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PubMed1989

Relative influence of plaque control, scaling and root planing on occlusal sounds.

Nine periodontally affected subjects and eight healthy subjects were selected in order to examine the effect of initial periodontal treatment on occlusal sounds. Gingival Index, probing depth, tooth mobility and occlusal sound duration via an occlusal sound analyser were recorded at the baseline. The nine periodontal patients were then treated by plaque control, root planing with general scaling and were re-examined at 1 month and 3 months post-operatively. The following results were obtained: (i) The normal duration of an occlusal sound is less than 10 ms. (ii) Occlusal sounds of periodontal patients were of longer duration compared with values in healthy subjects, but decreased and approached the normal value after treatment.

Adult↗
PubMed1991

Therapeutic effects of combined treatment using tetracycline-immobilized collagen film and root planing in periodontal furcation pockets.

46 upper and lower molars with furcation grade II involvement were selected from 16 patients with periodontal disease. The teeth were randomly allocated to the following groups according to treatment; (1) 4 consecutive administrations of tetracycline-immobilized cross-linked collagen film (TC film) at intervals of 1 week (TC group); (2) 1 root planing treatment (RP group); (3) combination treatment (TC + RP group); (4) no treatment (control group). The therapeutic effects of each treatment were compared both clinically and microbiologically. Records of plaque index, gingival index, bleeding on probing, probing depth, probing attachment level and microscopic counts were obtained at 0, 4, 6 and 8 weeks. The results showed marked decreases in probing depth and density of micro-organisms in both the RP and TC + RP groups. In particular, the TC + RP group was characterized by a decreased rate of bleeding on pocket probing and an increased probing attachment gain. The above findings demonstrated that root planning is effective in the treatment of furcation involvement and that the effects are enhanced by the local administration of TC films.

Collagen↗
PubMed2007

The effectiveness of subgingival scaling and root planing: an evaluation of therapy with and without the use of the periodontal endoscope.

BACKGROUND: A fiber-optic periodontal endoscope was developed to aid in the visualization of subgingival structures and to improve the diagnosis and management of periodontal diseases. The purpose of this study was to determine whether use of the periodontal endoscope with scaling and root planing (SRP) resulted in a decrease in residual calculus compared to SRP alone. METHODS: Fifteen subjects with 50 tooth pairs participated in this study. Each tooth per pair was randomized to receive SRP with or without the endoscope. Teeth were extracted, and a stereomicroscope and digital image analysis was used to determine percent residual calculus present in a masked fashion. RESULTS: There was 2.14% (P < 0.001) more residual calculus at control versus test sites. At buccal/lingual and interproximal surfaces, mean differences in residual calculus were 1.30% (P <0.015) and 2.93% (P < 0.001), respectively. Test treatment time decreased significantly as operator experience increased. There were no statistically significant differences between residual calculus for test and control teeth at shallower probing depths; however, at deeper probing depths, the use of the endoscope resulted in significantly less residual calculus. CONCLUSIONS: The use of the periodontal endoscope resulted in a statistically significant overall improvement in calculus removal during SRP, which was most evident in deeper probing depths. The clinical significance of this level of improvement is unknown.

Adult↗
PubMed1987

Correlation of histometric, microbial, and clinical indicators of periodontal disease status before and after root planing.

Effective diagnosis and treatment of periodontal disease requires accurate evaluation of disease status before and after treatment. This study evaluated relationships among multiple parameters that have been used for periodontal disease evaluation. A total of 61 initially deep (greater than or equal to 6 mm) interproximal pockets from 16 patients examined before and after a 3-week course of root planing therapy were evaluated for probing depth, bleeding on probing, darkfield and cultural characterization of subgingival plaque, and histometric indices of infiltrated connective tissue (ICT) and mature plasma cell infiltrate. 36 sites were evaluated before treatment, and 25 after treatment. A comparison of mean scores for pre-treatment sites versus post-treatment sites indicated that there was an average improvement in most disease-related parameters. However, patterns of significant correlations among the parameters differed markedly. Motile bacteria enumerated by darkfield microscopy were significantly correlated with ICT and plasma-cell populations before, but not after treatment. In contrast, probing depth and populations of black pigmented Bacteroides (BPB's), principally B. gingivalis, were significantly correlated with ICT after, but not before, treatment. Bleeding on probing was not significantly correlated with ICT levels before or after treatment. This suggests that different sets of parameters should be used for evaluating periodontal disease status before or after treatment. Our data further suggest that B. gingivalis populations may be related to delayed healing of deep periodontal lesions after instrumentation.

Adult↗
PubMed1989

[Topical chemotherapy of chronic periodontitis using controlled-release insert containing ofloxacin (PT-01) without root planing].

