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Results for “Subgingival Curettage”

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PubMed1976

[Evaluation of results of subgingival curettage in periodontology].

Introductory remarks review the extensive present range of literature with reference to the aim and evaluation of the results of the curettage. One of the definitions given by the authors considers indication and aim in a general form. The authors discuss their own histological examinations after curettage with a selection of typical figures. The clincal experiences and histological results presented lead to a vast restriction of the indication of this interference.

Adult↗
PubMed1977

Short term results of three modalities of periodontal treatment.

Short term data were obtained from 74 patients who recieved comprehensive periodontal treatment using a split mouth approach to test three variables; subgingival curettage, pocket elimination surgery, and modified Widman flap procedure. The patients initially had an average interproximal loss of attachment of 3.2 mm and an average interproximal pocket depth of 3.9 mm. Evaluation of the data indicate that after 4 to 6 weeks: 1. All three surgical procedures reduce pocket depths. In order of effectiveness they are: pocket elimination surgery, modified Widman flap, and subgingival curettage. 2. Pocket elimination surgery reduces pockets more than subgingival curettage on the buccal, lingual and interproximal, and more than the modified Widman flap on the lingual. The modified Widman flap procedure reduces pockets more interproximally than subgingival curettage. 3. Subgingival curettage results in a gain of attachment interproximally, and on the lingual side, while the modified Widman flap resulted in a gain of attachment interproximally only. 4 Pocket elimination surgery resulted in a loss of attachment buccally. 5 Subgingival curettage results in a more favorable postoperative attachment level on all surfaces than did pocket elimination surgery.

Adult↗
PubMed2002

Laser curettage: an overview.

The literature suggests that subgingival curettage has no benefit beyond traditional scaling and root planing. In addition, mounting evidence suggests that there is a risk of clinically significant collateral damage to using Nd:YAG laser energy within the sulcus. There also appears to be some confusion regarding the standards of evidence upon which to judge the performance of adjunctive procedures such as laser curettage. This article presents a review of the literature and a synopsis of the current scientific consensus regarding laser curettage, its effectiveness, its potential for collateral damage, and the scientific standards that apply.

Aluminum Silicates↗
PubMed1975

Results following three modalities of periodontal therapy.

Three methods for treatment of periodontal pockets (subgingival curettage, modified Widman flap surgery, and pocket elimination) were applied as a clinical trial to 82 patients. Follow up results over one to five years after the initial treatment are reported. The variations in attachment levels and pocket depth were analyzed statistically as related to methods of treatment and yearly time intervals following the initial treatment. The most favorable results regarding gain or maintenance of attachment levels and reduction of pocket depth were observed interproximally. Subgingival curettage provided the greatest gain in attachment level up to three years postoperatively, but after four to five years there was no significant difference in results following the three methods. The most significant loss of attachment and return of pocket depth occurred on the buccal aspects of the teeth, and the results were not significantly different for the three methods except at the first year of follow up when the attachment level was maintained best after curettage.

Adult↗
PubMed1989

[Long term effects of surgical and non-surgical periodontal treatment. 1. Attachment level changes].

The long term effectiveness of modified Widman flap and subgingival curettage techniques were evaluated in 21 patients who have chronic periodontitis. Individual acrylic reference plates and a color coded WHO probe were used for attachment level measurements. Attachment level changes which were determined in 3 rd, 6th, and 9th months calculated as percentage gain or loss of initial attachment level and compared statistically. Initially shallow pockets showed loss of attachment in both techniques. There was significant attachment gain in initially moderate and deep pockets. Accordingly, attachment gain occurred at facial, interproximal and oral surfaces with both techniques. It can be concluded that if the effective plaque control would be maintained post operatively, subgingival curettage is the first choice of method in the treatment of periodontal pockets.

Adult↗
PubMed1987

4 modalities of periodontal treatment compared over 5 years.

The purpose of the present study was to assess in a clinical trial over 5 years the results following 4 different modalities of periodontal therapy (pocket elimination or reduction surgery, modified Widman flap surgery, subgingival curettage, and scaling and rool planing). 90 patients were treated. The treatment methods were applied on a random basis to each of the 4 quadrants of the dentition. The patients were given professional tooth cleaning and oral hygiene instructions every 3 months. Pocket depth and attachment levels were scored once a year. 72 patients completed the 5 years of observation. Both patient means for pocket depth and attachment level as well as % distribution of sites with loss of attachment greater than or equal to 2 mm and greater than or equal to 3 mm were compared. For 1-3 mm probing depth, scaling and root planing, as well as subgingival curettage led to significantly less attachment loss than pocket elimination and modified Widman flap surgery. For 4-6 mm pockets, scaling and root planing and curettage had better attachment results than pocket elimination surgery. For the 7-12 mm pockets, there was no statistically significant difference among the results following the various procedures.

Clinical Trials as Topic↗
PubMed2002

[Lasers in dentistry. 5. The use of lasers in periodontology].

