& GBT
BEFORE GBTAFTER GBT137

ORTHODONTICS
CASE 65
CLINICIAN

Bianca Maria Messina
Dental hygienist
Italy

PATIENT INFORMATION
Age 22, female.

BACKGROUND INFORMATION

Invisible orthodontics, on 21 of 25 aligners. No relevant habits.

CLINICAL FINDINGSThe patient presents no bleeding on probing and no supragingibal calculus. Brushes
her teeth three times a day (after every meal) with a manual toothbrush before
putting on the aligners. Uses floss every day.

TREATMENT

Guided Biofilm Terapy (GBT) given to the patient using only AIRFLOW® PLUS
Powder to remove biofilm.

PATIENT FEEDBACK“I AM VERY HAPPY. IT WAS A GREAT EXPERIENCE.”
138

& GBT
BEFORE GBTAFTER DISCLOSINGAFTER GBT139

ORTHODONTICS
CASE 66
CLINICIAN

Wu Yuping
DentistChina

PATIENT INFORMATION
Age 17, female.

BACKGROUND INFORMATIONHigh school student, no special eating habits. Poor oral hygiene, not very motivatedto visit a dental office. High school student, no special eating habits.

CLINICAL FINDINGSWith a large amount of soft deposits attached to the labial tooth surface, the edgeof the attachment becomes yellow. Food residue accumulates between teeth.

TREATMENTLet the patient know the location of mature plaque and newly formed plaque andrelated reasons in order to strengthen her attention to oral health through GBT
treatment.

PATIENT FEEDBACK“FEEL VERY GOOD AFTER GBT TREATMENT. AS A SENIOR SCHOOL STUDENT I
AM BUSY WITH STUDIES, I ALSO WORRIED ABOUT DENTAL CARIES CAUSEDBY INADEQUATE BRUSHING. AFTER TODAY’S TREATMENT,MY UNDERSTANDING OF ORAL HEALTH CARE, ESPECIALLY
THE PRECAUTIONS TAKEN TO SEE BIOFILM, WHICH IS INVISIBLE TO
THE NAKED EYE, HAVE BEEN ENLIGHTENING.”
140

& GBT
BEFORE GBTAFTER DISCLOSINGAFTER GBT141

ORTHODONTICS
CASE 67
CLINICIAN

Chiara Deitos
Dental hygienist
Italy

PATIENT INFORMATION
Age 16, female.

BACKGROUND INFORMATION

The patient is in high school and 5 days a week she has lunch at school and she
doesn’t brush her teeth when she is at school. She uses manual toothbrush with soft
bristles, she doesn’t use interdental brushes and doesn’t floss regularly. The patient
has a regular diet and takes sport supplements. Non-smoker, no drinking habits.

CLINICAL FINDINGS

Gingivitis with BOP +. Presence of calculus + in lower anteriors.

TREATMENTThe dental biofilm was exposed and the patient motivated. Then biofilm, stains
and young calculus were removed with AIRFLOW® MAX and PLUS Powder. By
using PIEZON® with PS Instrument the remaining calculus was removed. After a
final check, a 3-month recall was scheduled.

PATIENT FEEDBACK“THE TREATMENT WAS MORE DELICATE THAN LAST TIME AND
BY SEEING THE COLORED AREAS I REALIZED THAT I NEEDTO PAY MORE ATTENTION TO ORAL HYGIENE.”
142

& GBT
BEFORE GBTAFTER DISCLOSINGAFTER GBT143

ORTHODONTICS
CASE 68
CLINICIAN

Cristina Pavan
Dental hygienist
Italy

PATIENT INFORMATION
Age 31, male.

BACKGROUND INFORMATION

Balanced diet, generally good oral hygiene. The patient is very motivated because,
after 5 years of doubts and rethinking, has decided to follow the orthodontic way.
First he put on MSE (Maxillary Skeletal Expander) and then underwent maxillofacial
surgery to improve the palatine bone’s fracture. Now he is in the expansion phaseand is finishing root canal treatment in the tooth number 11. No relevant habits.

CLINICAL FINDINGS

Presence of gingival inflammation, mild plaque deposits around the orthodontic
bands and lower incisors. Presence also of many chlorhexidine stains. BOP -.

TREATMENTGBT done with exclusively AIRFLOW® PLUS Powder, all the chlorhexidine stains
easily vanished. Perioflow was used around the MSE for the removal of non-visible
biofilm. PIEZON® PS Instrument then was used to remove hard calculus. Now thepatient will follow a limited recall every month.

PATIENT FEEDBACK“TOP TREATMENT! FINALLY I DON’T FEEL ANYMORE PAIN!”
144

& GBT
BEFORE GBTAFTER DISCLOSINGAFTER GBT

145

ORTHODONTICS
CASE 69
CLINICIAN

Esther Rovira
Dental hygienist
Spain

PATIENT INFORMATION
Age 22, female,BACKGROUND INFORMATION

The patient follows a Mediterranean diet, she shows motivation to improve her oral
health. She has been in orthodontic treatment for two years. In this case the GBT
treatment is the preparation for surgery. She is currently waiting to undergo bimaxillaryorthognatic surgery. Uses manual brush twice a day. Does not use floss or dental sticks
for interdental cleaning. Non-smoker; improper and incomplete oral hygiene.

CLINICAL FINDINGSNo pockets present, BOP + particularly in the interdental anterior region. Supraand subgingival calculus ++ in the lower mandibular posterior areas.

