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PubMed1997

Effect of mechanical treatment on healing after third molar extraction.

The aim of this study was to determine the effect of subgingival scaling and root planing on healing of the distal surface of second molars following extraction of third molars. Twenty-eight patients with contralateral erupted third molars and pocket depths greater than or equal to 3 mm on the distal surface of the second molars participated in this study. Measurements of supragingival bacterial plaque, bleeding on probing, pocket depth, and relative attachment level were performed at baseline and 2 months after treatment. Extraction of contralateral third molars was carried out simultaneously. The experimental site received thorough scaling and root planing of the distal surface of the second molar, while the control site received extraction alone. Experimental sites showed significant improvement in all clinical parameters assessed compared to the control sites. In conclusion, periodontal lesions on the distal of second molars can be significantly improved following scaling and root planing after extraction of third molars.

Adult↗

PubMed2000

Gingival fluid ciprofloxacin levels at healthy and inflamed human periodontal sites.

BACKGROUND: Polymorphonuclear leukocytes (PMNs) take up and accumulate ciprofloxacin. This may allow them to enhance the delivery of this agent to the inflamed periodontium. METHODS: Cross-sectional and longitudinal approaches were used to test the hypothesis. In the cross-sectional study, 7 periodontally healthy adults and 8 adults with untreated periodontitis were administered three doses of ciprofloxacin (500 mg bid). Gingival fluid (GF) and serum samples were obtained after 28 hours and analyzed by high-performance liquid chromatography (HPLC). In the longitudinal study, 8 adult periodontitis subjects were administered 500 mg ciprofloxacin bid for 8 days. After 28 hours, GF from 4 sites with 5 to 8 mm probing depths was sampled in each subject, serum samples were obtained, and 2 of the 4 sites were root planed. GF and serum were sampled again 7 days later (196 hours after the initial dose). RESULTS: The mean ciprofloxacin levels in the GF and serum of periodontally healthy subjects were 2.52 +/- 0.22 microg/ml and 0.47 +/- 0.05 microg/ml, respectively. In subjects with periodontitis, these levels were 2.69 +/- 0.44 microg/ml and 0.61 +/- 0.13 microg/ml, respectively. GF ciprofloxacin levels were significantly higher than corresponding serum levels in healthy and diseased subjects (P<0.01), but there were no significant differences in GF or serum levels between the 2 subject groups. Since GF flow was significantly higher at diseased sites, however, more ciprofloxacin was distributed to these sites than to healthy sites. In the longitudinal study, GF flow at 196 hours was 16% lower at root planed sites than at untreated control sites (P = 0.412). The minor decrease in this index of inflammation was accompanied by a small (9%), but statistically significant (P= 0.007), decrease in GF ciprofloxacin levels. CONCLUSIONS: GF ciprofloxacin levels decreased slightly at inflamed periodontal sites after root planing, but were significantly higher than serum levels even at healthy periodontal sites. Inflammation may enhance the distribution of ciprofloxacin to diseased sites, but it is not a major determinant of GF ciprofloxacin levels.

Adult↗

PubMed1993

The effect of subgingival debridement on periodontal disease parameters and the subgingival microbiota.

The aim of the present investigation was to analyse the effect of subgingival scaling and root planing in subjects who prior to treatment exercised meticulous supragingival plaque control. 300 subjects were examined at baseline and after 1 and 2 years without treatment. After the year 2 examination, 62 subjects were randomly selected for therapy. They were given detailed instruction in proper self-performed toothcleaning measures and were carefully monitored during the subsequent 2 years. Following the year-4 examination, 2 quadrants, 1 maxillary and 1 mandibular in each subject, were randomly selected for additional therapy. The teeth in the selected quadrants were exposed to subgingival scaling and root planing. The subgingival therapy was repeated until a site no longer bled on gentle probing. This basic therapy was completed within a 2-month period. All subjects were re-examined after another 12-month interval. The examinations at year 4 and 5 included assessment of plaque, gingivitis, probing pocket depth and analysis of samples obtained from the subgingival microbiota at 134 selected sites. The findings from the present study demonstrated: (i) that subgingival scaling and root planing were effective in eliminating subgingival plaque and gingivitis; (ii) that professional therapy resulted in a pronounced reduction of probing depth at sites which at year 4 had a probing depth > 3 mm; (iii) that in non-scaled quadrants, the extension of self-performed plaque control resulted in a continued improvement of the periodontal conditions at sites which at year 4 were < 5 mm deep.

