Supragingival treatment as an aid to reduce subgingival needs: a 450-day investigation

Abstract

Supragingival treatment as an aid to reduce subgingival needs: a 450-day investigation abstract: This study investigated the clinical effects of using a supragingival biofilm control regimen (SUPRA) as a step prior to scaling and root planing (SRP). A split-mouth clinical trial was performed in which 25 subjects with periodontitis (47.2 ± 6.5 years) underwent treatment (days 0-60) and monitoring (days 90-450) phases. At Day 0 (baseline) treatments were randomly assigned per quadrant: SUPRA, SRP and S30SRP (SUPRA 30 days before SRP). The full-mouth visible plaque index (VPI), gingival bleeding index (GBI), periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) were examined on days 0, 30, 60, 90, 120, 270, and 450. Baseline data were similar among all groups. From days 0 to 60, the groups showed similar significant decreases in VPI and GBI. Reductions in PPD for the SRP (3.39 ± 0.17 to 2.42 ± 0.16 mm) and S30SRP (3.31 ± 0.11 to 2.40 ± 0.07 mm) groups were greater (p < 0.05) than those for the SUPRA group. This pattern was also observed for BOP. Attachment gain was similar and greater for the SRP (3.34 ± 0.28 to 2.58 ± 0.26 mm) and S30SRP (3.25 ± 0.21 to 2.54 ± 0.19 mm) groups compared to the SUPRA group. Results were maintained from day 90 forward. Overall, the S30SRP treatment reduced the subgingival treatment needs in 48.16%. Performance of a SUPRA step before SRP decreased subgingival treatment needs and maintained the periodontal stability over time.

The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels

“…These study findings suggest that supragingival biofilm control is an important factor in modifying inflammatory clinical parameters. 40,41 The limitation of the present study is the small sample size due to eligibility criteria, which might have reduced the statistical power. In addition, the mean PD and CAL levels in the CP group were low, indicating that these patients did not present an extensive periodontal impairment, thereby limiting the effect of SSRP on changes in biomarker levels.…”

Impacts of supragingival and subgingival periodontal treatments on oral health‐related quality of life

“…While the motivations and skills of professionals are inherent, the involvement of patients with stringent daily oral care procedures along decades of life is on permanent liability for relapse . The main reasoning for proposing periodontal treatment protocols that place patient and professional responsibilities at different moments is the possibility of ascertaining the contribution patients and professionals have on the outcome of treatment . In the present study, the protocol of treatment was chosen exactly because it comprehends two distinct moments: the treatment of gingivitis (Day 30 examinations), achieved through the oral hygiene procedures executed by the patients ; and the treatment of periodontitis by means of subgingival scaling and root planing performed by professionals (Day 90 examinations).…”

“…The main reasoning for proposing periodontal treatment protocols that place patient and professional responsibilities at different moments is the possibility of ascertaining the contribution patients and professionals have on the outcome of treatment . In the present study, the protocol of treatment was chosen exactly because it comprehends two distinct moments: the treatment of gingivitis (Day 30 examinations), achieved through the oral hygiene procedures executed by the patients ; and the treatment of periodontitis by means of subgingival scaling and root planing performed by professionals (Day 90 examinations). This protocol has been described at the literature and shows both the potential to enable patient adherence to oral health measures as well as a benefit in reducing subgingival treatment needs after the gingivitis treatment .…”

“…In the present study, the protocol of treatment was chosen exactly because it comprehends two distinct moments: the treatment of gingivitis (Day 30 examinations), achieved through the oral hygiene procedures executed by the patients ; and the treatment of periodontitis by means of subgingival scaling and root planing performed by professionals (Day 90 examinations). This protocol has been described at the literature and shows both the potential to enable patient adherence to oral health measures as well as a benefit in reducing subgingival treatment needs after the gingivitis treatment . The compliance with the suggested protocol can be observed when considering low VPI (≤30%) and GBI (≤10%) scores throughout the study period.…”

“…In this sense, a treatment protocol that individualizes supragingival biofilm control from the subgingival interventions may be appropriate to ascertain eventual differences between these distinct steps of the treatment . A recent publication also shows the advantages of this protocol as compared to the supragingival and subgingival debridement performed simultaneously .…”