Topical chemotherapy of periodontal disease using several drug delivery systems (DDS) is currently being attempted. PT-01 is a DDS which consists of fast- and sustained- release parts containing ofloxacin as an antibacterial agent. Since PT-01 was found to sustain the antibacterial effect for 7 days in a periodontal pocket, it was used tor periodontal patients without root planing or scaling in this study. PT-01 and a placebo were applied to two separate and opposite pockets of 46 patients, once a week from the first visit (week 0) to week 3. The clinical parameters (plaque index, gingival index, tooth mobility, bleeding on probing, pus discharge, and probing depth) were evaluated from weeks 0 to 4. At the end of the test (week 4), global improvement at the two sites was assessed. The clinical parameters and the global improvement of the PT-01 and placebo-treated sites were compared statistically. All parameters at the PT-01 sites except for tooth mobility showed much greater improvement than at the placebo sites. The global improvement of PT-01 sites was also significantly greater than that of the placebo sites. No side effects could be seen in patients treated with PT-01. These results indicate that topical chemotherapy using PT-01 could be effective and safe for periodontal therapy.

Chronic Disease↗
PubMed1990

A clinical and microbiological comparison of the effects of water and 0.02% chlorhexidine as coolants during ultrasonic scaling and root planing.

The maxillary teeth of 10 patients with moderately advanced chronic periodontitis were treated in a split-mouth design study. The baseline examination included plaque and bleeding scores, probing depths and probing attachment levels. 2 sites in each quadrant were selected for dark-field microscopic analysis. Each quadrant was randomly assigned to test or control and instrumented with an ultrasonic scaler using either 0.02% chlorhexidine or water as the coolant. Measurements were repeated 2, 6 and 10 weeks later, together with additional plaque sampling. Ultrasonic instrumentation with either chlorhexidine or water was equally effective in reducing bleeding scores and improving probing attachment levels. 42% of chlorhexidine- and 38.7% of water-treated sites showed gains of 1 mm or more in clinical attachment. Mean reductions in probing depth were similar (0.9 mm chlorhexidine, and 0.8 mm water). At the final examination, the chlorhexidine-treated quadrants had significantly more sites with probing depths in the 1-3 mm category and less in the greater than 3 mm category than the control quadrants (P less than 0.05). Both treatments reduced the microscopic counts of motiles and spirochaetes, resulting in a subgingival microbiota consistent with periodontal health. The results indicate that chlorhexidine has a slight adjunctive effect in the reduction of pocket depth when used as a coolant during ultrasonic root planing for the treatment of chronic periodontitis.

Adult↗
PubMed2004

Effects of scaling and root planing on the amounts of interleukin-1 and interleukin-1 receptor antagonist and the mRNA expression of interleukin-1beta in gingival crevicular fluid and gingival tissues.

OBJECTIVE: The purpose of this study was to evaluate the relationship between the clinical changes after non-surgical periodontal therapy and interleukin 1 (IL-1) in gingival crevicular fluid (GCF) and gingival tissues from patients with chronic periodontitis. BACKGROUND: The inflammatory responses mediated by IL-1 play an important role in periodontal tissue destruction. Although numerous studies have attempted to elucidate the dynamic movement involved in chronic periodontitis, the results have often conflicted. Such discrepancies may have been due to the inability to determine clinical disease activity. METHODS: Seven patients with chronic periodontitis were examined. The severity of periodontal inflammation was expressed using clinical parameters before and after a scaling and root planing (SRP) procedure. The amounts and concentrations of IL-1alpha, IL-1beta and IL-1 receptor antagonist in GCF were measured by enzyme-linked immunosorbent assay (ELISA) and IL-1 activity index was calculated. A needle biopsy in matching gingival tissues was also performed before and after the SRP procedure. The localization and mRNA expression of IL-1beta were determined using histological methods. RESULTS: Clinical parameters improved slightly after the SRP procedure. Only the probing pocket depth (PPD) was reduced significantly (p < 0.05). However, the amount of IL-1beta in GCF was slightly increased. The localization and mRNA expression of IL-1beta could still be observed after the SRP procedure. Therefore, none of the clinical parameters showed a high sensitivity or specificity for evaluating subgingival inflammation. CONCLUSION: These observations suggest that IL-1 is effective for evaluating in detail the state of subgingival inflammation.

Adult↗
PubMed1998

The effects of a single course of a calculus-softening scaling and root planing gel. A scanning electron microscopic study.

The effect of a calculus scaling gel was evaluated as an adjunct to instrumentation in a double blind, split-mouth, clinical study. Fifteen comparable periodontally involved teeth from 5 patients were instrumented on the mesio-buccal root surface with the aid of either the test gel, placebo gel, or no gel until smoothness was achieved. Test or placebo gel was applied subgingivally for 10 minutes. Instrumentation time, ease, number of strokes, and gingival/tooth surfaces changes were recorded. Scanning electronic microscopic (SEM) evaluation of root surface topography was evaluated. The results demonstrated effective calculus removal in all treatment groups with no differences found between them. Instrumentation time, ease, and number of strokes were similar for all treatment groups. There were no harmful effects to soft or hard tissues. The results of this study do not support the use of calculus scaling gel as an adjunct to root instrumentation.

