What is Guided Biofilm Therapy?

Guided Biofilm Therapy (GBT) is a treatment protocol that combines a disclosing agent to visualise biofilm with air-abrasive powder (erythritol) delivered via an air-polishing device and ultrasonic piezoelectric instrumentation for subgingival debridement ^[1][2]. It was developed as an alternative to conventional mechanical approaches such as scaling and root planing (SRP) or scaling and root debridement (SRD) for both non-surgical periodontal therapy and supportive periodontal treatment ^[2][3].

In the non-surgical periodontal therapy setting, the GBT sequence has been described as staining, air-polishing, ultrasonic scaling, and then air-polishing again, adapted to the patient's clinical conditions ^[3]. The rationale is systematic biofilm detection followed by targeted removal, rather than empirical mechanical instrumentation alone ^[1][2].

Clinically, studies show GBT achieves comparable reductions in plaque scores, bleeding on probing, and pocket probing depths to conventional approaches, but the evidence on primary periodontal outcomes such as BOP, CAL, and PPD is inconsistent across studies ^[2][3][4]. Patient-centred advantages that have been reported include shorter chair time and more favourable patient perception compared with conventional methods, though these findings are not uniform across all trials ^[1][2][4]. The current evidence does not support clinical superiority of GBT over conventional therapy ^[2].