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PubMed1999

Longitudinal effect of non-surgical treatment and systemic metronidazole for 1 week in smokers and non-smokers with refractory periodontitis: a 5-year study.

BACKGROUND: Periodontitis consists of a mixture of diseases, most of which respond favorably to traditional mechanical therapy. It is now recognized that advanced periodontitis does not always respond to conventional management with scaling, periodontal surgery, and oral hygiene measures. However, various types of antibiotics given systemically or locally improve the success rate of periodontal therapy. In short-term studies, it has been shown that metronidazole, when systemically administered after debridement, resulted in treatment benefits including less need for surgical intervention. METHODS: In this double-blind study, we evaluated periodontal treatment involving initial non-surgical treatment, systemic administration of metronidazole for 1 week, and then follow-ups for scaling and root planing every 6 months, for 5 years. The study population consisted of 64 subjects (37 smokers and 27 non-smokers), mean age 36.3 (+/-3.0 SD) years, with severe periodontal disease. After initial scaling and root planing, patients were randomly assigned to the intervention or placebo groups: 400 mg metronidazole or a placebo administered at 8-hour intervals for 1 week. The participants underwent an extensive clinical periodontal examination. Gingival crevicular fluid (GCF) was analyzed for spirochetes and granulocytes. Samples were cultured for Actinobacillus actinomycetemcomitans (A.a.), Porphyromonas gingivalis (Pg.), and Prevotella intermedia (Pi.). RESULTS: The number of patients infected with A.a., Pg., Pi., and spirochetes decreased during the study. Most patients who harbored spirochetes at the end of the study had these microorganisms at the beginning. Smokers responded less favorably to periodontal therapy than non-smokers. Non-smoking patients who required only non-surgical therapy in the intervention group showed statistically significant improvement in the clinical parameters after 5 years. Patients with complete healing, defined as the absence of inflamed sites > or =5 mm, after 5 years were found only in the intervention group. The patients considered healthy after 5 years were the same patients found to be healthy after 6 months. CONCLUSIONS: Decisive factors in the sustained long-term improvement of patients who respond satisfactorily to treatment are probably initial scaling and root planing; a brief course of metronidazole; and regular follow-up examinations at 6-month intervals for oral hygiene and scaling and root planing.

Adult↗
PubMed1988

Use of antimicrobial containing acrylic strips in the treatment of chronic periodontal disease. A three month follow-up study.

Local antimicrobial therapy has been considered for use in the treatment of chronic periodontal disease. This study evaluated chlorhexidine, metronidazole, and tetracycline delivered into periodontal pockets in an acrylic resin vehicle and compared the results with root planed and untreated sites over a three-month follow-up period. One site per patient where pocketing greater than or equal to 6 mm associated with a single rooted tooth was randomly allocated to one of the five possible regimens. Baseline and follow-up measurements included probing depth, loss of attachment, bleeding on probing, crevicular fluid flow, and dark-field microscopy of a subgingival plaque sample. Intratreatment evaluations revealed no significant changes in any parameter for untreated sites. Significant improvements in many parameters occurred with all four therapies although the magnitude and duration were greater in metronidazole and root planing groups. The more important intertreatment comparisons indicated that most treatments produced significant benefits compared with the control group; however, again these were greater with metronidazole and root planing. Furthermore, significantly greater effects were noted for metronidazole and root planing compared with tetracycline and more particularly chlorhexidine. It is concluded that some locally delivered antimicrobials alone may be useful in the treatment of chronic periodontal disease. However, at this time local antimicrobial therapy should be considered as adjunctive to conventional debridement techniques.

Adult↗
PubMed2002

Gingival crevicular fluid matrix metalloproteinase-8 levels following adjunctive use of meloxicam and initial phase of periodontal therapy.

