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At least 73 records · Page 4Linked to original sources
PubMed2004

Locally delivered doxycycline as an adjunctive therapy to scaling and root planing in the treatment of smokers: a clinical study.

BACKGROUND: The aim of this clinical study was to evaluate the association of locally delivered doxycycline (10%) with scaling and root planing in the periodontal treatment of smokers. METHODS: Forty-three patients with chronic periodontitis and a minimum of four pockets (> or = 5 mm) on anterior teeth that bled on probing were selected. Patients were randomly assigned to scaling and root planing (SRP) or scaling and root planing followed by local application of doxycycline (SRP-D). Plaque, bleeding on probing, gingival recession, relative attachment level (RAL), and probing depth (PD) were recorded at baseline, 45 days, and 3 and 6 months. Differences between baseline and each period were considered for analysis. RESULTS: At 6 months, no difference was found between groups regarding plaque, bleeding reduction, gingival recession or PD (P > 0.05). However, RAL gain was greater for SRP-D (1.63 +/- 0.93 mm) than for SRP (1.04 +/- 0.71 mm) (P = 0.025). In addition, deep pockets (> or = 7 mm) showed a significant reduction (3.78 +/- 1.41 versus 2.60 +/- 1.28 mm, P = 0.039) and RAL gain (2.54 +/- 1.27 mm versus 1.29 +/- 0.95 mm, P = 0.01) when doxycycline was applied. The proportion of sites showing RAL gain of 1 to 2 mm was 36.8% versus 21.7% for SRP-D and SRP, respectively (P = 0.01). CONCLUSION: The use of locally delivered doxycycline may constitute an important adjunct for the treatment of severe periodontal disease in smokers.

Administration, Topical↗
PubMed1993

Effects of root planing on the distribution of microorganisms adult periodontitis sites.

The aims of this study were to identify the microbial species present in subgingival plaque in patients with adult periodontitis, and to investigate the effects of root planing upon the microbial flora for 12 months following root planing. Microorganisms from samples of subgingival plaque obtained from adult periodontitis sites in 15 patients were cultured, both aerobically and anaerobically, on a variety of media and identified. Prevotella intermedia and Porphyromonas asaccharolytica were the most frequently identified species before treatment. Bacteroides ureolyticus, the Prevotella veroralis/buccalis complex and other microorganisms including Capnocytophaga ochracea, species of streptococci, staphylococci and diphtheroids were also frequently isolated. Root planing improved periodontal health, and was accompanied by reductions in the frequencies with which P. intermedia, P. asaccharolytica, the P. veroralis/buccalis complex and C. ochracea were isolated. Regular scaling and oral hygiene reviews maintained the clinical improvements and balance in favour of beneficial microbial species during the study.

Adult↗
PubMed1990

[A longitudinal clinical study of the efficacy of tetracyclines combined with root planing in patients with periodontal disease].

A retrospective longitudinal study was performed to assess the effectiveness of tetracycline therapy associated with root planing compared with root planing alone in patients affected by medium to severe periodontal disease. From an analysis of results it appeared that the combined therapy was generally more successful, even though statistical significance was only achieved in cases of healing angular bone lesions. In conclusion, larger studies should be carried out to contribute to broaden the spectrum of indications for the use of antibiotic therapy in periodontal disease in adults.

Adult↗
PubMed1989

[Effects of scaling and root planing on clinical parameters and bacterial flora in periodontal pockets. 1. Changes in clinical parameters and subgingival bacterial flora after treatment].

