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PubMed2005

Effect of locally delivered doxycycline hyclate on human fibroblast attachment to subgingival calculus.

BACKGROUND: Clinical studies using locally applied doxycycline hyclate (DHV) have demonstrated significant probing depth reduction and gain in clinical attachment as a monotherapy without scaling and root planing. The mechanism for this attachment level gain to the non-root planed tooth is not understood. The purpose of this study was to investigate the effect of locally applied doxycycline hyclate on human gingival fibroblast attachment to subgingival calculus on contaminated root surfaces. METHODS: Two separate experiments were performed, both on subgingival calculus. In experiment 1, teeth with subgingival calculus were treated with either doxcycycline hyclate in bioabsorbable vehicle (DHV) or with vehicle control (VC) in vivo. In experiment 2, teeth with subgingival calculus were treated with DHV, VC, scaling and root planing (SRP), or no treatment in vitro. The amount of cell attachment to calculus-covered root surfaces was quantitatively compared using a fluorescent dye assay and epifluorescence microscope. Values for cell attachment are presented as the mean standard deviation of the mean. The data were evaluated using Student t test. RESULTS: In both experiments, there was no statistically significant difference in fibroblast attachment in the DHV, VC, or no treatment groups (P >0.05). The SRP group showed significantly more cellular attachment to tooth surfaces formerly covered by subgingival calculus than all other groups (P <0.001). In general, more cells attached to cementum than to calculus. Root chips that showed no attachment to the subgingival calculus also had no cells attached to the adjacent cemental root surface. CONCLUSION: The addition of doxycycline hyclate in a bioabsorbable vehicle used as a locally delivered drug did not enhance the initial cellular attachment of human gingival fibroblasts to subgingival calculus or contaminated root surfaces.

Absorbable Implants↗
PubMed1989

[Effect of various implant materials on cementogenesis].

Various implant materials have been used to stimulate the regeneration of supporting bone lost from periodontal disease. In addition, the histologic features of bone regeneration associated with their implantation have been evaluated. Very little, however, seems to be known about the effect of implant materials on cementum formation. The aim of this study was to determine whether implant materials stimulate the cementogenesis on adjacent planed root surfaces. Twelve monkeys with healthy gingivae were used in this experiment. Following mucoperiosteal flap elevation, "windows" were chiseled in the bone to the proximal root dentin surfaces and adjacent root surfaces were planed. Each of the three implant materials [tricalcium phosphate (TCP), decalcified bone matrix (DBM) and hydroxyapatite (HA)] were then placed in the cuspid and incisor root "windows" before the flap was sutured back into the previous position. Windows with no implantation served as a control. Animals were sacrificed 2, 4 and 8 weeks postoperatively. Biopsy specimens including the tooth and surrounding bone were examined by light and electron microscopy. At 2 weeks, all implant particles were surrounded by fibrous tissue. On the other hand, fibrous tissues filled the control defect. On the planed root surfaces after the implantation of TCP and DBM, furthermore, cementoid tissue appeared. At 4 weeks, a considerable amount of new cementum was deposited on the root surfaces except in the implantation of HA. It was especially pronounced after implantation of TCP and DBM which promoted bone regeneration after resorption. These results suggest that resorbable implant materials such as TCP and DBM not only facilitate the formation of new bone, but also of new cementum.

Animals↗
PubMed1996

Repopulation of periodontal pockets by microbial pathogens in the absence of supportive therapy.