Adult↗

PubMed1998

Local metronidazole application in maintenance patients. Clinical and microbiological evaluation.

The purpose of this investigation was to evaluate the clinical and microbiological effect of local antibiotic therapy in comparison with subgingival scaling and root planing in a randomized semi-masked study. Forty-six recall patients who completed systematic periodontal therapy 6 to 24 months prior to the study were enrolled. The inclusion requirements were at least one site with probing depth > or = 5 mm in each quadrant, no scaling, and no antibiotic therapy during the last 6 months. After randomization each patient received 2 different treatments: in 2 quadrants metronidazole 25% dental gel was applied subgingivally to the pockets at day 0 and day 7; scaling and root planing was carried out in the 2 other quadrants, one at day 0 and in the remaining quadrant at day 7. Subgingival microbiological samples were taken from each patient before treatment and on days 21, 91, and 175 after the treatment. The analyses were carried out by indirect immunofluorescence assay. At all treated sites probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded on days 0, 21, 91, and 175. Both treatments resulted in PD reduction and CAL gain. PD reduction was statistically significant (P < 0.01) for both treatment modalities after 6 months. The CAL gain was not significant for either treatment. There was no statistical significance between scaling and antibiotic therapy. Treponema denticola, Porphyromonas gingivalis, and Prevotella intermedia were significantly reduced after therapy; however, there were no statistically significant differences between treatments. If Actinobacillus actinomycetemcomitans was present before therapy, it was also present after treatment in both groups. The conclusion is that, in recall patients, local application of metronidazole and scaling and root planing showed similar clinical and microbiological effects without statistically significant differences.

Administration, Topical↗

PubMed1982

Effect of periodontal treatment on tooth mobility.

The purpose of this study was to compare tooth mobility at different time periods during periodontal treatment and to relate changes in mobility to each method of treatment. Ninety-three patients (2421 teeth) with moderate to severe periodontitis were scored: (1) at initial examination, (2) 1 month following scaling, root planing, instruction in oral hygiene and preliminary occlusal adjustment, (3) 1 month after treatment with pocket elimination or reduction, curettage, modified Widman flap or scaling and root planing by the periodontist, and (4) 1 and 2 years following completed periodontal treatment. After initial nonsurgical treatment there was a significant decrease in tooth mobility. Tooth mobility increased temporarily after pocket reduction surgery but was not altered following curettage, modified Widman flap or scaling and root planing. Two years post-treatment there was a trend toward further decrease in tooth mobility with professional tooth cleaning every 3 months.

Dental Scaling↗

PubMed1998

Clinical and microbiological effects of controlled-release local delivery of minocycline on periodontitis in dogs.

OBJECTIVE: To evaluate the clinical and microbiological efficacy of minocycline in a subgingival local delivery system as an adjunct to tooth scaling and root planing in dogs with periodontal disease. ANIMALS: Nine 4- to 7-year-old Beagles with periodontitis. PROCEDURE: After scaling of teeth and root planing, 2 treatment and 1 or 2 control sites were selected for each dog: treated sites (n = 18) received minocycline hydrochloride periodontal formulation and control sites (n = 12) received ointment base (no minocycline). Gingival crevicular fluid was collected at a baseline (prior to treatment) and at week 4. Clinical and microbiological effects were evaluated and compared among sites. RESULTS: In minocycline-treated sites, clinical indices were significantly decreased at week 4, compared with those at baseline. Minocycline-treated sites were associated with a significant decrease in gingival crevicular fluid, probing depth, and bleeding on probing values, compared with those for control sites at week 4. Compared with that for control sites, total bacteria count in periodontal pockets of minocycline-treated sites had an obvious tendency to decrease by week 4. Proportions of Porphyromonas and Fusobacterium spp were significantly decreased at week 4, compared with proportions at control sites and with pretreatment (baseline) values. CONCLUSIONS: When used as an adjunct to tooth scaling and root planing, minocycline periodontal formulation stimulated favorable clinical and antimicrobial responses.

Animals↗

PubMed1997

Short-term effects of triclosan on healing following subgingival scaling.