The purpose of this study was to clinically and microbiologically evaluate the effects of supragingival plaque control, scaling and root planing on periodontal therapy. Six patients affected with moderate or severe periodontitis were selected. The clinical status of each patient was recorded with such clinical parameters as probing pocket depth (PD), probing attachment level (PAL), gingival crevicular fluid flow (GCF), gingival index (GI), gingival bleeding index (GBI), suppurative index (SI), and mobility (Mo). After the patients had learned to perform their own oral prophylaxis, they were treated by scaling and root planing. Microbiological status was assessed by phase contrast microscopy and bacterial forms were classified into following six groups: coccoid cells, rods, filaments, fusiforms, motile rods, spirochetes. The number and the relative proportion of each group were compared statistically. Clinical and microbiological status from baseline to 5 months after scaling and root planing were re-examined. The results obtained were as follows. 1. The most significant change in clinical and microbiological status was observed one month after scaling and root planing. In particular, the total number of the microorganisms and the number and relative proportion of motile organisms were reduced. 2. Thereafter clinical and microbiological status was maintained during experimental period by means of supragingival plaque control.

Dental Plaque↗
PubMed2000

Comparison of treatment response patterns following scaling and root planing in smokers and non-smokers with untreated adult periodontitis.

The present study was conducted to compare short-term treatment response patterns following scaling and root planing in smoking and non-smoking Chinese patients with untreated adult periodontitis. Thirteen smokers and twelve periodontally matched non-smokers with untreated advanced adult periodontitis were evaluated prior to and at one, three, and six months after scaling and root planing. Probing depths (PD), probing attachment level (PAL) and gingival height (GH) were assessed at clinically healthy, gingivitis and periodontitis sites. PD and PAL were measured using electronic Florida pocket and disk probes, respectively. Non-smokers consistently showed significant gingival shrinkage in gingivitis sites, whereas smokers had no significant change in GH. In periodontitis sites, both groups exhibited significant decreases in PD (p < 0.001) at one month, and a greater reduction of PD was found in non-smokers than in smokers (p < 0.05), the difference being most notable at three months (2.4 +/- 0.2 mm vs. 1.1 +/- 0.3 mm, p < 0.001). Non-smokers showed a consistent gain of attachment in periodontitis sites from 0.5 +/- 0.2 mm at one month (p < 0.05) to 1.2 +/- 0.3 mm at six months (p < 0.001), whereas no significant gain of attachment was found in smokers until six months (0.5 +/- 0.2 mm; p < 0.05). Overall, the reduction of PD positively correlated with baseline PD in both smokers (p < 0.01) and non-smokers (p < 0.001), but when only the sites with an initial PD > or = 5 mm were considered, such a significant correlation was found only in non-smokers (p < 0.05). A positive correlation was also found between the change in PAL and baseline PD solely in non-smokers (p < 0.05). This study indicates that smokers have different treatment response patterns and healing dynamics compared to non-smokers following scaling and root planing, suggesting that for smoking patients a more intensive treatment regimen is needed for a better treatment outcome and reduced risk for further periodontal disease progression.

Adult↗
PubMed1985

Healing following reimplantation of teeth subjected to root planing and citric acid treatment.

The aim of the present study was to examine the effect of citric acid treatment on periodontal healing around teeth which were extracted, root planed and then reimplanted. Maxillary incisors and mandibular incisors, premolars and molars of 5 monkeys were used. The teeth were divided into 3 experimental groups. In 1 group, the teeth were extracted and immediately reimplanted into their own sockets. In a 2nd group, the teeth were extracted, root planed to a level corresponding to 50-75% of the root length and then reimplanted. In the 3rd group, periodontal breakdown extending to 50-75% of the root length was first induced by placing orthodontic elastic ligatures around the teeth. They were then extracted and root planed and transplanted into the sockets of the contralateral, periodontally healthy teeth which had just been extracted. Half the number of the teeth of groups 2 and 3 were treated with citric acid before reimplantation or transplantation. The animals were sacrificed after 6 months of healing. The jaws were removed and histological specimens prepared for microscopic examination. With the exception of a limited coronal regrowth of new cementum in the apical part of the planed portion of a few roots, connective tissue attachment failed to reform on most root surfaces deprived of their periodontal ligament tissue. Healing was most frequently characterized by root resorption and ankylosis. These were the most predominant features of healing both on root surfaces which had been deprived of the ligament tissue by mechanical means or during a course of experimentally-induced periodontal disease, and occurred in citric acid as well as non-citric acid treated roots. The findings imply that the result of healing following tooth reimplantation or transplantation is determined by the type of cells that repopulate the wound area adjacent to the denuded root surface.