This clinical study evaluated the reinfection incidence by Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi) in periodontal pockets following scaling and root planing (SRP) and intra-pocket irrigation with antimicrobial agents in a patient population who did not receive supportive maintenance therapy. The number of target organisms was determined utilizing DNA probes. Forty-one (41) inflamed pockets > or = 5 mm with attachment loss and containing at least one target species were selected in 6 adult patients. Following a baseline clinical and bacterial examination, all patients received thorough SRP. In addition, 1 to 2 teeth in each patient were randomly assigned to each of the following 4 treatment modalities: 1) control group, no irrigation; 2) saline group, irrigation with 2 cc of 0.85% saline; 3) tetracycline group, irrigation with 2 cc of aqueous tetracycline HCl, 50 mg/ml (5%); and 4) chlorhexidine group, irrigation with 2 cc, respectively. All selected sites were non-adjacent. No additional therapy was rendered during the entire 1-year observation period. Clinical parameters and microbial analyses were recorded again at 1 week, and 1, 3, 6, 9, and 12 months post-treatment. The effect of antimicrobial irrigation on the reinfection rate of sites by Aa, Pg, and Pi was compared with that of the control groups (1 and 2) by ANOVA. No statistically significant differences were observed among the irrigation treatment groups with regard to any of the clinical or bacterial parameters studied. Therefore, the 4 treatment groups were combined into a single group whereby the rate of bacterial repopulation following extensive scaling and root planing could be ascertained. The infection incidence of sites at baseline (of total sites), 1 week and 12 months (of sites originally infected at baseline) was 14/41, 3/14, and 7/14 for Aa; 33/41, 6/33, and 12/33 for Pg; and 37/41, 3/37, and 12/37 for Pi, respectively. Thus, half or fewer of the originally infected sites became reinfected at 12 months despite lack of maintenance therapy. The results suggest that 1) a single episode of pocket irrigation with antimicrobial agents following thorough scaling and root planing did not affect the rate of repopulation of periodontal pockets by the tested pathogens; 2) thorough scaling and root planing has a lasting suppressive effect on selected periodontal pathogens for the majority of sites in patients with adult periodontitis; 3) pre-operative probing depth, the amount of gingival fluid flow and the composition of the subgingival microflora may serve as predictors for reinfection in the absence of maintenance care; and 4) reinfection of the treated sites by Aa, Pg, and/or Pi may constitute a risk factor that diminishes the effect of therapy in the absence of supportive maintenance care.

Adult↗
PubMed1984

Variations in subgingival microflora from healthy and intervention sites using probing depth and bacteriologic identification criteria.

This investigation studied the changes in probing depths and subgingival microbial flora of clinically healthy and diseased sites before and after scaling and root planing. Thirty-six sites in 18 individuals were studied in two groups of patients, Group I (9 patients) had received no periodontal surgery, while group II had received surgery within the previous 4 years. Neither group had had professional prophylaxis or scaling and root planing within the previous 6 months. Group I had an average probing depth of greater than or equal to 5 mm and group II had an average of less than or equal to 4 mm. Scaling and root planing was performed on both groups at the beginning of the experiment and all patients were instructed in oral hygiene. Plaque and gingival indices, gingival fluid measurements, probing depths and dark field microscopic examination of subgingival plaque were evaluated immediately before scaling and root planing (baseline) and then once every 2 weeks for 2 months. For descriptive analysis of the data, all sites in both groups were classified according to probing depth or bacteriologic criteria. Sites with either greater than or equal to 85% nonmotile bacteria or less than or equal to 4 mm probing depth were presumed "healthy" and others were considered "diseased".(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Clinical, microbiological, and histological factors which influence the success of regenerative periodontal therapy.

The primary objectives of this double-blind, controlled clinical trial were to assess factor(s) which affect the success of guided tissue regeneration (GTR) procedures in mandibular Class II buccal furcation defects. Thirty subjects, with mandibular Class II furcation defects, were randomly assigned to one of two treatment groups; patients in Group A received oral hygiene instructions with scaling and root planing, while subjects in Group B received similar treatment but without subgingival scaling and root planing at the affected site. After initial oral hygiene instructions and scaling and root planing, GTR surgery was performed using ePTFE barrier membranes. Membranes were retrieved at 6 weeks and subjected to histological examination. Twelve months after regenerative therapy, clinical measurements and re-entry surgical measurements were repeated. Probing reduction (2.61 mm), horizontal probing attachment gain (2.59 mm), and vertical probing attachment gain (0.95 mm) were all significantly better compared to baseline. Likewise, significant improvements in furcation volume (8.0 microliters) and in bone measurements were observed at re-entry. There was no discernible difference between subjects for whom complete anti-infective therapy was deferred to the time of the surgery (Group B) compared to subjects in whom complete anti-infective therapy was performed as part of the hygienic phase of therapy (Group A). Pre-operative pocket depth was directly correlated with the magnitude of attachment gain as well as the amount of new bone formation in the furcation area. Subjects who maintained good oral hygiene and who had minimal gingival inflammation throughout the study demonstrated consistently better regenerative response.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

Some effects of non-surgical therapy on gingival inflammatory cell subsets in patients with early-onset periodontitis associated with Actinobacillus actinomycetemcomitans.