BACKGROUND: The purpose of the present study was to assess the effects of adjunctive meloxicam on the matrix metalloproteinase-8 (MMP-8) levels of gingival crevicular fluid (GCF) in chronic periodontitis patients following the initial phase of periodontal therapy. METHODS: Twelve chronic periodontitis patients received 7.5 mg meloxicam, and 10 patients received placebo tablets together with scaling and root planing in a 1 x 1 regimen for 10 days. Scaling and root planing were performed on day 3 of drug intake. The MMP-8 levels in GCF samples obtained before and on day 10 of drug intake were determined by using the immunofluorescence assay. Plaque index (PI), papilla bleeding index (PBI), and GCF MMP-8 levels were compared within each patient group, between the 2 patient groups, and also with a clinically healthy control group using non-parametric statistical analyses. RESULTS: Both meloxicam and placebo groups showed statistically significant reductions in PBI, PI, and GCF MMP-8 levels on day 10 compared to baseline (P<0.01). The GCF MMP-8 level on day 10 in the meloxicam group was similar to the clinically healthy control group (P>0.05), while it was significantly higher in the placebo group (P<0.01). Positive correlations were found between MMP-8 total amounts and PBI scores at baseline and day 10 of drug intake in the patient groups. CONCLUSIONS: Meloxicam showed a tendency to reduce GCF MMP-8 levels in vivo within the first 10 days when used as an adjunct in the initial phase of periodontal treatment that consists of scaling and root planing. Verification of this effect on collagenase-2 downregulation, as well as on the clinical periodontal parameters in long-term studies using larger test and control groups, is needed to provide further support for the adjunctive use of selective cyclooxygenase (COX)-2 inhibitors in the treatment of chronic periodontitis.

Adult↗
PubMed1986

The effectiveness of the Titan-S sonic scaler versus curettes in the removal of subgingival calculus. A human surgical evaluation.

This study evaluated clinically the effectiveness of hand versus sonic subgingival scaling and root planing in the removal of calculus by visually examining the root surface at the time of periodontal flap surgery. Consideration was given to the method of instrumentation, probing depth, number of roots, and type of tooth surface. Eleven patients with moderate to advanced periodontal disease were evaluated. Four subjects were scaled and root planed with the Titan-S only, four with curettes only, and three with the Titan-S + curettes. At reevaluation 3 to 6 weeks after scaling and root planing, the decision to perform periodontal flap surgery was made based upon probing depth, bleeding upon probing, previous access to the root surface, furcation involvement, and the patient's level of oral hygiene. A full thickness mucoperiosteal flap was elevated to gain access to the root surface and measure the distance from the cementoenamel junction to the residual calculus. A total of 690 surfaces were evaluated surgically. The percentage of surfaces with residual calculus for each method of instrumentation was: Titan-S only (31.9%), curettes only (26.8%), and Titan-S + curettes (16.9%). Overall, 15.7% of the surfaces probing 0 to 3 mm, 29.3% of the surfaces probing 4 to 5 mm, and 44.4% of the surfaces probing 6 to 12 mm had residual calculus.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Calculus↗
PubMed1987

The use of sodium bicarbonate and hydrogen peroxide in periodontal therapy: a review.

The comparative benefits from the use of sodium bicarbonate and hydrogen peroxide over the use of a commercial dentifrice in periodontal therapy is controversial. The consensus of the clinical research indicates that application by patients of sodium bicarbonate and hydrogen peroxide offers no advantage over the preestablished, properly performed home oral hygiene procedures. Any improvements in clinical and microbial parameters generally were attributed to scaling and root planing. The studies that have reported beneficial results with sodium bicarbonate and hydrogen peroxide have used additional antimicrobial agents, concomitant professional application of these substances, and scaling and root planing. In one of these reports, inorganic salts and chloramine-T were delivered subgingivally throughout root-planing procedures, in addition to home application of inorganic salts. Most of these patients also received at least one course of systemic tetracycline therapy. Because this study had no control group, it is impossible to determine whether this program is more effective than are other periodontal therapy programs. A more controlled clinical study involving professional application of sodium bicarbonate, sodium chloride, hydrogen peroxide, and povidone-iodine has shown greater gains in clinical attachment and bone mass than has brushing with toothpaste and water. Again, subgingival scaling and root planing were necessary to attain these results. Because multiple topical agents were applied in both of these reports and systemic antimicrobial agents were used by the Keyes group, it is impossible to determine which agent was responsible for the improvements. Further, professional application may be the crucial factor.(ABSTRACT TRUNCATED AT 250 WORDS)

Bicarbonates↗
PubMed1995

Collagen formation at the tooth-cell interface: comparative ultrastructural study on the effect of partial demineralization of cementum with dentin.