TREATMENTIn step one, I administered BacterX PRO mouth rinse to reduce the viral andbacterial load of the patient’s oral cavity. GBT protocol completed with emphasis on
disclosing agent and oral hygiene instructions.

PATIENT FEEDBACK“I ENJOYED MY APPOINTMENT WITH ESTHER! IT’S BEEN RELAXING, GENTLE
AND I NOW FEEL MY TEETH LIKE I’VE NEVER FELT THEM BEFORE! I FEEL GOOD!”
146

& GBT
BEFORE GBTAFTERDISCLOSINGAFTER GBT147

ORTHODONTICS
CASE 70
CLINICIAN

Kim Eunae
Dental hygienist
South Korea

PATIENT INFORMATION
Age 15, female.

BACKGROUND INFORMATION

Poor oral hygiene. The patient was having difficulty in self-management due toirregular teeth alignment. Her parents made her visit the clinic, but oral healthmotivation was very low.

CLINICAL FINDINGS

Generalized bleeding present. Swollen gingiva, presence of large amounts ofsupragingival calculus. After the bracket was installed, self-management was moredifficult, and motivation and direct patient engagement were needed for improvement..

TREATMENTThe areas requiring self-care were shown after disclosing, and TBI was provided
for brushing around the brackets and gingival area. The disclosed biofilm area wasbrushed by the patient and tooth brushing instructions. Used PS Instrument forremoving calculus. The patient started to enjoy GBT. Currently, the recall interval
has been extended from one or two months to three months.

PATIENT FEEDBACK“THANK YOU FOR ALWAYS TAKING GOOD CARE OF MY DAUGHTER.”
148

& GBT
BEFORE GBTAFTER DISCLOSINGAFTER GBT

149

ORTHODONTICS
CASE 71
CLINICIAN

Francesca Gammino
Dental hygienist
Italy

PATIENT INFORMATION
Age 13, male.

BACKGROUND INFORMATION

The patient eats a lot of sweets during the day. I motivated him to use the toothbrushand the brush. The patient decided not to brush his teeth for fear that the appliancewould become detached.

CLINICAL FINDINGS

Gingivitis, biofilm ++, BOP +.

TREATMENTA GBT session with AIRFLOW® MAX, AIRFLOW® PLUS Powder and PIEZON®
PS Instrument.

PATIENT FEEDBACK“I AM HAPPY AND FINALLY UNDERSTOOD THE IMPORTANCE
OF ORAL HYGIENE.”
150

& GBT
BEFORE GBTAFTER DISCLOSINGAFTER GBT151

ORTHODONTICS
CASE 72
CLINICIAN

Karolina Hrušová
Dental hygienist
Czech Republic

PATIENT INFORMATION
Age 31, female.

BACKGROUND INFORMATION

The patient came for dental hygiene one year ago. She has received Invisalignorthodontic therapy for 8 months. Aligners are removed before each meal and cleaned
by patient properly and regularly. She is bothered by stains on her teeth, which she
is not able to remove by herself at home. Smoker.

CLINICAL FINDINGS

Presence of numerous stains, biofilm around attachments, inflammation ininterdental areas, calculus behind front teeth in lower jaw.

TREATMENT

Dental hygiene done according to GBT protocol. Biofilm disclosed. Biofilm andstains removed with AIRFLOW® PLUS Powder, calculus with PIEZON® PS.
Motivated and instructed the patient (recommendation for single tooth brush andinterdental brushes). Recall set up every 3 months. Aligners were also cleaned with
AIRFLOW® PLUS Powder. Recall after 3 months: Significantly improved patient´sdental hygiene. No inflammation, fewer stains.

PATIENT FEEDBACK“AFTER TREATMENT MY TEETH LOOK BEAUTIFUL, ATTACHMENTS ARE NOTVISIBLE ANYMORE AND STAINS DO NOT FORM AS BEFORE!”
152

& GBT
BEFORE GBTAFTERDISCLOSINGAFTER GBT

3-MONTH
RECALL153

ORTHODONTICS
CASE 73
CLINICIAN

Monika Gątarczyk
Dental hygienist
PolandPATIENT INFORMATION
Age 27, male.

BACKGROUND INFORMATION

A healthy patient, he has been wearing a fixed orthodontic appliance for 8 months.
Inadequate oral hygiene.

CLINICAL FINDINGS

Presence of supragingival calculus, deposits and visible biofilm. The patient only uses
a manual toothbrush. He does not use interdental aids or an irrigator. The patientasks for advice on how to avoid the formation of plaque and interdental calculus.

TREATMENTGBT was performed with AIRFLOW® PLUS Powder and PIEZON® PS Instrument.
The focus was on education. Another instruction on the use of additional aids in theform of interdental brushes was carried out. The use of an irrigator was recommended.

PATIENT FEEDBACK“I FEEL SO CLEAN. MY ORTHODONTIC APPLIANCE FEELS LIKE NEW.”154

& GBT
BEFORE GBTAFTER DISCLOSINGAFTER GBT

155

ORTHODONTICS
CASE 74
CLINICIAN

Ke RongjiDentistChina

PATIENT INFORMATION
Age 20, female.

BACKGROUND INFORMATION

Orthodontic referral for treatment due to poor oral hygiene and discoloration ofanterior teeth.

CLINICAL FINDINGS

Brackets and arch wires can be seen on the tooth surface, and tons of plaques andsoft dirt accumulation can be seen on the adjacent surface of the anterior teeth.