Animals↗
PubMed1975

The clinical and histological response of periodontal pockets to root planing and oral hygiene.

The study evaluated, clinically and microscopically, the soft tissue response of suprabony periodontal pockets treated by root planing and oral hygiene or by oral hygiene measures alone. The participants were 22 adults beginning treatment for inflammatory periodontal disease. For each patient, three clinically similar labial or lingual pockets were scored for gingival inflammation, pocket depth, and the extent of plaque and calculus. One pocket in each patient served as a control, and a gingival biopsy was obtained to determine the pretreatment level of inflammation. The second pocket was treated by root planing and by the patient's oral hygiene measures. The third pocket was treated only by the patient's daily oral hygiene measures. Fifty-six to 63 days later, treated areas were reevaluated clinically, and biopsies were secured. Each type of therapy reduced the mean pocket depth and the incidence and severity of gingivitis; however, root planing accompanied by oral hygiene measures resulted in a statistically greater improvement than did oral hygiene measures alone.

Adult↗
PubMed1989

Scaling and root planing effectiveness: the effect of root surface access and operator experience.

This study investigated two variables associated with scaling and planning (S&RP): operator experience level and root surface access. One hundred and fourteen periodontally involved, single-rooted teeth designated for extraction were randomly distributed among four operators of various experience levels for either an open or closed session of S&RP. Immediately after treatment, the teeth were extracted, washed, and scored for residual calculus in a blind manner. Results showed that there was no difference in S&RP effectiveness for experience level or type of procedure in shallow (1-3 mm) pockets. However, in moderate (4-6 mm) and deep (greater than 6 mm) periodontal pockets, S&RP combined with an open flap procedure was more effective than S&RP alone for both experience levels. Also, the more experienced operators produced a significantly greater number of calculus-free root surfaces than the less experienced operators in periodontal pockets with moderate and deep probing depths. Clinical application of these results suggests that surgical access is associated with thorough surface debridement in periodontal pockets with moderate-to-advanced probing depths. However, more experienced operators could be expected to render more effective soft surface debridement.

Adult↗
PubMed1996

Smear removal and collagen exposure after non-surgical root planing followed by etching with an EDTA gel preparation.

Low pH aqueous solutions of citric acid have been used in surgical periodontal therapy mainly for two reasons. It dissolves smear after a relatively short exposure time and it has been claimed to selectively remove root surface-associated mineral exposing collagen to varying degrees. The use of low pH etching agents has recently been challenged in both experimental in vitro and in vivo studies based on their necrotizing effect on the surrounding periodontal tissues. The purpose of the present study was to assess the efficacy of subgingival application of an EDTA gel preparation in removing smear and exposing collagen fibers in root surfaces following non-surgical periodontal therapy. Root surfaces which were root planed did not reveal any patent dentinal tubuli or collagen fibers. This was in contrast to the findings seen after root planing followed by etching, where intertubular surfaces were covered by a dense fibrillar network extending into patent dentinal tubuli. In high magnification these intertubular fibers displayed the cross-striated texture typical for collagen fibers. Etching of root planed surfaces with EDTA may thus enhance the effect of non-surgical root debridement in the same way as has been shown during experimental surgical procedures.

Acid Etching, Dental↗
PubMed2005

Clinical efficacy of semiconductor laser application as an adjunct to conventional scaling and root planing.