Adult↗
PubMed1992

[Clinical and microbiological study of factors determining effective scaling and root planing].

The aim of the present study was to monitor longitudinally the clinical and microbiological parameters after root debridement in order to determine the factors affecting successful and unsuccessful results. Nine patients with moderate and severe periodontitis participated. Four sites of single root with over 5-mm periodontal pockets in each quadrant were selected. The oral hygiene was controlled in all patients, then root debridement was performed without anesthesia at the three sites of the quadrants every two weeks during eight weeks. The clinical parameters consisted of plaque index, gingival index, probing depth, clinical attachment level, bleeding on probing, tooth mobility and the value of gingival crevicular fluid (GCF). The microbiological parameters such as percentages of cocci, motile rods, non-motile rods and spirochetes and the number of microorganisms were examined and the percentages of black pigmented Bacteroides (BPB) and Actinobacillus actinomycetemcomitans as well as the number of anaerobic colonies were counted. The results demonstrated that a reduction in the probing depth was observed in all sites except four. The successful sites clinically showed a decrease of the probing depth and GCF value and, microbiologically, reduced percentages of the spirochetes and BPB. The results indicated that the decrease of the probing depth and GCF under 50 Periotoron units in coincidence with the bacterial reduction can be used to determine the successful response of root debridement.

Adult↗
PubMed2005

Loss of tooth substance during root planing with various periodontal instruments: an in vitro study.

Ultrasonic and power-driven instrumentation is gaining in significance as an acceptable alternative to manual periodontal root treatment. Some question whether they do not remove too much tooth substance. Various ultrasonic scalers, hand instruments and two power-driven systems were compared by assessing the loss of tooth substance due to root instrumentation. Quantitative analysis of this effect of the instruments used was performed on 20 freshly extracted, non-periodontally involved, large human molars. In the first study, 40 specimens were randomly assigned to four groups of treatment: combined use of ultrasonic scaler and Periopolisher diamond-coated inserts (US-POL), hand instruments (MANUAL), Perioplaner-Periopolisher system (PPL-POL) and Periokit ultrasonic-designed scalers (PERIOKIT). The second study involved two treatment groups, ultrasonic scaler alone and hand instruments, each allocated with 20 teeth (small root fragments). An unpaired two-tailed t test was carried out for both studies to compare the average weight loss of root substance with the modes of instrumentation. The level of significance was set at p<or=0.05. The overall results of the first and second experimental trials did not reveal obvious differences in weight loss between the manual, ultrasonic or power-driven root treatments. Based on the results of these two comparative studies, the power-driven inserts or the various ultrasonic scalers tested did not remove more tooth substance than conventional hand instruments. They may thus be a useful alternative for the debridement of root surfaces.

Dental Scaling↗
PubMed1997

Meta-analysis of the effect of systemic metronidazole as an adjunct to scaling and root planing for adult periodontitis.

The purpose of this meta-analysis was to provide a quantitative overview of clinical trials assessing the use of systemic metronidazole (S-MET) as an adjunct to scaling and root planning (S&RP) in the treatment of adult periodontitis. Eight clinical trials were chosen based upon a priori selection criteria, and two outcomes, "reduction in probing pocket depth" (PD) and "gain in clinical attachment level" (CAL), were analyzed. Results for each outcome were stratified by initial PD 1-3 mm, 4-6 mm, or > or = 7 mm and length of follow-up 4-6 wk, 9-13 wk, or 14-26 wk. S-MET in conjunction with S&RP was superior to S&RP alone in reducing PD where initial PD was 4-6 mm and follow-up was 9-13 wk (0.43 mm; 99% CI 0.12, 0.73). No significant advantage was observed for S-MET for reducing PD where initial PD was less than 4 mm or follow-up was longer than 13 wk. S-MET in conjunction with S&RP was superior to S&RP alone in reducing CAL where initial PD was 4-6 mm and follow-up was 4-6 wk (0.29; 99% CI 0.01, 0.58) and where follow-up was 9-13 wk (weighted mean difference 0.32; 99% CI 0.03, 0.61). Significant heterogeneity of effect was not seen for PD or Cal at any level of initial PD or length of follow-up. No significant dose-response relationship was observed. This meta-analysis was limited due to diversity of data presentation and the small number of trials in each stratum. These results suggest that S-MET in conjunction with S&RP may offer a benefit over S&RP alone in the treatment of adult periodontitis patients in managing pockets of 4 mm or greater, but the additional benefit was not evident if initial PD was less than 4 mm or follow-up was beyond 13 wk.

Adult↗