This literature review shows that the Nd:YAG laser and the Er:YAG laser can be beneficially used in periodontology for subgingival curettage and gingivectomy. Studies demonstrated that subgingival laser treatment can result in significant reduction of the initial levels of periodontal pathogens. It is beneficial to perform laser curettage under water irrigation prior to scaling in order to destroy of the structure of the calculus and its attachment to the root surface. During laser curettage sufficient haemostasis is obtained, which improves detection of subgingival calculus. Nd:YAG laser gingivectomy results in similar improvement of deep periodontal pocket as conventional flap surgery, with the advantages such as minimal bleeding and post-operative pain, no swelling, and neither sutures nor post-surgical dressing are needed. Both non-surgical and surgical laser treatments are often performed without local anaesthesia, making full-mouth treatment in one session possible. Treatments are well accepted by the patients and require about 50% less time than the conventional therapies. Laser-de-epithelialization for periodontal regeneration has been experimentally attempted, but more controlled studies are needed to establish its usefulness in the clinic. Laser treatment of peri-implantitis is not recommended.

Dental Calculus↗
PubMed1980

Root planing and curettage.

Root planing and curettage are at least as satisfactory as other surgical techniques for the gain and maintenance of attachment in most periodontal pockets. Reduction of pocket depth and root exposure are less following subgingival curettage than after other modalities of surgery. It is not known if soft tissue curettage adds anything to the results of scaling and root planing. Curettage is demanding with regards to technical skill and time, and may be impractical in many instances compared to flap surgery.

Dental Instruments↗
PubMed2001

Generalized aggressive periodontitis in a prepubertal patient: a case report.

A 10-year-old boy presented with generalized gingival inflammation, extensive alveolar bone loss, and tooth mobility. Clinical and radiographic examination supplemented by microbiologic investigation led to a diagnosis of classically termed prepubertal periodontitis (now known as generalized aggressive periodontitis). Other than severe periodontitis, the child was systemically healthy. Neither unusual infections nor abnormalities in neutrophil functions were detected. Microbiologic examinations by culture revealed the presence of the periodontal pathogen Actinobacillus actinomycetemcomitans. Treatment consisted of extraction of mobile teeth, supragingival and subgingival debridement, subgingival curettage, and root planing combined with a 1-week prescription of a combination of metronidazole and amoxicillin. Scanning electron microscopy of extracted teeth revealed hypoplastic and aplastic cementum at the periodontally exposed and intact surfaces. Clinical and microbiologic follow-up was continued over a 1-year period. No periodontal lesions have been detected, and A actinomycetemcomitans could not be isolated from the subgingival areas of the remaining teeth at the end of the first year. Since A actinomycetemcomitans was the main pathogen present in the subgingival microflora of the patient, it might play a key role in the etiology of prepubertal periodontitis.

Actinobacillus Infections↗
PubMed1980

Comparison of results following three modalities of periodontal therapy related to tooth type and initial pocket depth.

Results following three modalities of periodontal therapy (subgingival curettage, modified Widman flap surgery, and pocket elimination or reduction surgery) in 78 patients over 8 years were compared for variations in pocket depth and clinical attachment level related to tooth types (maxillary molars, mandibular molars, maxillary biscupids, mandibular biscupids, maxillary anterior teeth, mandibular anterior teeth). The analysis was based on a classification of three severity groups according to initial crevice or pocket depth (Class I, 1-3 mm; Class II, 4-6 mm; and Class III, 7-12 mm) and with patient's means of measurements being the experimental units for the statistical analysis. Reduction in pocket depth and gain of clinical attachment for pockets 4 mm or deeper occurred following all three methods of treatment, and was well sustained over 8 years. No one modality of treatment was consistently superior to any of the other two with regards to sustained reduction of pocket depth and gain of clinical attachment. Surgical pocket elimination or reduction did not enhance the prognosis for maintenance of periodontal support in either moderate or advanced periodontal lesions anywhere in the mouth compared with more conservative modalities of treatment. In spite of prophylaxis and instruction in home care every 3 months, there was a slight progressive loss of attachment over time in areas of shallow crevices (1-3 mm).

Bicuspid↗
PubMed1981

Four types of periodontal treatment compared over two years.

Results of various modalities of periodontal therapy were studied in 90 subjects (mean age 45 years) with moderate to severe periodontitis. Initial measurements of pocket depth and clinical attachment levels were compared with measurements obtained after the initial hygienic phase of the treatment and measurements of the same areas 1 and 2 years after four different types of periodontal treatment had been applied on a randomized basis to each of the four quadrants of the dentition. These treatments were: (1) surgical pocket elimination or reduction, (2) modified Widman flap surgery. (3) subgingival curettage, (4) scaling and root planing only. The patients were recalled for prophylaxis every 3 months, and rescored annually. One-way analysis of variance and Scheffe's method were used to test the hypothesis of equal treatment effects. The results were analyzed both with initial pocket depth as the baseline and with pocket depth at the hygienic phase as the baseline using a grouping of pockets 1 to 3 mm, 4 to 6 mm, and greater than or equal to 7 mm. For the 1 to 3 mm pockets there was a slight reduction in depth at the hygienic phase, with only minor changes after the various modalities of treatment over 2 years. However, significant losses of attachment after all modalities of periodontal therapy, including scaling alone, were observed at both the 1-year an 2-year intervals. For pockets 4 to 6 mm deep, the main reduction in pocket depth occurred at the hygienic phase, but the pockets also were reduced by further treatment, most by pocket elimination and modified Widman surgery. However, this reduction in pocket depth after surgery had no beneficial influence on maintenance of the attachment level, which actually was maintained best by scaling alone. For deep pockets greater than or equal to 7 mm, significant reduction in pocket depth occurred both at the hygienic phase and 1 to 2 years after treatment, with the greatest initial reduction after pocket elimination surgery. However, again there was no significant difference in attachment results among the four methods.

Adult↗