[1] Debridement may be performed using ultrasonic instruments, which fracture the calculus, thereby facilitating its removal, as well as hand tools, including periodontal scaler and curettes, or through the use of chemicals such as hydrogen peroxide.

[3] Bacterial plaque initiates a nonspecific host inflammatory response with the intention of eliminating necrotic cells and harmful bacteria.

During this process cytokines, proteinases, and prostaglandins are produced which can cause damage, or kill healthy tissues such as macrophages, fibroblasts, neutrophiles, and epithelial cells.

[4] Clinical signs of periodontal pockets include bluish-red, thickened gingiva, gingival bleeding, localized pain and in some cases exudate.

At home treatment for periodontal pockets include meticulous and routine plaque removal by brushing and interproximal cleaning.

Professional treatment includes routine dental visits for debridement, scaling and root planing.

Clinical treatment goals are set to control the inflammatory disease by removal of coronal and subgingival plaque containing destructive pathogens.

[5] Smoking also delays the healing process once debridement, scaling, root planing and adequate home care has been completed.

NSPT includes but is not limited to initial debridement, scaling, root planing, antibiotic treatment, and oral health education.

[2] Surgical periodontal therapy creates a stable and maintainable environment for the patient by eliminating pathological changes in the pockets.

The overall purpose of surgical therapy is to eliminate the pathogenic plaque in pocket walls to get a stable and easily maintainable state.

The shank of periodontal instruments can either be rigid, which works better with heavy and tenacious calculus or flexible for fine tuning and light deposit.