BACKGROUND: Limited information is available as to whether local cellular immunity in early-onset periodontitis (EOP) subjects harboring Actinobacillus actinomycetemcomitans (Aa) differs from that in patients without Aa. In addition, the effect of scaling and root planing on various lymphocyte subsets is described rather sparsely. METHODS: In 10 subjects with early-onset periodontitis harboring Aa (EOP-Aa) and in 10 subjects without Aa (EOP-nonAa), clinical measurements were recorded and gingival biopsies were performed before and after scaling and root planing. The specimens were cut into serial sections; using the alkaline phosphatase-antialkaline phosphatase technique, monoclonal antibodies to CD20 (B cells), CD30 (plasma cells), and CD45RO (T-memory cells) were applied as well as polyclonal antibodies to alpha, gamma, and mu chains (Ig A, G, and M). Cells were counted from an area of 0.25 mm2 in areas showing the largest infiltration. RESULTS: Before therapy, mean counts of all cell phenotypes were found to be markedly enhanced in the EOP-Aa group compared to EOP-nonAa subjects. Following scaling and root planing, the numbers of all phenotypes decreased in both groups. However, comparing the data before and after therapy in the EOP-Aa group, the P value was <0.05 only for CD30-positive cells. In the EOP-nonAa group, the differences before and after therapy reached statistical significance (P<0.05) for all cell counts, except for IgM-positive cells. Furthermore, reduction of probing depth and gain of clinical attachment reached the 0.05 level of statistical significance only in EOP-nonAa subjects. CONCLUSIONS: In EOP subjects harboring Aa, inflammatory cell subsets were detected in 2- to 3-fold higher numbers compared to patients without Aa. Scaling and root planing resulted in a decrease of all cell phenotypes studied in individuals without Aa, whereas in subjects with Aa, the only significant decrease that was seen occurred in plasma cells.

Adult↗
PubMed2004

Periodontal treatment by Arestin and its effects on glycemic control in type 1 diabetes patients.

Studies indicate that a dual pathway between diabetes mellitus and periodontal disease exists. Elimination of periodontal infection by using systemic antibiotics in conjunction with scaling and root planing (SRP) improved metabolic control in diabetic patients, as defined by reduction in glycated haemoglobin or reduction in insulin requirements (Grossi and Genco, 1998). The aim of this randomised pilot clinical trial was to determine if type 1 diabetes patients with periodontitis will experience a reduction in HbA1c levels when treated with locally delivered minocycline microspheres (Arestin) as an adjunct to scaling and root planing. Twenty adult patients with poorly controlled diabetes (HbA1c 7.5%) and adult periodontitis, as determined by the presence of four teeth with 5 mm periodontal pockets, two of which had 6-9 mm pockets and bleeding on probing, were included in the study. All patients received full mouth SRP at baseline. Arestin was administered to all pockets > or => or = 5 mm at baseline and again at 12 weeks in the test group. Probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and HbA1c were evaluated at baseline and at weeks 6, 12, 18 and 24. The results demonstrated that local administration of Arestin as an adjunct to scaling and root planing is significantly more effective in reducing probing depths and providing a gain in clinical attachment levels than scaling and root planing alone in type 1 diabetic patients. Hb1Ac was reduced in all patients; however the difference between the test and control groups was not significant.

Adult↗
PubMed2006

Long-term clinical effects of a chlorhexidine varnish implemented treatment strategy for chronic periodontitis.

