A double‐masked Randomized Clinical Trial (RCT) comparing four periodontitis treatment strategies: 5‐year clinical results

Abstract

While single-level analyses showed statistically significant differences, they could not be confirmed with more appropriate analyses and were too small to recommend MTZ, with its risk of patient side effects and environmental consequences, for the treatment of patients with severe periodontitis.

Oral hygiene phase revisited: How different study designs have affected results in intervention studies

“…Recently, we published the latest results from a longitudinal intervention study in which a 3‐month rigorous oral hygiene phase preceded the interventions (Preus, Gjermo, & Baelum, ). This approach to periodontal therapy planning was later reviewed by Özbozdoganli, Findik, and Müezzinoglu, (), who concluded that the 3‐month oral hygiene phase before the intervention was a limitation of the study since this procedure did not “corroborate with everyday clinical practice, making it difficult to extract conclusions.” If this is the perception among dental clinicians and periodontal specialists, relevant literature must be consulted to establish why.…”

“…(a) Reduction of inflammatory symptoms prior to therapy will influence on intervention protocol (Morrison, Ramfjord, & Hill, ). (b) Mastering oral hygiene prior to periodontal therapy is essential for the maintenance phase, in which the patient must exercise rigorous oral hygiene to prevent recurrence (Preus et al, ).…”

“…For any periodontal intervention, the individual approach to oral hygiene is of the essence (Klukowska et al, ; Morrison et al, ; Preus et al, ). The reason for this is the difference with which patients react in terms of personal adherence to instruction and motivation, but also because of differences in personal and biological responses (Fowler, Garrett, Crigger, & Egelberg, ; Klukowska et al, ).…”

“…Some mentioned that the pre‐intervention phase lasted a month (Hill et al, ), others that acceptance into the study was based on the patient having <20% of sites with plaque and had remained so for a non‐disclosed period of time (Isidor, Attström, et al, ; Isidor, Karring, et al, ; Kaldahl et al, , ). Researchers have advocated that the oral hygiene phase must be of considerable length before an intervention (Preus et al, , Kaldahl et al, 1990, Cercek et al, , Morrison et al, 1980). Indeed, Morrison et al () explicitly stated “one might question if the time period allowed for initial therapy phase was long enough to allow for complete healing to occur” although the oral hygiene phase in this study was at least 4 weeks.…”

“…The optimal duration of this oral hygiene phase has not been established, nor tested. The three‐month oral hygiene phase mentioned in this letter came about largely through coincidence, since it had to match the long waiting list at the clinic in which we performed our trial (Preus et al, , , ) just as the patients enrolled in our trial needed dental work to be performed by the referring dentists prior to the active periodontal treatment.…”