TREATMENT

Dental caries covered by plaque is difficult to find. Using the AIRFLOW® to remove
biofilm is more convenient for dental exam. Choosing AIRFLOW® PLUS Powder toensure the efficiency of cleaning while being minimally invasive.

PATIENT FEEDBACK“UNPARALLELED WONDERFUL EXPERIENCE ! LOVE GBT !”156

& GBT
BEFORE GBTAFTER DISCLOSINGAFTER GBT

157

ORTHODONTICS
CASE 75
CLINICIAN

Khalid M Hannouneh
DentistUAE

PATIENT INFORMATION
Age 33, female.

BACKGROUND INFORMATION

Overall poor oral hygiene, With a history of orthodontic treatment. No relevant
habits.

CLINICAL FINDINGSBOP -, supragingival calculus present. She has attachments on the teeth for theinvisible aligner treatment. Doesn’t brush her teeth regularly and doesn’t use floss.
Patient came mainly to improve the color of her teeth

TREATMENT

Patient education about follow-up every 4 months. GBT was done with emphasison disclosing agent and patient education. She saw the biofilm distribution andunderstood the importance of GBT and flossing. AIRFLOW® PLUS Powder wasused to remove all biofilm followed by PIEZON® PS Instrument.

PATIENT FEEDBACK“I AM CONFIDENT THAT MY ATTACHMENTS HAVE BEEN CLEANED AND
THAT MY PROPHYLAXIS TREATMENT WITH GBT WILL GIVE ME
BETTER ORAL HEALTH.”
158

& GBT
BEFORE GBTAFTERDISCLOSINGAFTER GBT

159

ORTHODONTICS
CASE 76
CLINICIAN

Leon Zhong Hong
DentistChina

PATIENT INFORMATION
Age 22, female.

BACKGROUND INFORMATION

The patient started orthodontics a few months ago. It was inconvenient to brush her
teeth during the period. Recently, she felt that her teeth were gradually yellowish, so
she asked for professional cleaning. Has a history of tooth extraction but no historyof systemic diseases.

CLINICAL FINDINGS

Orthodontic routine follow-up, requiring teeth cleaning.

TREATMENTGBT full mouth cleaning and orthodontic bracket cleaning. AIRFLOW® MAX wasused with AIRFLOW® PLUS Powder.

PATIENT FEEDBACK“FEELING SUPER GOOD WHEN ORTHODONTIC BRACKET IS CLEAN !
I LOVE GBT !”160

& GBT
BEFORE GBTAFTER DISCLOSINGAFTER GBT

161

ORTHODONTICS
CASE 77
CLINICIAN

Liu ZhengDentistChina

PATIENT INFORMATION
Age 21, female.

BACKGROUND INFORMATION

Nurse, came for an orthodontic follow up. orthodontic treatment was started 1
year ago. GBT was performed every six months. Tooth extraction done because oforthodontic treatment. No systemic diseases.

CLINICAL FINDINGS

Presence of gingivitis, BOP +. Average oral hygiene.

TREATMENTGBT with AIRFLOW® PLUS Powder. Lots of motivation including use of oral
hygiene aids.

PATIENT FEEDBACK“BIOFILM DISCLOSING MAKES ME REALIZE THERE SO MUCH
HORRIBLE BIOFILM AROUND THE BRACKET IN MY MOUTH.
GBT CLEARED IT QUICKLY AND COMPLETELY !”162

& GBT
BEFORE GBTAFTERDISCLOSINGAFTER GBT

163

ORTHODONTICS
CASE 78
CLINICIAN

Magdalena Michałowska
Dental hygienist
PolandPATIENT INFORMATION
Age 28, female.

BACKGROUND INFORMATION

The patient has been treated with Invisalign appliance for a year. There areattachments bonded to the teeth. Very poor oral hygiene. Professional hygiene has
never been performed while wearing the appliance. No relevant habits.

CLINICAL FINDINGS

Generalized gingival inflammation. Massive biofilm, supragingival calculus.
BOP ++. Numerous, extensive enamel decalcifications.

TREATMENTThe GBT procedure was performed, the next control visit was scheduled for 1
month later. Subsequent visits take place every 3 months. Thorough oral hygiene
instructions were carried out along with motivation. It was recommended to usea soft brush at the beginning, then switch to an electric OralB toothbrush. It isnecessary for a patient to use dental floss.

PATIENT FEEDBACK“NEVER REALIZED THAT MY ATTACHMENTS NEEDED TO BE CLEANED.
GBT ASSURES ME THERE IS NO DAMAGE. THANK YOU!”164

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ORTHODONTICS
CASE 79
CLINICIANMaria Fernanda Kolbe
Dental hygienist
Brazil

PATIENT INFORMATION
Age 26, male.

BACKGROUND INFORMATION

He works in the financial market, is a sportsman, has a healthy and slightly acidic
diet. He doesn’t smoke, he drinks 3 coffees a day and occasionally red wine. Patientreports brushing his teeth 3 times a day and flossing “almost every night”. Cameto the office for prophylaxis and check-up, complaining of “bleeding gums”.

CLINICAL FINDINGSOn clinical examination, he was diagnosed with generalized gingivitis, bleedingon probing in more than 50% of the sites and gingival hyperplasia in the lower
anterior teeth.