In order to compare the effect of partial demineralization with root planing and partial demineralization of cementum with that of dentin on healing, the ultrastructural morphology of the interface between the layer of human periodontal ligament-derived, fibroblast-like cells (HPF) and the treated root surface was studied in an in vitro culture system. Sixty (60) pairs made from transversally-cut root slices, 500 microns thick, were obtained from extracted human periodontally diseased teeth. Thirty (30) pairs of the root slices were preliminarily root planed (RP). The remaining half were root planed and then partially demineralized in a solution of citric acid (RP+CA). The opposite surface of paired slices was made uniform by using either cementum or dentin. Consequently, all root slices were classified into four experimental groups: RP-cementum and RP-cementum pairs (group 1), RP-dentin and RP-dentin pairs (group 2), RP+CA-cementum and RP+CA-cementum pairs (group 3), and RP+CA-dentin and RP+CA-dentin pairs (group 4). Each pair of root slices was placed on the floor of a 35-mm culture dish. HPF were seeded at a concentration of 4 x 10(5) cells/dish. Co-cultures of HPF and the root slices were examined using phase contrast and electron microscope after 4, 6, and 10 weeks. Electron-dense material covered non-demineralized root surfaces and the lining cells in accumulating cell layers were oriented parallel to the root surface and attached to the material in groups 1 and 2.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Adhesion↗
PubMed2003

Adjunctive periodontal treatment with Centella asiatica and Punica granatum extracts. A preliminary study.

BACKGROUND: Centella asiatica and Punica granatum are medicinal herbs that have been reported to promote tissue healing and modulate host responses. The purpose of this study was to investigate the effects of the combined extracts from C. asiatica and P. granatum pericarp on periodontal healing following scaling and root planing in adult periodontitis patients. METHODS: An innovative herbal medicament was formulated in the form of biodegradable chips for subgingival application. Twenty patients with initial pocket depth 5-8 mm were enrolled into the study. After baseline examination, scaling and root planing of non-target teeth, the target teeth received scaling and root planing followed by subgingival delivery of medicated chips in the test group and unmedicated chips in the placebo group. Probing pocket depth, attachment level, bleeding on probing, gingival index, and plaque index were recorded at baseline, 3 and 6 months. RESULTS: The results showed significant improvements of pocket depth and attachment level in the test sites when compared with the placebo sites at 3 months and with the placebo and control sites at 6 months. All treatment sites exhibited a similar trend of decreasing plaque score. However, the test sites seemed to show slightly better percentage of bleeding on probing. CONCLUSION: The results indicate that local delivery with C. asiatica and P. granatum extracts plus scaling and root planing significantly reduced the clinical signs of chronic periodontitis.

Adult↗
PubMed1991

The effects of metronidazole administration on clinical and microbiologic parameters of periodontal disease.

The purpose of this study was to assay the concentration of metronidazole in gingival fluid, to correlate clinical and microbiologic parameters of periodontal disease to each other and to the gingival fluid concentration of the drug. Ten subjects with a minimum of two contralateral pairs of periodontal pockets of greater than or equal to 5 mm were utilized. One side of the mouth was selected to serve as the root-planed site while the other was left untreated. On day 0, plaque and bleeding-time indexes and probing depths were recorded. Subgingival plaque was analyzed using phase contrast microscopy. When root planing was completed, the subjects were prescribed either metronidazole or placebo three times daily for seven days. Within 24 hours of the last dose, and thereafter at intervals of 1, 2 and 3 weeks, fluid samples were assayed for metronidazole. Clinical and bacterial data were likewise recorded. The results indicate that root planing with metronidazole appears to be more effective in promoting periodontal health than root planing alone. Concentrations of metronidazole ranging from 5 to 20 micrograms/ml were detectable in fluid samples obtained within 24 hours of administration of the last dose. No discernible levels could be found in samples taken at the longer intervals.

Analysis of Variance↗
PubMed1989

Clinical and microbiologic changes following the irrigation of periodontal pockets with metronidazole or stannous fluoride.

The purpose of this investigation was to determine the efficacy of subgingival irrigation with 1.64% stannous fluoride or 0.5% metronidazole solutions on the clinical and microbiologic parameters of adult periodontitis as compared with scaling and root planing. Twelve patients with moderate to advanced periodontitis were selected, and one pocket of a minimum 5-mm probe depth in each quadrant received one of the following treatments: (a) one session of scaling and root planing at the beginning of the experiment, (b) stannous fluoride irrigation, (c) metronidazole irrigation, and (d) saline irrigation. Results showed that scaling and root planing provided significantly better improvement in most of the clinical parameters than did the two tested irrigants. Saline also provided a statistically significant improvement, but only during the first 4 weeks. The four methods of treatment provided a sustained decrease in spirochetes, with a concomitant increase in coccoid cells. It was concluded that although subgingival irrigation with 1.64% stannous fluoride or 0.5% metronidazole solutions improved periodontal health, they never achieved the same efficacy as scaling and root planing and, therefore, should not be substituted for fastidious mechanical subgingival plaque and calculus removal.