The present clinical trial was performed to evaluate short-term effects of a triclosan-containing dentifrice/gel combination on soft tissue healing, when applied supra-/sub-gingivally at periodontal sites treated with scaling and root planing. 16 subjects with moderate periodontitis participated in a 2x 2-week, split-mouth designed clinical trial. 2 combinations of gel/dentifrice (the test combination containing triclosan) were used. 2 pairs of contralateral sites with probing pocket depth (PPD) > or 5 mm, and which bled on probing (BoP +) were selected in each patient as experimental units. A baseline examination included assessments of PPD, BoP, gingival index scores, plaque index scores, and the composition of the subgingival microbiota (dark-field microscopy). The assigned quadrant was anaesthetized and the teeth exposed to meticulous scaling and root planing. Immediately after the completion of mechanical therapy, either the test or control gel was applied subgingivally at the experimental sites. The volunteer was instructed to brush his/her teeth with an assigned dentifrice and to apply the gel (via a custom-made stent) supra-gingivally 2x daily for the following 2 weeks. He/she was recalled on day 7 for a second professional subgingival gel application. Re-examinations were carried out on days 2, 7 and 14 after treatment. 1-week wash-out periods separated the 2 experimental periods. The mean PPD reductions (between days 0 and 14) were 1.8 mm and 1.9 mm for the test and control gel/dentifrice sites. The reduction in BoP and gingival index scores was significantly greater during the test than during the control regimen. No significant differences were observed between the 2 regimens regarding plaque scores and composition of the subgingival microbiota. The findings from the present investigation demonstrated that triclosan, applied both sub- and supra-gingivally reduced soft tissue inflammation following scaling and root planing.

Anti-Infective Agents, Local↗

PubMed1998

Evaluation of tetracycline fiber therapy with digital image analysis.

The aims of the present study were to assess radiographically the effects of scaling/root planing combined with antibiotic therapy using tetracycline fibers (TCF): (I) on alveolar bone density and linear descriptors and (II) on supracrestal soft tissue density. 19 subjects with generalized adult periodontitis (with at least 20 teeth present, at least 4 teeth with pockets >4 mm and bleeding upon controlled force probing) and high cultural counts of Porphyromonas gingivalis were recruited from a pool of 57 patients. The full mouth treatment group (FT) consisted of 10 patients, who underwent a full mouth supra-gingival scaling and prophylaxis treatment and were instructed to rinse 2x daily with a 0.1% chlorhexidine solution. 1 week later, tetracycline-hydrochloride-containing fibers (Actisite periodontal fiber) were applied around all teeth. After 7-12 days, the fibers were removed and all teeth were scaled and root planed under local anaesthesia. The chlorhexidine rinsing continued for another 2 months. In 9 subjects (local treatment group LT), 2 teeth with periodontal lesions with pocket probing pepth (PPD) > or =5 mm were treated by placement of tetracycline fibers, which remained in place for 7 to 12 days. Upon removal of the fibers, scaling and root planing was performed on these 2 teeth, while the rest of the dentition remained untreated, and no chlorhexidine rinse was applied. 2 of the untreated teeth revealing similar periodontal lesions were chosen to represent sites affected by untreated periodontitis (NT). In this group, a limited local treatment was performed (2 teeth) with the inherent potential for recolonization from the untreated pocket sites. Standardized periapical radiographs were obtained from the 4 monitored sites within each patient at baseline (before treatment) and 2 and 6 months thereafter. One radiograph was exposed in a standard way for bone assessment. The second radiograph was underexposed, at about a 1/5 of the original exposure time to allow the evaluation of soft tissue. Mean changes in the linear parameters and changes in density (CADIA) observed at multiple sites within each patient and treatment group were used as the best estimate of treatment outcome. Over the observation period of 6 months, a significant difference in bone height changes was found between the untreated sites (median loss -0.29 mm) and the sites from full-mouth treated patients (median gain 0.24 mm, p=0.008). When comparing the baseline to the 6 months radiographs, a loss in bone density was observed for the untreated group (median=-2.13 CADIA). Both treatment groups revealed a gain in density (median=1.58 and 2.43 CADIA for the locally and the full-mouth treated groups, respectively). Differences in density were significant, both between the nontreated and locally treated sites (p=0.026) and between the nontreated sites and the sites from the full mouth treated patients (p=0.002). The analysis of the soft tissues showed a similar pattern of changes in density to those seen in the bone defect. At 2 months, there was a tendency for loss in density for the nontreated group (median=-0.17 CADIA) that continued over the 6 month period (median=-0.31 CADIA). A significant increase in density was observed for the full-mouth treated sites (median=1.57 and 0.64 CADIA for the 2 and 6 months radiographs, respectively). A significant increase was also observed for the locally treated group when compared to the untreated sites (median=0.13 and 0.10 CADIA for the 2 and 6 months radiographs, respectively). Comparing untreated sites with full-mouth treated sites, a significant difference was observed for CADIA measurements (p<0.001). No significant difference was observed comparing locally treated and untreated sites (p=0.24). It was concluded that scaling and root planing combined with TCF therapy can result in increased bone density and alveolar bone height. Full-mouth treatment seemed to result in more pronounced gains compared to local tre

Adult↗

PubMed1998

Effects of topical metronidazole and tetracycline in treatment of adult periodontitis.