TREATMENT

Used GBT protocol on patient. He had no idea how poor his hygiene was.
Subsequently, he was instructed on the technique of flossing, brushing and interdental
brushing. Despite the bleeding, patient reported not feeling any pain or evendiscomfort during AIRFLOWING with AIRFLOW® PLUS. As there were no pockets
larger than 4mm, the PERIOFLOW® step was skipped. After removing all biofilm,a PIEZON® PS Instrument was used to remove calculus from lower anterior teeth.

PATIENT FEEDBACK“I WANT TO DO THIS PROPHYLAXIS EVERY 4 MONTHS AND NEVER LEAVEMY MOUTH LIKE THIS AGAIN! I DON’T WANT TO KNOW ABOUTANY OTHER KIND OF CLEANING…”
166

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6-MONTH
RECALL167

ORTHODONTICS
CASE 80
CLINICIANMariana Fonseca
Periodontist
Brazil

PATIENT INFORMATION
Age 60, male.

BACKGROUND INFORMATIONWith a history of periodontal disease returning for maintenance after 1 year.
Smoker with poor oral hygiene and under orthodontic treatment.

CLINICAL FINDINGS

Poor plaque control, bleeding on probing with gingivitis and some periodontal
pockets.

TREATMENT

Performed GBT protocol, starting with oral hygiene guidance to improve dental
plaque control, followed by AIRFLOW® and AIRFLOW® PLUS Powder and PIEZON®
PS Instrument (subgingival)..

PATIENT FEEDBACK“I FOUND THE NEW PROTOCOL INTERESTING. THE BIG DIFFERENCE
FOR ME WAS THE WARM WATER. I DIDN’T FEEL ANY DISCOMFORT.
THANKS FOR THE EXCELLENT SERVICE AND TREATMENT!”
168

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ORTHODONTICS
CASE 81
CLINICIAN

Marina Rusu
Dental hygienist
Italy

PATIENT INFORMATION
Age 21, male.

BACKGROUND INFORMATION

He is in his second year of university specializing in law. He uses a hard manual
toothbrush and he doesn’t use any device for interproximal hygiene or for fixedbraces. He practices football three times a week. Smoker, no drinking or otherrelevant habits.

CLINICAL FINDINGS

Gingivitis and gum recession.

TREATMENTThe biofilm was highlighted with EMS Biofilm Discloser and the patient was
motivated. The biofilm and smoke stains were removed with AIRFLOW® PLUS
Powder. I then used PIEZON® PS Instrument to remove remaining calculus. Afterthe final check we fixed the recall after 4 months.

PATIENT FEEDBACK“THIS NEW PROTOCOL HAS BEEN REALLY HELPFUL IN
UNDERSTANDING WHERE I DON’T BRUSH WELL.
I WOULD ALSO LIKE TO USE THIS METHOD IN THE FUTURE.”
170

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171

ORTHODONTICS
CASE 82
CLINICIAN

Zhang Li
Dental hygienist
China

PATIENT INFORMATION
Age 28, male.

BACKGROUND INFORMATION

Orthodontic patient, Poor brushing habits. Gingival recession existed before
orthodontic treatment.

CLINICAL FINDINGS

Poor oral hygiene, Lots of calculus visible. Patient was never instructed on oral
hygiene and health. Never used interdental aids.

TREATMENTGBT done using both AIRFLOW® and PIEZON® to remove biofilm, stain andcalculus very quickly. Attention paid to patient’s cleaning habits and routine.

PATIENT FEEDBACK“THIS IS WHAT CLEAN REALLY FEELS LIKE!”
172

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PERIODONTAL DEBRIDEMENTCASE 83
CLINICIAN

Karen NG
Dental hygienist
CanadaPATIENT INFORMATION
Age 28, Male.

BACKGROUND INFORMATION

Chronic moderate cigarette/marijuana smoker. Client not ready for smoking
cessation program. Microbiological biofilm DNA testing was completed and key
pathogens were identified in the oral cavity.

CLINICAL FINDINGS

Generalized gingival inflammation with moderate subgingival calculus; cariogenic
biofilm present around the anterior teeth; interdental CAL 3-4mm ; probing depths
5mm or less; generalized horizontal bone loss; generalized bleeding on probing;
Unstable, localized stage II, grade B.

TREATMENTGBT treatment protocol completed with AIRFLOW® PLUS Powder, PERIOFLOW®
and PIEZON® PS, PSR & PSL Instruments to access the crowded and difficult areas.
Educated the patient and instructions were given for home management. Patientvery motivated to attend the 3-month maintenance care visits because of GBT.

PATIENT FEEDBACK“I HAVE STRUGGLED FOR MANY YEARS TRYING TO MAINTAIN MY DENTALHEALTH. I REALLY APPRECIATE THE THOROUGH AND COMFORTABLE CARETHAT I RECEIVE WITH THIS TREATMENT. MY TEETH FEEL INCREDIBLYSMOOTH, AND MY GUMS FEEL REJUVENATED AFTER EACH VISIT!”
174

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175

PERIODONTAL DEBRIDEMENTCASE 84
CLINICIAN

Marija Scheffler
Dental hygienist
Germany

PATIENT INFORMATIONAge 87, female.

BACKGROUND INFORMATION

Very motivated patient, determined to save her teeth, She suffered a lot due toperiodontal disease and lost teeth. No systemic disease.

CLINICAL FINDINGS

Deep pockets in many teeth, BOP +, good oral hygiene.