BACKGROUND AND OBJECTIVES: The aim of the in vitro study was to examine the clinical efficacy of semiconductor laser periodontal pocket irradiation as an adjunct to conventional scaling and root planing. MATERIALS AND METHODS: Twenty-two healthy patients with a need of periodontal treatment (15 women, 7 men, mean age 45.0 +/- 10.8 years) with at least four teeth in all quadrants, were included. All of them underwent a conventional periodontal treatment including scaling and root planing. Using a split mouth design, two randomly chosen quadrants (one upper and the corresponding lower one) were subsequently treated with an 809 nm GaAlAs laser operated at a power output of 1.0 Watt using a 0.6 mm optical fiber. The teeth in the control quadrants were rinsed with saline. The clinical outcome was evaluated by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), sulcus fluid flow rate (SFFR), Periotest (PT), probing pocket depth (PPD), and clinical attachment loss (CAL) at baseline and at 3 months after treatment. A total of 492 teeth in both groups were evaluated and differences between the laser and the control teeth were analyzed using the Wilcoxon test (P < 0.05). RESULTS: Teeth treated with the laser revealed a significantly higher reduction in tooth mobility, pocket depth, and clinical attachment loss. Twelve percent of the teeth in the laser group showed an attachment gain of 3 mm or more, compared to 7% in the control group. An attachment gain of 2-3 mm was found in 24% of the teeth in the laser group and 18% in the control group. No significant group differences, however, could be detected for the plaque index, gingival index, bleeding on probing, and the sulcus fluid flow rate. CONCLUSIONS: The higher reduction in tooth mobility and probing depths is probably not predominantly related to bacterial reduction in the periodontal pockets but to the de-epithelization of the periodontal pockets leading to an enhanced connective tissue attachment. The application of the diode laser in the treatment of inflammatory periodontitis at the irradiation parameters described above is a safe clinical procedure and can be recommended as an adjunct to conventional scaling and root planing.

Adult↗
PubMed2006

Locally delivered doxycycline as an adjunctive therapy to scaling and root planing in the treatment of smokers: a 2-year follow-up.

BACKGROUND: The aim of this clinical study was to evaluate the association of locally delivered doxycycline 10% with scaling and root planing in the periodontal treatment of smokers during a 2-year period. METHODS: Forty-eight chronic periodontitis patients, presenting a minimum of four pockets (>or=5 mm) that bled on probing on anterior teeth were included. Patients were randomly assigned to receive one of the following treatments: scaling and root planing (SRP) and scaling and root planing followed by local application of doxycycline (SRP-D). Assigned treatments were performed at baseline and at 12 months. Clinical parameters, including probing depth (PD) and relative attachment level (RAL), were recorded at baseline; 45 days; 3, 6, and 12 months (retreatment); 45 days following retreatment; and at 15, 18, and 24 months. RESULTS: In initially deep pockets (>or=7 mm), SRP-D showed greater PD reduction than SRP at 6 and 18 months (mean difference between groups of 1.18 and 1.73 mm, respectively; P <0.05) and greater RAL gain in all periods after 3 months (mean difference between groups of 1.16, 1.99, and 1.78 mm, at 6, 18, and 24 months, respectively; P <0.05). Also, the proportion of sites showing >or=2 mm PD reduction was greater for SRP-D at 6 months (81.2% x 50.8%; P <0.001) and at 24 months (65.5% x 46.5%; P = 0.01). As for RAL gain, this proportion was 34.4% and 18.1% for SRP-D and SRP at 24 months, respectively (P = 0.008). CONCLUSION: The use of locally delivered doxycycline may constitute an important adjunct for the active and supportive treatments of severe periodontal disease in smokers.

Adult↗
PubMed1989

Treatment of recurrent periodontal disease by root planing and Ornidazole (Tiberal). Clinical and microbiological findings.