Fluorides↗
PubMed1999

One stage full- versus partial-mouth disinfection in the treatment of chronic adult or generalized early-onset periodontitis. I. Long-term clinical observations.

BACKGROUND: A standard treatment strategy for periodontal infections often consists of 4 consecutive sessions of scaling and root planing (per quadrant, at 1- to 2-week intervals), without proper disinfection of the remaining intra-oral niches for periodontopathogens. This could theoretically lead to a reinfection of previously disinfected pockets by bacteria from an untreated region/niche. This study aimed to investigate, over an 8-month period, the clinical benefits of a one stage full-mouth disinfection in the control of severe periodontitis. METHODS: Sixteen patients with early-onset periodontitis and 24 patients with severe adult periodontitis were randomly assigned to test and control groups. The control group was scaled and root planed, per quadrant, at 2-week intervals and given standard oral hygiene instructions. A one stage full-mouth disinfection (test group) was sought by scaling and root planing the 4 quadrants within 24 hours in combination with the application of chlorhexidine to all intra-oral niches for periodontopathogens. Besides oral hygiene, the test group also rinsed twice daily with a 0.2% chlorhexidine solution and sprayed the tonsils with a 0.2% chlorhexidine spray, for 2 months. The plaque index, gingival index, probing depth, bleeding on probing, gingival recession, and clinical attachment level were recorded at baseline and at 1, 2, 4, and 8 months afterwards. RESULTS: The one stage full-mouth disinfection resulted, in comparison to the standard therapy, in a significant (P <0.001) additional probing depth reduction and gain in attachment up to 8 months. For initial pockets > or =7 mm, the "additional" probing depth reduction at the 8 month follow-up was 1.2 mm for single-rooted and 0.9 mm for multi-rooted teeth, with corresponding additional gains in attachment of 1.0 mm and 0.8 mm, respectively. The additional improvements were observed for all subgroups (adult periodontitis, generalized early-onset cases, smokers), with the largest differences in the non-smoking adult periodontitis patients. CONCLUSIONS: These findings suggest that a one stage full-mouth disinfection results in an improved clinical outcome for the treatment of chronic adult or early-onset periodontitis as compared to scaling and root planing per quadrant at 2-week intervals.

Adult↗
PubMedDate not supplied

Comparative SEM study on the effect of root conditioning with EDTA or tetracycline Hcl on periodontally involved root surfaces.

This study compared the surface characteristics of periodontally diseased single human teeth extracted after treatment with either EDTA or Tetracycline Hcl. The study was comprised of 30 teeth from 20 patients with advanced periodontal disease. Diseased root surfaces were root planed by hand curette or finishing bur. The teeth were sectioned and solutions of EDTA (pH 7.3) or Tetracycline Hcl (pH 1.8) were applied to the surface with cotton pellets for 3 minutes using light pressure. Specimens were processed and examined by Scanning Electron Microscope. The surfaces of both etched treated sets of specimens differed considerably from specimens treated with root planing alone, regardless of the root planing method. The etched specimens exhibited numerous dentinal tubules exposed by the removal of smear layer.

Acid Etching, Dental↗
PubMed2004

Comparative clinical responses related to the use of various periodontal instrumentation.

AIM: The aim of this study was to evaluate in vivo the effectiveness of scaling and root planing of a power-driven mechanism compared with hand instruments and ultrasonic insert alone with a split-mouth design after 3 and 6 months. METHODS: Healing events after initial periodontal therapy were investigated in 20 patients with moderate-to-severe adult periodontitis. Plaque index (PlI), bleeding on probing (PBI), probing pocket depth (PPD), probing attachment level (PAL) and number of moderate and deep pockets (NMP, NDP) were recorded at baseline and 3 and 6 months after treatment. Oral hygiene instruction was provided for each patient. Randomly assigned quadrants per patient were scaled and root planed with hand instrumentation (curettes, hoes and files), with reciprocating power-driven instruments, with ultrasonic scaler alone and with the combined use of ultrasonic scaler and power-driven inserts. The Friedman test was applied to test the significance of difference between the various methods of root instrumentation. Repeated measures of analysis of variance (manova) were used to analyse the time effect on the different treatments. RESULTS: At the 6-month evaluation, all groups in the scaling and root planing treatment presented with an improvement in the measured clinical parameters, as compared with baseline. No statistical differences (p>0.05) were observed in the assessed periodontal indices among the study sites between the four groups for either treatment. CONCLUSIONS: Under our experimental conditions, this clinical study demonstrates that mechanized root planing with power-driven instruments, as effective as the usual procedures (hand and sonic instruments), represents a satisfactory and alternative means of nonsurgical root therapy.