TREATMENTGBT with AIRFLOW® PLUS Powder and PIEZON® PS Instrument. PERIOFLOW®
nozzle used with AIRFLOW® PLUS Powder on a few teeth. Fluoride applied to teeth
after GBT. Recalled every 4 months.

PATIENT FEEDBACK“THANK YOU FOR SAVING MY TEETH!”
176

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PERIODONTAL DEBRIDEMENTCASE 85
CLINICIAN

Meredith Gantos
Dental hygienist
United States

PATIENT INFORMATION
Age 65, male.

BACKGROUND INFORMATION

Patient is on a 4-month recall due to generalized moderate staining. Habit ofclenching and grinding.

CLINICAL FINDINGS

Patient was diagnosed with generalized stage III, grade B periodontal disease.
Probing depths range from 1-6mm with localized bleeding points in the posterior.
17% of teeth have a 6mm probing depth. 82% of teeth have recessive defects.
Generalized moderate plaque and staining with localized mild calculus present on
the lower anteriors.

TREATMENT

Patient was disclosed with GC Tri Plaque ID Gel which reveals various colors
based on the pathogenicity of the plaque. A pink color indicates fresh plaque, a blue
or purple color indicates mature plaque, and a light blue color indicates matureplaque that is strongly acid producing. After educating the patient and reviewing
oral hygiene instructions, the AIRFLOW® was used to remove the biofilm on teeth,
tongue, and soft tissues. Special care and attention to light blue and purple areas
to ensure complete debridement. The 11/12 explorer was used to check all surfaces
for complete debridement.

PATIENT FEEDBACK“I’M HAPPY WITH THE RESULT!”
178

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PERIODONTAL DEBRIDEMENTCASE 86
CLINICIAN

Adina Mauder
Dental hygienist
Germany

PATIENT INFORMATION
Age 45, female.

BACKGROUND INFORMATION

No existing diseases, no medication. Smoker. Last treatment 3 months ago.
Uses manual toothbrush and floss sometimes.

CLINICAL FINDINGSDefects seen around the cervical areas of the tooth, bleeding gums, oral habits,
clenching and grinding, redness, occasional swelling, calculus present on all teeth,
severe staining on all teeth, periodontal disease diagnosed.

TREATMENTGBT done the usual way with AIRFLOW® MAX and PLUS Powder. Calulus wasremoved using PIEZON® PS supra- and subgingivally. After 2 months, BOP reduced
drastically. Patient had better oral hygiene and was motivated.

PATIENT FEEDBACK“I FEEL GOOD. MY TEETH ARE SAVED.”180

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181

PERIODONTAL DEBRIDEMENTCASE 87
CLINICIAN

Beatriz Rosell
Periodontist
Spain

PATIENT INFORMATION
Age 42, female.

BACKGROUND INFORMATION

She reports that her last prophylaxis was 6 months ago. Throughout her life she has
undergone prophylaxis with curettes. Poor oral hygiene. No diseases, no medication
currently. Smokes 20 cigarettes a day.

CLINICAL FINDINGS

Gingivitis. BOP +, pocket probing depth (PPD) 3mm or less. Several recessions.
Widespread presence of calculus supra- and subgingival, mature biofilm and stains.
Enamel hypoplasia in upper incisors. Large enamel erosions produced in previous
treatments with curettes.

TREATMENTThe treatment starts with BacterX-Pro prerinse. Once the assessment has been
done, one of the most important parts is disclosing and showing the patient her
shortcomings, educate in oral hygiene techniques and motivate her to put thesetechniques into practice. GBT was performed with AIRFLOW® MAX, using only
PLUS Powder which is harmless to damaged enamel and has removed completely
biofilm and stains. Subsequently PIEZON® PS Instrument. Patient recall every 6months. Smoking cessation advised.

PATIENT FEEDBACK“IT´S THE FIRST TIME I HAVE FELT MY MOUTH SO CLEAN, WITHOUT USINGINSTRUMENTS THAT SCRATCH AND SQUEAK AGAINST MY TEETH. ”
182

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PERIODONTAL DEBRIDEMENTCASE 88
CLINICIAN

Bibiána Dugasová
Dental hygienist
Slovakia

PATIENT INFORMATION
Age 26, male.

BACKGROUND INFORMATION

The patient had visited another dental clinic in the past, but the treatment was sensitiveand painful for him. The last treatment was about 3 years ago, due to fear. He is alsobothered by the color of his teeth. (B4 on the VITA Classical scale). No relevant habits.

CLINICAL FINDINGSOn teeth, after detection, visible mature plaque. Predominantly on the frontal
sections of the teeth, the distal sections were covered with plaque minimally, onlyin the interdental space and the cervical area. The reason for the plaque on thefrontal sections indicates a minor injury from a few days ago on a bicycle. He had
pain in this area, he skipped this place when brushing his teeth.

TREATMENT

Complete GBT protocol with AIRFLOW® PLUS Powder, PIEZON® PS Instrument,with focus on patient motivation and education. We focused on cleaning the cervicalarea and interdental spaces at home and set up a regular recall after the first visit
for 3 months and then every six months.

PATIENT FEEDBACK“LOVE IT, GBT IS A REAL GAME CHANGER!”184

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BLEACHING

185

PERIODONTAL DEBRIDEMENTCASE 89
CLINICIAN

Binta Visser
Dental hygienist
Germany

PATIENT INFORMATION
Age 42, male.

BACKGROUND INFORMATION

Poor oral hygiene. Last professional cleaning more than 2 years ago. Smokes 5
cigarettes a day.