BACKGROUND: Scaling and root planing in combination with oral hygiene monitoring are still considered the therapeutic standards for periodontitis. Although this treatment concept customarily results in satisfactory clinical improvements, treatment outcome may become less favorable predominantly when full access to periodontal defects is compromised, thereby leaving accretions behind. The purpose of this study was to investigate, over a 9-month period, the clinical benefits of a treatment strategy for chronic periodontitis based on a combination of sequential scaling and root planing and subgingival chlorhexidine varnish administration. METHODS: This randomized controlled, single blind, parallel trial included 26 volunteers with chronic periodontitis. The control group received oral hygiene instructions and was scaled and root planed in two sessions. The test group received the same instructions and treatment; however, all pockets were additionally disinfected using a highly concentrated chlorhexidine varnish. Clinical response parameters were recorded at baseline and at 1, 3, 6, and 9 months. The impact of the initial strategy on the decision-making process for supplementary therapy at 9 months was investigated based on treatment decisions made by five independent clinicians. RESULTS: Both treatment strategies showed significant reductions in probing depth and gains in clinical attachment at study termination in comparison with baseline (P<0.001). However, combination therapy resulted in a significant additional pocket reduction of 0.62 mm (P<0.001). Initially deep pockets (>or=7 mm) around multirooted teeth seemed to benefit most from the combination strategy, resulting in an additive pocket reduction of 1.06 mm (P=0.009) and a clinical attachment gain of 0.54 mm (P=0.048) in comparison to scaling and root planing alone. A trend toward a reduction of surgical treatment needs following the varnish-implemented strategy was found (P=0.076). CONCLUSION: These findings suggest that the outcome of initial periodontal therapy may benefit from the adjunctive subgingival administration of a highly concentrated chlorhexidine varnish.

Adult↗
PubMed1993

Topical application of tetracycline-HCl in human periodontitis.

Previous in vitro studies have suggested that tetracycline-HCl (TTC-HCl) is adsorbed and actively released from root dentin. The aim of the current study was to evaluate the binding to and release of TTC-HCl from human root dentin surfaces in vivo, and to evaluate the clinical utility of TTC-HCl irrigation as an adjunct to scaling and root planing. Experiment I utilized two contralateral mandibular single-rooted teeth which were examined in four adults with severe generalized periodontitis. One tooth in each patient was carefully scaled and root planed, under local anesthesia, and the other used as an unscaled control. Each subgingival root surface was irrigated for 5 min with an aqueous TTC-HCl solution at a concentration of 100 mg/ml. Gingival crevicular fluid samples were collected on paper strips for the next three weeks. The TTC-HCl concentrations in each sample were determined by the inhibition zone of B. cereus cultured on agar plates. The TTC-HCl concentrations in gingival crevicular fluid collected 15 min after irrigation were 3100 +/- 670 micrograms/ml from the scaled lesions and 4700 +/- 1300 micrograms/ml from the unscaled root surfaces. The antibiotic concentrations decreased logarithmically over the next 7 days; 1500 +/- 270 micrograms/ml and 1100 +/- 330 micrograms/ml at 2 h, 880 +/- 350 micrograms/ml and 1300 +/- 360 micrograms/ml at 6 h and 19 +/- 5 micrograms/ml and 31 +/- 26 micrograms/ml at 1 week for scaled and unscaled root surfaces, respectively. Results for week two and three indicated an average of over 8 micrograms/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Topical↗
PubMed1997

Interleukin-8 and beta-glucuronidase in gingival crevicular fluid.

Polymorphonuclear leukocytes (PMN) play a critical role in the host's response to the subgingival microflora. Interleukin-8 (IL-8) is a potent chemotactic and activating factor for PMN. In this study, the presence of IL-8 in gingival crevicular fluid (GCF) was examined in relation to the PMN indicator beta-glucuronidase (beta G), as well as clinical parameters of chronic inflammatory periodontal disease. Data was obtained from 30 patients with periodontitis and 14 healthy controls. For the control group, GCF and clinical data were obtained only once. For the periodontitis patients, clinical data and GCF samples were collected prior to treatment, and GCF samples were again collected 2 weeks after scaling and root planing. Comparing control and periodontitis patients prior to treatment, IL-8 concentration was lower in the patients with periodontitis. Scaling and root planing resulted in either an increase or a decrease in total IL-8 and IL-8 concentration GCF. A reduction in total IL-8 or IL-8 concentration was accompanied by a corresponding reduction in beta G activity. An increase in total IL-8 or IL-8 concentration after scaling and root planing was associated with an increase in beta G activity in some patients and a reduction in beta G activity in other patients. The periodontitis patients who did not demonstrate a linkage between IL-8 and beta G activity in GCF were those individuals with the highest beta G activity prior to treatment. As elevated beta G activity in GCF has been associated with an increased risk for probing attachment loss, the absence of a direct relationship between IL-8 in GCF and PMN recruitment into the gingival crevice may characterize individuals at risk for progression of periodontitis.