The present study was performed to assess and compare the clinical healing and the microbiological findings following local application of metronidazole or tetracycline to augment subgingival scaling in previously untreated adult periodontitis sites. Eighteen patients with moderate to severe adult periodontitis at single-rooted teeth were selected. In each patient, 3 interproximal sites having comparable root anatomy, probing depth > or =5 mm and bleeding on probing were randomly assigned to 1 of 3 treatment groups: 1) two sessions of subgingival scaling and root planing; 2) similar to 1, with each treatment supplemented with a 25% metronidazole sustained release gel; 3) similar to 1 with each treatment supplemented with a 3% tetracycline ointment. The treatments were performed by 1 operator and the clinical variables probing depth, attachment level, and bleeding on probing were evaluated at baseline, 3 months and 6 months by a second blinded examiner. The microbiological findings were evaluated using a commercial test kit. The average probing depth reduction for the 3 groups at 6 months was 1.5 mm and the average gain of clinical attachment was 0.8 mm. There were no significant differences between the effects following topical application of the metronidazole gel or the tetracycline ointment. Scaling and root planing alone appeared as effective as the drug augmented regimens, although there was a weak but non-significant tendency for better results in sites treated with the antibiotic drugs. Actinobacillus actinomycetemcomitans was generally not detected; Prevotella intermedia was not significantly reduced, while Porphyromonas gingivalis was significantly reduced in all treatment groups. It was concluded that the augmentative effect of the metronidazole gel and the tetracycline ointment was comparable but small compared to scaling and root planing alone. The clinical importance of such small augmentation effects should be further evaluated.

Administration, Topical↗

PubMed1995

Response to intracrevicular controlled delivery of 25% tetracycline from poly(lactide/glycolide) film strips in SPT patients.

Controlled local delivery of antibiotics has been shown to reduce periodontopathic micro-organisms with minimal side-effects. Clinical studies in our laboratory have shown that 25% tetracycline HCl delivered from poly(D,L-lactide/glycolide) film strips (25 TTC-PLGA) released therapeutic concentrations of tetracycline for 10 days. The present pilot study compared the intracrevicular delivery of 25% tetracycline HCl incorporated in these biodegradable film strips to scaling and root planing (SRP) in 10 adult periodontitis patients, who in spite of therapy and regular supportive periodontal treatment (SPT), continued to possess 5 bleeding periodontal pockets at least 5 mm deep. Sites were randomly selected to receive the following treatments: (1) 25 TTC-PLGA, (2) control strips without TTC (PLGA), (3) SRP, and (4) untreated control. Film-strip retention was augmented with a suture/cement technique, followed by strip removal after 2 weeks. Clinical parameters and subgingival bacterial morphotypes (darkfield analysis) were evaluated over time (0, 2.4, 8, 12, 26 weeks). Results indicated that, compared to baseline, 25 TTC-PLGA film strips caused significant (p < or = 0.01): (1) probing depth reduction for 26 weeks, (2) a clinical attachment level gain for 12 weeks, (3) lower %s of spirochetes for 4 weeks and motile rods for 8 weeks (p < or = 0.05), and (4) an accompanying increase in cocci for 4 weeks. In the scaled and root planed sites, probing depth was the only finding that demonstrated a significant change from baseline (p < or = 0.01). Controls and PLGA showed isolated reductions in probing depth and % of motile organisms. From these findings, applications of intracrevicular 25 TTC-PLGA, when compared to scaling and root planing, appears to have an enhanced antibacterial effect and a similar clinical effect in SPT patients. The results of this study indicate further investigation of 25 TTC-PLGA film strips should be undertaken using more subjects and sophisticated microbiological and clinical measurements.

Adult↗

PubMed1982

Attachment levels and crevicular depths at the distal of mandibular second molars following removal of adjacent third molars.