CLINICAL FINDINGS

Heavy tenacious supra- and subgingival calculus with generalized 4 mm pockets,
localized 5/6mm pockets . BOP + Gum is ready to heal after Guided Biofilm Therapy
treatment. Post GBT (3 weeks) later - no inflammation of the gum = irritation, redness
and swelling. Partial BOP + in pockets > 5mm, Patient shows a good compliance inoral hygiene, beginning of periodontal treatment.

TREATMENT

Started by disclosing the biofilm with the Biofilm Disclosure to make the biofilm
visible, then used the AIRFLOW® PLUS Powder in combination with the AIRFLOW®
MAX handpiece to easily and safely remove biofilm and early calculus from coronalsurfaces. Subgingival biofilm was removed from deeper periodontal pockets of morethean 4mm. PIEZON® PS Instrument was used to remove calculus in a minimallyinvasive way.

PATIENT FEEDBACK“I FEEL MOTIVATED TO MAINTAIN THE RESULT BY TAKING CAKE OF MY TEETHAT HOME AND I WILL TRY MY BEST THAT WE WILL BOTH SEE LESS OF THE
BLUE/PURPLE COLOR NEXT TIME.”
186

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PERIODONTAL DEBRIDEMENTCASE 90
CLINICIAN

Bülent Kurtis
DentistTurkeyPATIENT INFORMATION
Age 36, male.

BACKGROUND INFORMATION

Dense biofilm formation, gingival inflammation and ulcerations around interdental
papillae. No relevant habits.

CLINICAL FINDINGS

Generalized gingival inflammation especially around left upper and lower incisorsand canine teeth and apparent poor oral hygiene. Clinically painful, spontaneously
bleeding gums, and ulceration of interdental papillae defines and characterizes
acute necrotizing ulcerative gingivitis (ANUG). Predisposing factors were poor oral
hygiene and psychological stress.

TREATMENT

Following the clinical and radiographical examinations, biofilm disclosing andoral hygiene motivation were done and AIRFLOW® PLUS Powder with AIRFLOW®
Handpiece was used to remove soft disclosed deposits and all biofilm around teeth
according to the sequence of Guided Biofilm Therapy (GBT). PIEZON® PS Instrument
was used to remove hard deposits (calculus). In addition to GBT, prescription of
antibiotic therapy (metronidazole 500mg/daily 3 times) for 7 days was given. Control
session was done at first month and biofilm disclosed again.

PATIENT FEEDBACK“GBT TREATMENT WAS VERY GENTLE, COMFORTABLE AND SATISFYING.
I EXTREMELY APPRECIATE THIS NEW TREATMENT METHOD.”
188

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PERIODONTAL DEBRIDEMENTCASE 91
CLINICIAN

Esther Rovira
Dental hygienist
Spain

PATIENT INFORMATION
Age 48, male.

BACKGROUND INFORMATION

The patient follows a Mediterranean diet. He uses only electric toothbrush oncea day for less than two minutes. He doesn´t use interdental sticks and never has
used a tongue scraper. Non-smoker, poor oral hygiene. Improper and inadequate oral
home care.

CLINICAL FINDINGS

Some pockets present, all less than 5mm, BOP + in almost all gingival areas,supragingival, subgingival and interdental calculus present. Some stains and visible
biofilm present. Agenesis of 12 and 22. He has dental implants in position 21, 25
and 26.

TREATMENTGBT protocol completed with emphasis on disclosing agent and oral hygiene
instructions (electric toothbrush, interdental sticks - Easy-picks by TePe andtongue scraper by Halita, Dentaid). AIRFLOW® with PLUS Powder to remove thebiofilm and stains. PIEZON® PS Instrument and PSL-PSR Instruments to remove
supragingival, subgingival and interdental calculus.

PATIENT FEEDBACK“I FELL ASLEEP DURING THE TREATMENT. IT´S INCREDIBLE! IT WAS
UNBELIEVABLY RELAXED AND COMFORTABLE. THANK YOU FOR CONNECTING
ME WITH MY DENTAL HEALTH. I FEEL REALLY GOOD!!”
190

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PERIODONTAL DEBRIDEMENTCASE 92
CLINICIAN

Kim Eunae
Dental hygienist
South Korea

PATIENT INFORMATION
Age 47, male.

BACKGROUND INFORMATION

Severe periodontitis around molars in 2018. Especially maxilla molars needed to
be extracted for implant placement.

CLINICAL FINDINGSDue to severe bone resorption in the maxillary molars, implant treatment wasplanned after extraction. Periodontal treatment was required for generalized
periodontitis.

TREATMENT

After implant treatment and no surgical periodontal therapy in 2018, the patient
has participated in continuous maintenance through the GBT program since 2020.
Through GBT program every three months for a year, his self-management habits
have dramatically improved. Currently, he is maintaining a healthy oral condition
by receiving a recall and GBT program every 6 months.

PATIENT FEEDBACK“I DON’T WANT TO GO BACK TO WHERE I WAS BEFORE.
I WANT TO KEEP COMING BACK FOR GBT.”
192

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PERIODONTAL DEBRIDEMENTCASE 93
CLINICIAN

Abdalla Hanan
Dental hygienist
UAE

PATIENT INFORMATION
Age 38, female.

BACKGROUND INFORMATION

Diet: Variety of food/high refined sugar and carbohydrate intake, regular awayfrom-home dining. Poor oral hygiene: brushing once a day with manual toothbrushand no flossing. High level of patient motivation. Healthy and non-smoker.