Adult↗
PubMed2001

A 2-step non-surgical procedure and systemic antibiotics in the treatment of rapidly progressive periodontitis.

BACKGROUND: In the last few years knowledge about periodontal infections has increased enormously, nevertheless practitioners are still seeking guidelines for suitable treatment concepts. METHODS: The aim of this study was to examine the effect of doxycycline, metronidazole, and clindamycin used adjunctively in a 2-step nonsurgical procedure in patients with rapidly progressive periodontitis (RPP). The first step included scaling, root planing, and polishing (SRP) in each quadrant using 4 to 5 visits. The second step included full-mouth enhanced root planing (RP) and wound dressing in 1 or 2 visits after SRP and the beginning of antibiotic therapy. Forty-eight patients (mean age 32.4 years) with generalized RPP, with an average of 16 sites with probing depths (PD) deeper than 8 mm, and high counts of Porphyromonas gingivalis were randomly assigned to 4 different groups: group 1 (doxycycline) n = 12, group 2 (metronidazole) n = 15, group 3 (clindamycin) n = 11, and group 4 (control group; no antibiotic treatment) n = 10. Clinical evaluations, including plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), clinical attachment level (CAL), and bacteriological and crevicular cell sampling, were done at baseline (BL), 3 weeks after SRP, and 6 and 24 months after RP. RESULTS: After the first step (SRP), we observed an improvement of PI and SBI in all 4 groups, but did not see any statistically significant PD reduction 3 weeks after SRP compared to baseline. However, 6 and 24 months after the second step (RP) we observed a significantly greater reduction of PD in groups 2 and 3 and a significantly greater CAL gain in comparison to groups 1 and 4. After 24 months, the attachment level gain in group 1 and group 4 was less than 1.5 mm, and less than 1.0 mm in PD site categories 6 to 9 mm and >9 mm. PI showed no significant difference between the groups throughout the period after SRP until 24 months, compared to 3 weeks after SRP. SBI decreased most in the metronidazole and clindamycin groups. P. gingivalis and Actinobacillus actinomycetemcomitans were almost completely eradicated in these 2 groups 24 months after RP. In addition, the phagocytotic capacity of crevicular polymorphonuclear neutrophils was increased in groups 2 and 3 after the second step. CONCLUSIONS: The present results show that metronidazole and clindamycin are effective antibiotics when used adjunctively in a 2-step nonsurgical procedure of scaling and root planing in RPP patients.

Adult↗
PubMed2005

A 2-year follow-up of root coverage using sub-pedicle acellular dermal matrix allografts and subepithelial connective tissue autografts.