The effect of root planing and curettage on the crevicular depth and periodontal attachment at the distal of mandibular second molars following removal of adjacent impacted or partially erupted third molars was evaluated in 18 patients, between the ages of 18 and 25, presenting with similar bilateral impactions. No significant difference was demonstrated in the crevicular depths and attachment levels between the curetted, root planed side, and the untreated controls. Thus, any benefits derived by root planing and curettage of mandibular second molars immediately following removal of adjacent impacted third molars are minimal. The best means of preserving periodontal attachment on mandibular second molars may be the removal of third molars at an early stage of tooth development.

Adolescent↗

PubMed1989

The effect of 2% chlorhexidine digluconate irrigation on clinical parameters and the level of Bacteroides gingivalis in periodontal pockets.

Eight patients with moderate periodontitis volunteered to participate in a study to assess the effect of subgingival 2% chlorhexidine irrigation, with and without scaling and root planing, on clinical parameters and the level of Bacteroides gingivalis in periodontal pockets. Each quadrant was required to have at least one site with a probing depth of 6 mm or greater and bleeding on probing. The patients were treated following a randomized four quadrant design: one quadrant received no treatment; a second quadrant received scaling and root planing only; a third quadrant received chlorhexidine irrigation only; the fourth quadrant received scaling and root planing, plus chlorhexidine irrigation. Sites to receive chlorhexidine were irrigated at 0, 1, 2, and 3 weeks. Clinical and microbiological indices were measured and recorded at 0, 5, 7, 11, and 15 weeks. The clinical parameters measured included; Plaque Index (PI), Gingival Index (GI), probing depth (PD), Bleeding Tendency (BT), and attachment level (AL). The attachment level was measured using an occlusal stint as a fixed reference point. The level of Bacteroides gingivalis was measured by labeling the plaque sample with a polyclonal fluorescent antibody. The plaque smear was then read using a fluorescent microscope at 1000 magnification. The Spearman Rank-Order Correlation was used to determine the relationship between parameters at baseline. The effects of the treatment groups were compared using the Neuman-Keuls Multiple Comparison Technique. The results showed that a positive correlation existed between B. gingivalis (rs = 0.68) and Bleeding Tendency and between P1I (rs = 0.77) and GI.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1998

Local delivery of chemotherapeutic agents in periodontal therapy: has its time arrived?

The concept of locally delivering chemotherapeutic agents to the periodontal pocket as a method to treat periodontal disease has been studied for over 20 years. A number of locally delivered chemotherapeutic agents in periodontal therapy are either currently available or under investigation. Clinical efficacy derives from sustained-release technology to maintain an effective concentration of drug within the periodontal pocket for a clinically relevant length of time. Studied drugs have mainly been antimicrobials, both antibiotics and antiseptics. Most agents have been tested as adjuncts to scaling and root planing; a few have been studied as stand-alone monotherapies. Collectively, the data indicate that the use of locally delivered antimicrobials as adjuncts results in a significant increase in the reduction of probing depth compared with scaling and root planing alone. In other trials, results in reducing probing depth following the use of stand-alone locally delivered antimicrobials have been equivalent to those of scaling and root planing over a specified time. This Symposium was organized to present the current state-of-the-art with regard to the use of locally delivered antimicrobials in the treatment of periodontal disease. 5 experts in the field who have had considerable experience in studying locally delivered antimicrobials presented data. These speakers reviewed the clinical findings regarding efficacy of 5 different antimicrobial agents. An ensuing panel discussion was to consider treatment recommendations for locally delivered antimicrobials.

Administration, Topical↗

PubMed1987

Effect of an air-powder abrasive system on root surfaces in periodontal surgery.

The purpose of this study was to compare the effectiveness of an air-powder abrasive technique to conventional root planing during periodontal surgery. 7 patients scheduled for multiple extractions of periodontally-involved teeth were selected. Full thickness mucoperiosteal flaps were reflected, and proximal surfaces of 32 teeth were either ultrasonically scaled and exposed to the air-powder abrasive, or ultrasonically scaled and then manually root planed. Following extraction, teeth were stained for residual plaque and photographed, or prepared for scanning electron microscopy. The air-powder abrasive technique used for surgical root preparation was found to produce a root surface favorably comparable to manual root planing with regard to removal of plaque, calculus, and exposed cementum. A mean of 80 micron of cementum was abraded away after 40 s of exposure to the air-powder spray. The air-powder abrasive spray demonstrated an advantageous ability to remove plaque and cementum from areas of difficult access, such as furcations and root flutings.

Dental Prophylaxis↗

PubMed1990

Pulpal and root sensitivity rated to periodontal therapy.

