Healing following surgical non‐surgical treatment of periodontal disease

Abstract

A clinical trial was undertaken to study the effect of one surgical and one non‐surgical treatment modality in patients with advanced periodontal disease. Fifteen patients were selected for the study. Following a Baseline examination comprising assessments of oral hygiene status, gingival conditions, probing depths and attachment levels, all participants were subjected to treatment. In each patient, scaling and root planing were carried out in conjunction with the modified Widman flap procedure in two jaw quadrants while in the contralateral quadrants the treatment was restricted to scaling and root planing. During the phase of active treatment, i.e. the period between the first and last operation, and for the subsequent 6 months of healing, the patients were subjected to “professional toothcleaning” once every 2 weeks. From this time until the end of the trial which was 24 months after active treatment, the patients were recalled for prophylaxis once every 3 months. Reexaminations were performed 6, 12 and 24 months after the completion of active treatment. The results demonstrated that scaling and root planing used alone were almost equally effective as their use in combination with the modified Widman flap procedure in establishing clinically healthy gingiva and in preventing further loss of attachment. Both treatment modalities prevented recurrence of periodontal disease for the 24 months of observation. The analysis of the probing depth data revealed that both methods of treatment resulted in a high frequency of probing depths of <4 mm. The probing depth reduction was more pronounced in initially deep than in initially shallow pockets and, for initially deep pockets, more marked in sites subjected to surgery than in sites exposed to scaling and root planing alone. The measurements also showed that sites with initially deep pockets exhibited more pronounced gain of clinical attachment than sites with initially shallow pockets. Significant loss of attachment did not occur in sites treated with scaling and root planing alone while attachment loss was found following Widman flap surgery in sites with initial probing depth of <4 mm.

Full-mouth treatment versus quadrant root surface debridement in the treatment of chronic periodontitis: a systematic review

“…[45][46][47] Some of the studies in this field made the case for using short-term data (eg four months) to simulate peri odontal day-to-day practice. This may be used to plan periodontal surgery but biological and clinical comparisons between FRp and Q should be followed for at least one year to establish whether one modality is superior to the other.…”

Comparison of nonsurgical periodontal therapy with oral hygiene instruction alone for chronic periodontitis

“…This significant gain in attachment level might have been due to healing at very deep sites after NSPT or OHI (27). Longitudinal studies indicate that NSPT results in significant attachment gain but unpredictable PPD reduction, as pocket formation starts to recur after treatment (25).…”

Aggressive Periodontitis

“…Sadece cerrahi+plus doksisiklin kullanan grupta A.a. eliminasyonunun daha etkili olduğu saptanmıştır. 45 Hastalığın ciddiyetinden ve defektlerden dolayı rezektif prosedürün uygulanması oldukça sınırlıdır. Agresif periodontitiste de terapötik yaklaşım, rejeneratif periodontal tedavinin başarısını etkiler.…”