BACKGROUND: Coverage of roots exposed by gingival recession is one of the main objectives of periodontal reconstructive surgery. A large variety of mucogingival grafting procedures are available. However, the long-term effectiveness of this procedure is still not clear. This study compared the effectiveness of sub-pedicle acellular dermal matrix allografts with subepithelial connective tissue autografts in achieving root coverage 2 years postoperatively. METHODS: One hundred one (101) patients were treated with dermal matrix allografts (mean age, 28.4+/- 0.7 years; mean recession, 4.2 mm) and 65 patients treated with connective tissue graft (mean age, 30.1+/- 1.4 years; mean recession, 4.9 mm). All patients underwent full periodontal evaluation and presurgical preparation, including oral hygiene instruction and scaling and root planing. The exposed roots were thoroughly planed and covered by a graft without any further root treatment or conditioning. There were no differences in the average age, time of follow-up, or gender between the two groups. Patients were evaluated periodically between 1 and 2 years. Residual recession and defect coverage were assessed. RESULTS: Mean residual root recession after root coverage with acellular dermal matrix allograft was 0.2 +/- 0.04 mm, with defect coverage of 95.9% +/- 0.9%. Frequency of defect coverage was 82.2%. Root coverage was 98.8% +/- 0.2%, resulting in a frequency of root coverage of 100%. Gain in keratinized gingiva was 2.2+/- 0.04 mm and attachment gain was 4.5+/- 0.1 mm per patient. Connective tissue autografts resulted in mean residual root recession of 0.1+/- 0.04 mm, with percent defect coverage of 97.8%+/- 0.6% and frequency of defect coverage of 95.4%. Root coverage was 99.1%+/- 0.2%, and frequency of root coverage was 100%. Gain in keratinized gingiva was 3.0+/- 0.1 mm and attachment gain was 5.3+/- 0.2 mm per patient. No significant differences in final recession and root coverage between the two treatment methods were found. However, autografts resulted in significant increases in defect coverage, keratinized gingival gain, attachment gain, and residual probing depth. The clinical results were stable for the 2-year follow-up period. CONCLUSIONS: These results indicate that coverage of root by sub-pedicle acellular dermal matrix allografts or subepithelial connective tissue autografts is a very predictable procedure which is stable for 2 years postoperatively. However, subepithelial connective tissue autografts resulted in significant increases in defect coverage, keratinized gingival gain, attachment gain, and residual probing depth.

Adult↗
PubMed1987

New attachment in monkeys with experimental periodontitis with and without removal of the cementum.

Experimental periodontitis was induced in monkeys by means of elastic orthodontic ligatures. The periodontally-involved teeth were then treated with different methods. At the end of the treatment period, the monkeys were sacrificed. The premolar-molar areas were dissected out and embedded in a low-viscosity embedding medium (Spurr). The results of the treatment procedures were analyzed on ground sections. Formation of new cementum and new bone was determined by means of tetracycline labeling. Root planing with an ultrasonic device or with hand instruments almost completely removed the cementum and a portion of the peripheral dentin. The root surface was more uneven after treatment with the ultrasonic device than after using hand instruments. No new attachment could be found after root planing. Cleaning of the periodontally-involved root surfaces with two detergents (cetylpyrimidinium chloride and sodium-N-lauroyl sarcosine) without root planing resulted in a significant amount of new attachment.

Animals↗
PubMed1997

Clinical efficacy of the Nd:YAG laser for combination periodontitis therapy.

Recent results of a limited clinical trial suggest that mechanical root scaling and root planing therapy alone may not be the most effective mode of treatment for patients affected by moderate to severe adult periodontitis. However, scaling and planing combined with laser therapy utilizing a low-powered pulsed Nd:YAG laser have been shown to be successful in the elimination of the bacteria commonly associated with the development of this oral condition. The double-blind, split mouth design study involved 10 human subjects randomly assigned to one of three treatments: 1) scaling and root planing alone, 2) dental laser plus scaling and root planing, and 3) control only. This article presents the clinical results of the trial, which suggest that laser therapy is a viable adjunct to local, nonsurgical therapy such as scaling and planing.

Adult↗
PubMed1977

A comparison of tooth accumulated materials from quadrants treated surgically or nonsurgically.

The objective of this study was to test the validity of the clinical concept that periodontal surgery is beneficial in aiding the patient to reduce the amount of tooth accumulated materials in moderate to advanced cases of periodontal disease. Twelve arches in eight patients with moderate to severe bone loss were selected for this investigation. Using a split-mouth technique, 12 quadrants were subjected to pocket elimination by the use of osseous and soft tissue recontouring, and 12 quadrants received thorough deep scaling, root planing, and polishing. These patients were seen at 1,2, and 4 weeks after surgery for root planing and more oral hygiene instructions. At 6 weeks they received a prophylaxis, including root planing if indicated, throughout the mouth. The patients returned in 2 weeks, at which time plaque accumulations were then removed and collected by quadrant to be subjected to analysis using wet weights, dry weights and ash weights. The quantity of tooth accumulated debris on the surgically-treated quadrants was significantly greater than on those treated nonsurgically, as determined by the wet weight (P less than 0.01) and dry weight (P less than 0.05). There was, however, no significant difference with ash weight comparisons. The dry weight was the more accurate indicator of tooth accumulated materials. The mean ash weight on the surgically-treated mandibular quadrants (2.21 mg) was significantly greater (P less than 0.05) than from those treated nonsurgically (1.35 mg). The investigators' hypothesis that there would be more accretions on the side not involved in osseous surgery and pocket eradication was not supported in this study. Several possible reasons for this were elucidated and discussed.