Adult↗
PubMed1996

The effect of subgingival antimicrobial therapy on the levels of stromelysin and tissue inhibitor of metalloproteinases in gingival crevicular fluid.

Recent investigations imply that a key mechanism in the pathogenesis of periodontal disease may be the ability of oral microorganisms to induce production and/or activation of matrix metalloproteinases (MMPs) in the host tissues. It has been suggested that the pharmacologic inhibition of MMP activity could play an important role in achieving a desirable outcome in periodontal therapy. The efficacy of locally delivered antibiotics on the level of gingival crevicular fluid (GCF) stromelysin (SL) and tissue inhibitor of metalloproteinases (TIMP) on sites with a history of a poor response to mechanical treatment was studied. Fifty-two patients with 4 periodontal pockets > or = 5 mm and bleeding on probing were randomized into four groups of 13 patients. One group received scaling and root planing alone and the other three groups received scaling and root planing plus a locally delivered antimicrobial system. These included 25% tetracycline fiber, 2% minocycline gel, and 25% metronidazole gel. The GCF samples taken at baseline and 6 weeks after treatments were analyzed using an enzyme linked immunosorbent assay (ELISA). GCF SL levels significantly decreased after adjunctive tetracycline fiber (paired t-test, P = 0.020) and minocycline gel (paired t-test, P = 0.023) treatments whereas it remained almost unchanged in the other two groups. While the GCF TIMP level did not change significantly in the scaling and root planing alone group, it significantly increased for all three adjunctive antimicrobial treatments (for tetracycline fiber P < 0.001, minocycline gel P = 0.005, metronidazole gel P < 0.001). The use of adjunctive locally delivered antimicrobial systems, particularly the tetracycline family, may offer an advantage in changing the metalloproteinase profile of the GCF to one more compatible with periodontal health.

Administration, Topical↗
PubMed2001

Attachment of human gingival fibroblasts to periodontally involved root surface following scaling and/or etching procedures: a scanning electron microscopy study.

This study evaluated, in vitro, fibroblast attachment to periodontally involved root surfaces which were either root planed or acid/chelated by different agents. Specimens were divided into 3 groups of 12 specimens each. The root surfaces were root planed with a Gracey 7/8 curette, an EMS or an Amdent piezo-electric scaler and treated with saline, citric acid, tetracycline hydrochloride or EDTA to produce different surface textures. They were then cultured with fibroblasts for 72 h and examined by scanning electron microscopy. There was a significantly greater number of fibroblasts attached to specimens treated with citric acid, tetracycline and EDTA than to those root planed only. Furthermore, fibroblasts were more likely to attach to rough-surfaced than to smooth-surfaced specimens.

Acid Etching, Dental↗
PubMed2002

Right- and left-handed dentists in periodontal therapy.

The purpose of this study was to determine whether successful dental therapy (scaling and root planing) depends upon handedness of dentists in right-handed dental chairs (units) Participants were 28 voluntary dentists (14 female and 14 male, ranging in age from 26 to 34 years). Patients (7 female and 7 male with a mean age of 39.6 years) had advanced periodontitis. Handedness was assessed using the Turkish version of the Edinburgh Handedness Inventory. There were two equal groups of dentists: left-handers (7 female, 7 male) and right-handers (7 female, 7 male). Initial examination of patients was performed using a pressure-controlled periodontal probe. During scaling and root planing, the negative interstroke forces were recorded using a piezo-electric receiver, an electronic transducer, and an analogue writer. The results showed that during scaling, mean negative forces reached a mean of 0.74 N in left-handed dentists and 0.52 N in right-handed dentists. During root planing, these forces were 0.86 N in left-handed dentists, and 0.63 N in right-handed dentists. These differences were statistically significant. The right-handed dentists were more successful than the left-handed dentists at scaling and root planing, provided that both of them used the same right-sided dental chairs. The importance of handedness of the dentists was accentuated in dental practice.

