Full‐ versus partial‐mouth disinfection in the treatment of periodontal infections

Abstract

A standard periodontal treatment consists of 4 to 6 scalings and rootplanings at a 1- to 2-week interval, which allows reinfection of a previously disinfected area before completion of the treatment. The present pilot study aims to examine the microbiological long-term effects of a full-mouth disinfection. 10 patients with advanced chronic periodontitis were randomly allocated to a test and control group. The patients from the control group received scaling and rootplaning and oral hygiene instructions at a 2-week interval. The full-mouth disinfection (test group) consisted of a full-mouth scaling and rootplaning in 2 visits within 24 h in combination with: tongue brushing with 1% chlorhexidine gel for 1 min, mouth rinsing with 0.2% chlorhexidine solution for 2 min and subgingival irrigation of all pockets (3x in 10 min) with 1% chlorhexidine gel. The patients of the test group were instructed to rinse 2x daily with 0.2% chlorhexidine. Plaque samples were taken at baseline and after 1, 2, 4 and 8 months. Differential phase-contrast microscopy showed a significantly larger reduction of spirochetes and motile organisms in the test group up to month 2 for the single-rooted and up to month 8 for the multi-rooted teeth. Furthermore, the culture data supported the effectiveness of the new treatment strategy. In both groups, the number of anaerobic CFU decreased 1 log around single- and 0.5 log around multi-rooted teeth. The number of anaerobic CFU remained low in the test group, in contrast to the control group. At 1 month, the test group harboured a significantly (p<0.01) lower proportion of pathogenic organisms, but this difference disappeared with time. Moreover, the test sites showed a significantly higher (p<0.02) increase in the proportion of beneficial micro-organisms up to 4 months. These findings suggest that a full-mouth disinfection leads to a significant microbiological improvement up to 2 months, which could be consolidated, although not significant, for the next 6 months.

The Antimicrobial Treatment of Periodontal Disease: Changing the Treatment Paradigm

“…When examined one and two months later, the test group showed a significantly greater reduction in probing depths and fewer periodontopathic species compared with the control group (Bollen et al, 1996). Since there were only five subjects in each group, the demonstration of a significant difference indicated that this was a highly effective treatment.…”

Antiplaque and Antigingivitis Toothpastes

“…CHX gels may also be used for other purposes, such as prevention of alveolitis after tooth extraction [120,121]. Its use has also been suggested as part of the full-mouth disinfection protocols, including tongue brushing with 1% CHX gel for 1 min and subgingival irrigation of pockets with 1% CHX gel [122,123]. More recently, it has been evaluated in peri-implant mucositis therapy [124], although with limited effects.…”

Application of Diode Laser Fotona XD-2 as Adjunctive Therapy in Non-Surgical Treatment of Periodontal Infections Among Patients on Renal Replacement Therapy

“…taking into consideration the advantages of one-stage full-mouth disinfection (11,12,40,42,47), we did a total management of the mouth within 24 hours with renal transplant patients. With patients receiving haemodialysis the whole management of the mouth was modified and was done within two appointments and 72 hours (the shortest possible interval) due to the fact that they undergo dialysis procedure every 2 days and receive heparin before dialysis procedure starts, which is contraindication for performing the manipulation.…”