CLINICAL FINDINGS

Gingiva: inflamed, marginal redness, bleeding gum and heavy plaque. Acutegingivitis plaque induced. Generalized chronic periodontitis.

TREATMENT

Complete GBT protocol with AIRFLOW® PLUS Powder, PIEZON® PS Instrument.

PATIENT FEEDBACK“I HAVE COMPLAINED ABOUT GUM BLEEDING FOR MANY YEARS AND VISITED
MANY DENTISTS WITH PAINFUL TREATMENT WITH NO SOLUTION, I REACHED
THE POINT WHERE I ACCEPTED MY GUMS WILL ALWAYS BLEED.
NOW AFTER THE GBT TREATMENT I AM REALLY HAPPY BECAUSE MY GUMSHAVE HEALED AND THEY LOOK AND FEEL SO HEALTHY.”194

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3-MONTH
RECALL195

PERIODONTAL DEBRIDEMENTCASE 94
CLINICIAN

Ivona Bondorová
Dental hygienist
Slovakia

PATIENT INFORMATION
Age 41, female.

BACKGROUND INFORMATION

Dental phobia. There was no visit to the dentist or dental hygienist for 10 years.
Very poor oral hygiene.

CLINICAL FINDINGS

Presence of supra- and subgingival calculus. Periodontal pockets 4-6mm.
BOP +++. Caries. Halitosis present. Gingival pain.

TREATMENT

Followed GBT protocol. Biofilm removal with AIRFLOW® PLUS Powder. Supra- andsubgingival calculus removal using PIEZON® PS Instrument. Use of chlorhexidine
gel 0,2% was prescribed for the next 2 weeks. First recall after 1 month demonstrated
patient compliance, as there has been an overall improvement in patient care.

PATIENT FEEDBACK“I FEEL VERY ASHAMED. YOU ARE PERFECT AND YOU HAVE GOLDENHANDS. WELL, THANK YOU! EVERY TIME I LOOKED IN THE PAST AT PHOTO
ADVERTISING FOR DENTAL HYGIENE, I THOUGHT IT WAS A PHOTOMONTAGE.
NOW I AM VERY HAPPY!”196

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AFTER
1 MONTH197

PERIODONTAL DEBRIDEMENTCASE 95
CLINICIAN

Khanda Yousef
Dental hygienist
SwedenPATIENT INFORMATION
Age 57, male.

BACKGROUND INFORMATION

Patient thought he brushed his teeth properly until he received the GBT treatment.
No relevant habits.

CLINICAL FINDINGS

Periodontitis, bleeding on probing positive, presence of biofilm, calculus, deep
periodontal pockets ( between 5-8 mm).

TREATMENT

GBT. I described to him how to brush his teeth properly. He has a regular recall
every 6 months.

PATIENT FEEDBACK“I’M VERY SATISFIED WITH THE RESULTS. MY TEETH HAVEN’T BEEN THIS
CLEAN FOR 20 YEARS. I WILL DEFINITELY FOLLOW YOUR ADVICE AND COME
BACK FOR THIS TREATMENT. I WILL TELL MY FAMILY ABOUT YOU AND GBT SO
THEY ALSO CAN EXPERIENCE THIS TREATMENT.”
198

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PERIODONTAL DEBRIDEMENTCASE 96
CLINICIAN

Minjung Kim
Dental hygienist
South Korea

PATIENT INFORMATION
Age 63, female.

BACKGROUND INFORMATIONNo medical history.

CLINICAL FINDINGS

Need for improved anterior and lingual dental care. After taking interest in dental
care, the patient began to pay more attention to mandibular anterior and improved
self-care on lingual side. BOP- but with swollen gingiva. Presence of discomfort.
Some interdental calculus present.

TREATMENT

After periodontal treatment, overall management such as dental care is important,so management improves every three months. The patient has a growing interestin oral health, and complies with recalls.

PATIENT FEEDBACK“I CAN SEE MY ORAL HEALTH IS GETTING BETTER. COMPARED TO OTHER
TREATMENTS, GBT IS REALLY PAIN-FREE AND COMFORTABLE. THAT’S WHY I
HAVE ENJOYED IT FOR YEARS NOW.”
200

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201

PERIODONTAL DEBRIDEMENTCASE 97
CLINICIAN

Magdalena Gocoł
Dental hygienist
PolandPATIENT INFORMATION
Age 46, male.

BACKGROUND INFORMATION

Patient with periodontal disease. Patient has been smoking for the past 30 years,
about 1 pack/day. Occlusal disfunction. Last hygiene visit 10 years ago when only
calculus was removed.

CLINICAL FINDINGSThe patient shows numerous recessions and occlusal problems as well as occlusion
overload. Visible attritions, non-carious enamel lesions. In the interview, the patientmentioned sensitivity in reaction to cold. The patient also complains of unpleasantsmell from his mouth and bleeding while brushing. BOP 60% PI 98%.

TREATMENT

Full GBT protocol was performed. The procedure was started by plaque disclosure.
After disclosing, biofilm with AIRFLOW® PLUS Powder, then proceeded to remove hard
deposits with a scaler, along with the cleaning of interdental spaces. AIR-FLOWING®
was performed again in order to remove stain residues and to smooth out the tooth
surface. After the procedure, the teeth were protected with a preparation with fluoride
and hydroxyapatite and a chx rinse with colostrum was prescribed for 14 days.