The purpose of this study was to evaluate the use of Ornidazole as an adjunct to root planing in the therapy of patients suffering from recurrent periodontal disease. In 10 individuals who had previously been treated with scaling, root planing and periodontal surgery and who had followed a regular maintenance program including recall visits every 3-5 months for 1-7 years, 2 sites with recurrent periodontitis and 1 shallow site were selected. Reinfected sites had a record of losing clinical attachment of more than 3 mm since the completion of initial therapy, were bleeding upon probing and had a mean pocket probing depth of 7.85 +/- 1.31 mm. They had been reinstrumented several times by a registered dental hygienist, when clinical signs of recurrence of disease had appeared and the root surfaces were judged to be smooth and free of deposits. Clinical parameters were recorded and microbial samples were collected twice prior to retreatment. Then, 500 mg Ornidazole, to be taken twice a day for 10 days, was administered, and the whole dentition was thoroughly scaled and root planed. At day 10 as well as 2, 5, 8 and 11 months thereafter, samples were again obtained. At baseline, reinfected sites showed over 20% spirochetes, over 20% motile rods and over 9% fusiform organisms in darkfield preparations of subgingival plaque samples. Culturally, over 1/10 of organisms were identified as black pigmenting Bacteroides and in 18% of all baseline samples collected, B. gingivalis was found.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[In vivo study of bacterial invasion in root planed and citric acid treated radicular surfaces of periodontally involved human teeth].

The purpose of this study was to investigate whether plaque bacteria invade the exposed radicular dentin after root planing or chemical root treatment in vivo. Eighteen caries-free human periodontally involved teeth with hopeless prognoses were studied. Fourteen teeth were scaled and root planed with hand curette type scalers. The proximal surface of each treated tooth was designated as the RP surface. The remaining half of the proximal surface was treated with citric acid (pH 1.0) for 3 minutes and was designated as the CA surface. Four untreated teeth served as controls. After 4 weeks, the teeth were extracted, and were processed for light microscopy and for scanning electron microscopy concerning bacterial invasion into the supragingival radicular dentin. The following results were obtained. 1. Radicular cementum was present on most untreated tooth surfaces. However, bacteria were never seen in the dentinal tubules. 2. Bacterial invasion into the dentinal tubules was observed in five of the 10 proximal surfaces (50% of the RP surfaces) and in nine of the 10 proximal surfaces (90% of the CA surfaces). 3. The depth (9.5 +/- 24.1 microns vs 84.6 +/- 136.3 microns) and percentage (0.8 +/- 2.1% vs 20.3 +/- 17.3%) of bacterial invasion in the dentinal tubules of the RP surfaces was lower than that of the CA surfaces. 4. Cocci and short rods were present in the supragingival dentinal tubules. 5. Since CA surfaces may accelerate bacterial invasion the citric acid treatment might be harmful in patients with inadequate plaque control.

Citrates↗
PubMed1979

The attachment between tooth and gingival tissues after periodic root planing and soft tissue curettage.

Utilizing a nonhuman primate model, a study was carried out to determine the nature of the attachment between the tooth and the gingival tissues following periodic root planing and soft tissue curettage. Under the conditions of this investigation, periodic root planing and soft tissue curettage combined with thrice weekly plaque control resulted in the formation of a long junctional epithelium with no new connective tissue attachment. In eight of the 22 experimental pockets, however, this procedure produced discontinuities or "windows" in the junctional epithelium. The coronal attachment of gingival tissues to the root surface (increased resistance to probing) commonly reported following root planing and soft tissue curettage appears to result from the formation of a long junctional epithelium rather than new connective tissue attachment.

Animals↗
PubMed1998

Bone regeneration in advanced periodontitis lesions after a single episode of root planing--case report with ten-years of follow-up.

This report describes a significant bone regeneration in a mandibular molar with advancing long-standing periodontal disease (defect extending to apex and into furcation) following a single episode of scaling and root planing. A 52-year-old female suffered from generalized moderate periodontitis for two years. An acute periodontal abscess with a 12 mm probing depth around the right mandibular first molar was noted. After incision and drainage, thorough scaling and root planing was performed under local anaesthesia. Three months later, radiographic examination showed complete bone regeneration with formation of a distinct lamina dura. It was concluded that favorable clinical and radiographic results could be obtained after a single episode of thorough subgingival root planing combined with excellent oral hygiene maintenance.

