Relative Influence of Scaling and Root Planing and Occlusal Adjustment on Sulcular Fluid Flow

Abstract

The aim of the investigation was to clarify the effects of the resolving of inflammation on one hand and the removal of occlusal trauma on the other hand on the rate of sulcular fluid flow (SFF) from deep periodontal pockets. Forty-seven adult patients having at least one tooth with an inflamed greater than 5 mm periodontal pocket and elevated mobility associated with occlusal trauma were selected for the study. After oral hygiene instruction and supragingival scaling, the rate of sulcular fluid flow of the test teeth was recorded on Day 0. After the baseline recording, each patient was randomly assigned to either Group A or Group B. The test teeth of Group A were subjected to subgingival scaling and root planing under local anesthesia, and the test teeth of Group B were subjected to occlusal adjustment. On Day 14 sulcular fluid flow was recorded for both groups, after which Group A received occlusal adjustment and group B received scaling and root planing. On Day 28 the sulcular fluid flow recordings were repeated for both groups. The mean flow rates of both Group A and Group B decreased significantly (P less than 0.05) from Day 0 to Day 28. When the occlusal interference was eliminated 2 weeks after scaling and root planing (Group A), no additional decrease in sulcular fluid flow was observed. When the occlusal interference was eliminated before scaling and root planing (Group B), the reduction in sulcular fluid flow remained statistically insignificant through the first 2-week observation period.(ABSTRACT TRUNCATED AT 250 WORDS)

Collagenase activity and protein content of sulcular fluid after scaling and occlusal adjustment of teeth with deep periodontal pockets

“…The finding that occlusal adjustment alone (Group B) also resulted in decreased collagenase activity was somewhat unexpected. In a previous investigation the flow rate of sulcular fluid was not decreased by occlusal adjustment (14). In the present study, scaling and root planing was, however, the more effective of the two treatment modes, since a further significant decrease of sulcular fluid collagenase activity was noted when the teeth were scaled and root planed 14 d after oc-cJusal adjustment (Table 2, Fig.…”

“…Although the importance of bacteria as a causal factor of inflammation is evident (10-13), the impression still remains among clinicians that elimination of occlusai interferences speeds up the healing of the periodontium. To clarify this question we earlier measured the quantity of stilcular fluid flow around occiusally adjttstcd teeth and around scaled and root planed teeth both before and after each treatment (14). The results of that sttjdy suggested that occlusai interferences have no effect on the quantity of sulcular fluid flow, and it was suggested that the presence of occlusal trauma would not affect the rate of periodontal breakdown.…”

Occlusal trauma and excessive occlusal forces: Narrative review, case definitions, and diagnostic considerations

“…In an earlier study, the flow rate and quality of gingival crevicular flow (GCF) after removal of occlusal interferences was examined in patients with advanced periodontitis. 57,58 It was found that occlusal adjustment reduced the protein content and collagenase activity without affecting the quantity of GCF. Later, a well-controlled clinical trial was conducted to evaluate the effect of the occlusal adjustment on healing outcomes after periodontal treatment.…”

Role of trauma from occlusion in periodontal disease- A controversy

“…Human research studies reported from 1986-87 questioned the effects of occlusal forces on the progression of periodontitis (Hakkarainen 1986, Philstrom et al 1986, Houston et al 1987. [8][9][10] …”