The purpose of this clinical investigation was to determine if periodontal treatment consisting of scaling, root planing, and periodontal surgery produced any change in pulpal or root sensitivity. Ten patients were tested, with a total of 84 observations. There were 42 periodontally treated teeth, with 42 contralateral teeth serving as control specimens. The teeth were evaluated with stimuli from an electric pulp tester, cold, and air. The electric pulp tester was found to be reliable in assessing the pulpal sensitivity. Neither the amount of periodontal destruction nor the extent of periodontal treatment had any effect on the pulp. Scaling and root planing had no significant effect on root sensitivity. Periodontal surgery was directly related to root sensitivity in terms of the extent of root surface exposure. An association was observed clinically between plaque accumulation after periodontal surgery and root sensitivity.

Adult↗

PubMed1991

Effect of different sharpening stones on periodontal curettes evaluated by scanning electron microscopy.

The purpose of this study was to evaluate sharpening effect of different sharpening stones on periodontal curettes. In conjunction with 21 brand-new Gracey No. 1/2 curette blades, the Arkansas, India synthetic and ceramic stones were used in this study. The simulated root planing procedure was performed with 45 strokes on freshly extracted, single-rooted teeth. Positive and negative controls were provided. All sharpening procedures were carried out by a clinician and 10 sharpening strokes were applied to each blade with an angle of approximately 70 degrees. The blades were then examined by scanning electron microscopy (SEM). The working edges were investigated within the first 1 to 2 mm from the top of the blade under 500 times of magnification and 3 SEM micrographs were taken from each blade. Micrographs were examined for sharp wire edges, narrow bevel and wide bevel. The Fisher's exact test, Mantel-Haenszel test for trend and 1% probability were used for data analysis. Results indicate that (1) following the simulated root planing procedure, blades became dull, (2) among all the sharpening stones, the ceramic stone was least effective (p less than 0.01) in limited sharpening strokes, (3) with the India synthetic stones, no significant difference was found and they had better sharpening effects than others. This study demonstrates that the sharpening effect of India synthetic stones is the best under SEM examination with a standardized sharpening procedure.

Adult↗

PubMed1984

The effect of citric acid on repair after delayed tooth replantation in dogs.

An experimental study of maxillary incisors in dogs was carried out to test the hypothesis that demineralization of denuded root surfaces by citric acid to expose collagen matrix fibrils might improve the rate of periodontal regeneration after replantation of traumatically avulsed and dried teeth, provided that the root surface is not traumatized during replantation or postoperatively. Experimental teeth (group 4) were allowed to dry in air for 45 min. A mid-portion of the root was then root-planed extensively, treated with citric acid for 3 min, rinsed with saline, and replanted. The apical region and a cervical collar were not instrumented, ensuring precise reseating and stability of the tooth during the postoperative period. Control teeth were either replanted immediately (group 1), bench-dried for 45 min and replanted (group 2), or bench-dried and the entire root surface root-planed and acid-treated before replantation (group 3). Histological examination of block specimens after 21 days of healing showed complete periodontal regeneration in group 1 and, by contrast, a high rate of ankylosis, inflammatory resorption, and surface resorption in group 2. Root planing and acid treatment of bench-dried teeth (group 3) did not improve the healing response, whereas the mid-root region of teeth in group 4 showed an absence of inflammatory resorption and less ankylosis than groups 2 and 3. These preliminary observations indicate that the frequency of adverse healing results after delayed replantation can be reduced by removing nonvital soft tissue remnants, demineralizing the root surface, and preventing mechanical trauma to the root surface in the postoperative period.

Animals↗

PubMed1990

Subgingival irrigation in the maintenance phase of periodontal therapy.

The purpose of this study was to evaluate the effect of subgingival scaling versus subgingival pocket irrigation with 0.1% chlorhexidine or saline controls on the repopulation of subgingival periodontal sites with disease-associated micro-organisms following a single procedure of scaling and root planing. Additionally, pertinent clinical parameters (attachment level, plaque index, bleeding on probing) were also recorded. 375 sites in 30 individuals with previously untreated periodontal disease were thoroughly scaled and subsequently either rescaled, irrigated, or not treated at all for the following 6 months at 1-month intervals. The results show that the initial scaling and root planing procedure led to significant clinical and microbiological improvements in all experimental groups. These improvements were maintained in all but the untreated sites. Based on the observed clinical and microbiological changes, subgingival irrigation of periodontal pockets at 1-month intervals was equally effective as scaling and root planing performed at the same pace. 0.1% chlorhexidine however, being used as test irrigant, was not more effective than saline controls.

Adult↗