Adult↗
PubMed1995

A scanning electron microscope study comparing the effectiveness of different types of sharpening stones and curets.

The effects of various types of sharpening stones on standard carbon steel Gracey type curets, and the influence of the sharpened curets on periodontally involved root surfaces, during in vitro scaling and root planing, was evaluated by means of scanning electron microscopy (SEM). Six different sharpening stones of varying texture, two of aluminum oxide, two India, and two Arkansas stones were assigned to sharpen six groups of 10 curets each. The curets were first examined under SEM and photographed and all exhibited edge irregularities. They were then sharpened with the different stones and again examined and photographed using SEM. The sharpness of each instrument was graded, related to the type of stone used, and the data compared statistically. A positive correlation was found between the texture of stone used and the surface sharpness it produced on the cutting edge of the instrument. The curets were then used to root plane the root surfaces on periodontally involved, extracted teeth. Replicas of the root surfaces were examined with SEM before and after removal of the smear layer with 10% EDTA. The planed and cleaned root surfaces revealed the effects of the sharpened instruments, with the relative surface roughness of the instrument being imparted to the tooth surface. The curets sharpened with finger grit stones produced smoother surfaces than those sharpened with the rough or coarse grit stone. It may be concluded that the sharpness of curets is related to the type of sharpening stone used and in turn to the smoothness of the planned root.

Aluminum Oxide↗
PubMed1999

Microbiological response of localized sites with recurrent periodontitis in maintenance patients treated with tetracycline fibers.

BACKGROUND: Whether adjunctive tetracycline fibers can provide an additive effect to scaling and root planing in treating non-responsive sites in maintenance subjects is still controversial. Recolonization of the bacteria from untreated sites or from the extracrevicular region may explain the insignificant response to local therapy. The purpose of the present study was to evaluate the microbiological response of sites treated with tetracycline fibers combined with scaling and root planing. METHODS: The study was conducted in a split-mouth design. Thirty patients on maintenance therapy having at least 2 non-adjacent sites in separate quadrants with probing depths between 4 to 8 mm with bleeding on probing, or aspartate aminotransferase enzyme levels > 800 microIU in the gingival crevicular fluid, were treated with scaling and root planing plus tetracycline fibers or with scaling and root planing only. Subgingival plaque samples were collected at baseline, and 1, 3, and 6 months following treatment. A. actino-mycetemcomitans, C. rectus, B. forsythus, E. corrodens, F. nucleatum, P. gingivalis, and P. intermedia were detected by culture, immunofluorescence, or PCR technique. RESULTS: There was a reduction of total bacterial cell count, as well as of certain periodontal pathogens, following treatment. The prevalence of A. actinomycetemcomitans, B. forsythus, and P. gingivalis and the mean proportions of C. rectus, P. intermedia, F. nucleatum, and P. gingivalis decreased after therapy, but there was no statistically significant difference between the 2 treatment groups with respect to bacterial proportions or the number of positive sites. Besides, the pathogens could not be eliminated from the periodontal pocket, and recolonization of the pocket was noted at 3 months post-treatment. CONCLUSIONS: Bacteria located within the cheek, tongue mucosa, saliva, or untreated sites may contribute to reinfection of the pockets and explain the insignificant response to local tetracycline therapy.

Adult↗
PubMed1997

Histologic evaluation of soft tissue attachment to CO2 laser-treated root surfaces: an in vivo study.

There is little support in the dental literature to justify the use of lasers for periodontal root therapy. To the contrary, there are several in vitro studies suggesting potentially adverse effects when lasers are applied to root surfaces. The purpose of this study was to evaluate, in vivo, soft tissue attachment to root surfaces following CO2 laser irradiation. Using a four-quadrant design with one quadrant serving as an untreated control, the remaining quadrants in each of two dogs were treated by (1) scaling and root planing, (2) laser only, and (3) laser followed by scaling and root planing. Prior to the assigned treatments, the roots of three teeth in each quadrant (including the control) were exposed by flap reflection and ostectomy. After root therapy the flaps were repositioned and allowed to heal for 28 days. Clinical attachment levels were determined prior to surgery, at 28 days, and by histologic measurement. Results indicate that specimens treated with laser only lost attachment compared to controls and other treatment groups. Furthermore, there was no histologic evidence of soft tissue attachment to a laser-treated surface that featured a residual char layer.

Animals↗