PATIENT FEEDBACK“I AM SURPRISED BY THE CONDITION OF MY ORAL CAVITY. I DID NOTTHINK THAT A PROFESSIONAL HYGIENE TREATMENT COULD MAKE SUCH ADIFFERENCE. I FEEL THAT I HAVE GAINED NEW TEETH.”
202

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PERIODONTAL DEBRIDEMENTCASE 98
CLINICIAN

Aleksandra Michalska
Dental hygienist
PolandPATIENT INFORMATION
Age 67, female.

BACKGROUND INFORMATION

The patient underwent oncological treatment 5 years ago. She came to the dentist’s
office complaining of pain and bleeding around the teeth in the upper jaw. The
patient has prosthetic restoration. Irregular professional hygiene treatments, lastone - 3 years ago.

CLINICAL FINDINGS

General inflammation, periodontal disease, bleeding on probing, presence ofsupragingival and subgingival calculus, teeth #13 and #21 are mobile.

TREATMENT

Dental cleaning was performed based on the GBT protocol. The disclosed biofilm wasremoved with AIRFLOW® MAX and AIRFLOW® PLUS Powder. Hard supragingival
and subgingival calculus was removed with PIEZON® PS Instrument. Oral hygiene
instructions were carried out. The patient was advised to change to a manual brushwith soft bristles and to use interdental brushes on a regular basis. A follow-up visit
and 3-month recall visits were recommended.

PATIENT FEEDBACK“EXTREMELY GENTLE AND PAINLESS. MUCH MORE COMFORTABLECOMPARED TO THE PREVIOUS TREATMENT. NO POWDER ON THE FACE AND
CLOTHES. IT’S A REAL TOOTH SPA.”
204

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205

PERIODONTAL DEBRIDEMENTCASE 99
CLINICIAN

Nadine Strafela-Bastendorf
DentistGermany

PATIENT INFORMATION
Age 36, male.

BACKGROUND INFORMATION

Diet, oral hygiene status, level of motivation of the patient, relevant dental history.
Patient came to the emergency consultation because tooth 25 had broken off. He
has a normal diet without high sugar consumption (max. 4 sugar contacts per day),average bleeding index 100%. According to his medical history he cleans his teeth
once a day with a manual toothbrush. Anxious, non-smoker, no general diseases.

CLINICAL FINDINGSHalitosis, mobility etc. Periodontitis stage IV, grade B. BOP +.

TREATMENTThe entire treatment was done following the GBT protocol with AIRFLOW® PLUS
Powder, PERIOFLOW® Nozzle and PIEZON® PS Instrument. Gingiva healed andhealthy after 6 months.

PATIENT FEEDBACK“I`M VERY HAPPY. I FEEL LIKE A NEWBORN.”
206

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6-MONTH
RECALL207

PERIODONTAL DEBRIDEMENTCASE 100
CLINICIAN

Matej Hropko,
Dental hygienist
Czech Republic

PATIENT INFORMATION
Age 37, male.

BACKGROUND INFORMATION

Patient used only regular toothbrush, (never used interdental brushes), no dietary
restrictions, high level of stress from dental appointment. Was sent to dental hygienist
by dentist. Sales assistant, never saw a dental hygienist. Believed he had no dental
problems, thought that bleeding of gums is normal. Non-smoker.

CLINICAL FINDINGSBPI - 86, CPITN 222/232, periodontal pockets up to 4 mm. Calculus mostly inlower frontal teeth.

TREATMENTI treated patient with GBT protocol. In first appointment we removed most of
calculus. We measured interdental brushes. In 6 weeks, I treated patient with GBT
protocol and re-evaluated the size of interdental brushes. We also added single
toothbrush for daily care routine. Second appointment results: PBI: 18, CPITN:
121/121, and periodontal pockets fell to 3 mm.

PATIENT FEEDBACK“I NEVER THOUGHT I WOULD FEEL THE SMOOTHNESS OF MY TEETH AGAIN.”
208

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6-MONTH
RECALL209

„The GBT Certification to me is a community. It’s a community where providers canshare knowledge, where they are being continuously trained and making sure that
we always follow the standardized protocol for the benefit of our patients. I am
absolutely thrilled to be the first group of GBT-certified practices.“- PATRICK SAASEN, CEO OF ADENT DENTAL CLINICS, FIRST GBT-CERTIFIED DENTAL CLINIC

Call your GBT Expert from EMS Tel. +41 22 99 44 700210

CERTIFY YOUR PRACTICE

As a GBT Certified practice, become a part of an exclusive network of passionate dental
professionals offering dental prophylaxis at the highest possible standards. Backed by the evidencebased GBT protocol, GBT Certified practices benefit from a wealth of exclusive services.

GAIN MORE VISIBILITYYour practice listed on the GBT Patient Finder, an interactive
map allowing patients to find their nearest GBT practice

ACCESS TO THE GBT CERTIFIED MARKETING KIT  Welcome kit to give your practice a GBT look  Customizable GBT brand assets  Social media templates  3D patient video

EXCLUSIVE EDUCATION PROGRAMS AND TRAINING  Regular e-learning modules and webinars  Continuing education and accreditation  Training based on the latest scientific and clinical research  On-demand training for new team members

PREMIUM CUSTOMER SERVICE  First-line support for GBT Certified practices  Preferential GBT service agreement

211

©EMS SA FA-799/EN_rev.A_Edition 2021/10

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