Dental Deposits↗
PubMed1996

Electron probe analysis of cementum surfaces.

The purpose of this study was to determine the presence of certain inorganic elements in various cementum surfaces. The electron probe analysis appears to be the most suitable technique for examining elemental composition within localized small areas of mineralized tissue, it was used to determine the mineral contents of nondiseased, periodontally diseased and root planing applied diseased cementum surfaces were determined by electron probe. Calcium (Ca) and phosphorus (P) were the elements searched for. Surface morphological features of these cementum surfaces were also examined. Electron probe analysis indicated an elevated Ca and P content in diseased cementum surfaces. Root planing of these surfaces did not reduce the mineral contents of these root surfaces. Our findings indicate that on the cementum surfaces affected by periodontal disease inorganic contents were altered and the hypermineralized layer in diseased cementum may play a role in preventing total diseased cementum removal by root planing.

Analysis of Variance↗
PubMed2005

Er:YAG laser in defocused mode for scaling of periodontally involved root surfaces: an in vitro pilot study.

BACKGROUND: The Er:YAG laser may be used on periodontally involved teeth in combination with conventional periodontal therapy in order to improve the efficacy of root instrumentation. The aim of this study was to compare the effect of hand instrumentation on root surfaces of periodontally involved teeth with Er:YAG laser application. METHODS: Thirty freshly extracted, non-carious, single-rooted, periodontally diseased human teeth from adult humans with advanced periodontal disease were used in this study. The teeth were divided into three groups of 10 specimens each. Group A was treated with scaling and root planing (SRP) with curets only (control). In group B, the root surfaces were scaled with curets and then lased with an Er:YAG laser (wavelength 2.94 microm). A handpiece with a water spray was used in non-contact mode (defocused) at a distance of 1 cm from root surface. Laser parameters were set at energy of 100 to 200 mJ/pulse, with 10 Hz of frequency. In group C, the root surfaces were lased only with power settings 250 to 300 mJ/pulse and 10 Hz frequency. An epon-araldite plastic embedding technique was used for light microscopic investigation. RESULTS: Histologic findings showed significant differences between the test and control sites. In control sites, after hand instrumentation, the surface was smooth, without a cementum layer, and the dentin layer presented opened tubules. Defects on the dentin layer were also present along root surfaces. In the test sites (B, C) root surfaces revealed no thermal damage; no cracking or tissue carbonization were observed. The superficial layers of lased surfaces appeared smooth and melted without alterations. CONCLUSION: Based on these findings, it appears that it may be feasible to use the Er:YAG laser for root instrumentation without prior root planing if the proper parameters are followed.

Adult↗
PubMed1989

Refractory chronic periodontitis: effect of oral tetracycline hydrochloride and root planning.

Refractory chronic periodontitis of 16 patients was treated by root planing and adjunctive tetracycline hydrochloride therapy. The antibiotic was taken orally one hour before root planing and continued for six days at a dosage of 250 mg six hourly. The clinical data for each patient were recorded as the number of probing depths in each of the 1-3 mm, 4-6 mm and 7-10 mm ranges. The Multivariate Analysis of Variance (MANOVA) procedure for repeated measurements was used to analyse the data. The results demonstrated that the number of sites with probing depths of 4-6 mm and 7-10 mm associated with incisors, canines, premolars and molars decreased with a corresponding increase in the number of sites in the 1-3 mm range. Incisor and canine teeth showed a better response to treatment than premolars, which responded better than molars. The cases were followed for varying periods of time from six months to two years following antibiotic therapy. The probing depth reduction achieved following root planing and tetracycline hydrochloride therapy was maintained during this review period.

Administration, Oral↗