Bone Regeneration↗
PubMed1999

Two multi-center studies evaluating locally delivered doxycycline hyclate, placebo control, oral hygiene, and scaling and root planing in the treatment of periodontitis.

BACKGROUND: The clinical efficacy and safety of doxycycline hyclate (8.5% w/w) delivered subgingivally in a biodegradable polymer (DH) was compared to placebo control (VC), oral hygiene (OH), and scaling and root planing (SRP) in 2 multi-center studies. METHODS: Each study entered 411 patients who demonstrated moderate to severe periodontitis. Patients had 2 or more quadrants each with a minimum of 4 qualifying pockets > or =5 mm that bled on probing. At least 2 of the pockets were > or =7 mm. Treatment with DH, VC, OH, or SRP was provided at baseline and again at month 4. Clinical parameters were recorded monthly. RESULTS: DH and SRP resulted in nearly identical clinical changes over time in both studies. Mean 9 month clinical attachment level gain (ALG) was 0.8 mm for the DH group and 0.7 mm for the SRP group in Study 1, and 0.8 mm (DH) and 0.9 mm (SRP) in Study 2. Mean probing depth (PD) reduction was 1.1 mm for the DH group and 0.9 mm for the SRP group in Study 1 and 1.3 mm for both groups in Study 2. Frequency distributions showed an ALG > or =2 mm in 29% of DH sites versus 27% of SRP sites in Study 1 and 31% of DH sites versus 34% of SRP sites in Study 2. PD reductions > or =2 mm were seen in 32% of DH sites versus 31% of SRP sites in Study 1 and 41% of DH sites versus 43% of SRP sites in Study 2. Comparisons between DH, VC, and OH treatment groups showed DH treatment to be statistically superior to VC and OH. Safety data demonstrated a benign safety profile with use of the DH product. CONCLUSIONS: Results of this trial demonstrate that treatment of periodontitis with subgingivally delivered doxycycline in a biodegradable polymer is equally effective as scaling and root planing and superior in effect to placebo control and oral hygiene in reducing the clinical signs of adult periodontitis over a 9-month period. This represents positive changes resulting from the use of subgingivally applied doxycycline as scaling and root planing was not limited regarding time of the procedure or use of local anesthesia.

Absorbable Implants↗
PubMed1986

Relative influence of scaling and root planing and occlusal adjustment on sulcular fluid flow.

The aim of the investigation was to clarify the effects of the resolving of inflammation on one hand and the removal of occlusal trauma on the other hand on the rate of sulcular fluid flow (SFF) from deep periodontal pockets. Forty-seven adult patients having at least one tooth with an inflamed greater than 5 mm periodontal pocket and elevated mobility associated with occlusal trauma were selected for the study. After oral hygiene instruction and supragingival scaling, the rate of sulcular fluid flow of the test teeth was recorded on Day 0. After the baseline recording, each patient was randomly assigned to either Group A or Group B. The test teeth of Group A were subjected to subgingival scaling and root planing under local anesthesia, and the test teeth of Group B were subjected to occlusal adjustment. On Day 14 sulcular fluid flow was recorded for both groups, after which Group A received occlusal adjustment and group B received scaling and root planing. On Day 28 the sulcular fluid flow recordings were repeated for both groups. The mean flow rates of both Group A and Group B decreased significantly (P less than 0.05) from Day 0 to Day 28. When the occlusal interference was eliminated 2 weeks after scaling and root planing (Group A), no additional decrease in sulcular fluid flow was observed. When the occlusal interference was eliminated before scaling and root planing (Group B), the reduction in sulcular fluid flow remained statistically insignificant through the first 2-week observation period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