Long-Term Assessment of Periodontal Surgery Versus Curettage or Scaling and Root Planing

1990 ◽  
Vol 6 (3) ◽  
pp. 392-402 ◽  
Author(s):  
Sigurd P. Ramfjord

AbstractThe various treatments for periodontal disease must be assessed in light of the recently articulated goals of periodontal therapy to preserve teeth for a lifetime and to enhance esthetics and comfort as well as oral health. This article examines the long-term comparisons of periodontal surgery, curettage, and scaling and root planing in improving attachment levels instead of the more traditional pocket depth.

2021 ◽  
Vol 11 (16) ◽  
pp. 7463
Author(s):  
Maria Jesús Lisbona-González ◽  
Esther Muñoz-Soto ◽  
Candela Reyes-Botella ◽  
Maria Victoria Olmedo-Gaya ◽  
Javier Diaz-Castro ◽  
...  

Periodontal disease encompasses gingivitis and periodontitis and is one of the most common chronic infections in the adult population. This study aimed to evaluate the influence of Spanish propolis extract (EEP) on the effect of the clinical and microbiological parameters as an adjuvant to scaling and root planning in patients undergoing supportive periodontal therapy (SPT). Forty chronic periodontitis patients were randomly assigned into two groups for the treatment. In the control group (n = 20), the sites were treated by scaling and root planing followed by gingival irrigation with physiological saline and in the test group (n = 20), the sites were treated by scaling and root planing followed by subgingival placement of EEP. At baseline (BL), bleeding on probing positive (BOP+) sites with probing pocket (PPD) ≥ 4 mm were defined as study sites. Plaque index, PPD, BOP, clinical attachment level (CAL), and subgingival plaque were evaluated at BL and 1 month later. The results showed a significant clinical improvement (p < 0.05) in the PPD, CAL and BOP+ comparing them with BL and one month after the periodontal treatment and a significant reduction (p < 0.05) for Tannerella forsythensis, Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola in both groups. In addition, the improvement of clinical parameters was observed with subgingival use of EEP and also statistically significant differences between groups were observed (p < 0.05) such as reductions of BOP+ % and reduced counts of T. forsythensis and P. gingivalis, considered as the “key pathogens” for the periodontal diseases. Our results suggest prophylactic and therapeutic potential for EEP against periodontal diseases, improving clinical parameters, reducing gingival bleeding and decreasing bacterial counts of T. forsythensis and P. gingivalis. The subgingival use of EEP represents a promising modality as an adjuvant in periodontal therapy to avoid microbial resistance and other adverse effects.


Author(s):  
P. Karthickeyan ◽  
J. Bhaskar ◽  
K. Mahalakshmi ◽  
B. Krishna Prasanth ◽  
Bhagavad Gita ◽  
...  

Background: The goal of periodontal therapy is to eliminate bacterial plaque and the factors favoring its formation. Conventional therapy includes scaling, root planing and curettage along with appropriate maintenance of oral hygiene. However, complete elimination of sub gingival micro flora is difficult from areas inaccessible to periodontal instrumentation, which demands the use of antimicrobials as adjuncts in periodontal therapy. Periodontal pocket provides an ideal environment for the growth of anaerobic pathogenic bacteria. In the course of initiation and progression of the inflammatory process, the sub gingival bacteria increase in numbers and invade the pocket epithelial cells and subsequently, the underlying tissues. Aim: To evaluate the efficacy of the adjunctive use of curcumin with scaling and root planing as compared with scaling and root planing alone in the treatment of the  periodontitis. Materials and Methods: Twenty patients with two contralateral sites were identified for the study having probing pocket depths (PPDs) of >5mm. Full mouth scaling and root planing (SRP) was done followed by subgingival application of curcumin gel only on one side. Assessment of Plaque index (PI), Gingival index (GI), Probing Pocket Depth, Clinical attachment levels (CALs) were done at both baseline and at 4th week. Subgingival plaque samples was collected from the root surface and standard microbiologic assessment was done both from the control and the test sites before scaling and root planing. Result: There was a reduction in PI, GI, PPD, CAL and microbiologic parameters in test sites followed by SRP and curcumin gel application, when compared with SRP alone in control group. Conclusion: The subgingival application of curcumin gel in adjunct with scaling and root planing has shown good improvement in periodontal parameters and has a beneficial effect in periodontitis patients. Keywords: Curcumin, Periodontitis, Scaling and root planing.


Author(s):  
Reya Shree ◽  
Varun Dahiya ◽  
Pradeep Shukla ◽  
Prerna Kataria ◽  
Mona Dagar

Introduction: The motive of the present study is to comparatively measure the competence and effectiveness of diode laser and chlorhexidine chip as adjuncts to the scaling and root planing procedure, in patients with chronic periodontitis. Aim: To evaluate the efficacy of diode laser and chlorhexidine chip before and after scaling and root planing in the management of chronic periodontitis. The objective is to compare the efficacy of chlorhexidine chip and diode laser before and after scaling and root planning on clinical parameters. Study and design: Randomized clinical trial with split mouth design done in the Department of Periodontics and Implantology. Materials and methods: Twenty chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were selected in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). All subjects received a clinical periodontal examination by single examiner who recorded all the variables by manual procedure. Clinical parameters namely Plaque index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using one-way ANOVA followed by Post Hoc Analysis. Results: The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Conclusion: Within the limitations in the present study, the following conclusions were derived, i.e., chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in improving oral hygiene, reducing gingival inflammation, reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis. Keywords: Diode laser decontamination, Local drug delivery, Scaling and root planing.


Author(s):  
Sangeeta Roy ◽  
C.S. Joshi ◽  
Pradeep Shukla ◽  
Gaurav Malhotra ◽  
Prerna Kataria ◽  
...  

Background and Objectives: C?reactive protein (CRP) is a type I acute phase reactant. A number of studies have reported elevated gingival crevicular fluid (GCF) CRP levels in periodontitis subjects, which decrease following periodontal therapy. Effect of diode laser as an adjuct to Scaling & Root planing is also well stablished. The aim of the present study was to evaluate the effect of periodontal treatment SRP with diode laser, on CRP levels in GCF in patients with chronic periodontitis. Materials and Methods: A total of 40 subjects with moderate periodontitis based on community periodontal index scores, were included in the study. Periodontal therapy was performed dividing each side of jaw as a group (Split mouth); one side SRP alone & another Diode laser with SRP. GCF was collected from each subject at Baseline (prior to treatment) and 1 month after periodontal therapy. The collected sample was subjected to biochemical analysis to detect CRP levels by using a commercially available highly sensitive kit. Results: The present study demonstrated that the mean CRP values at baseline were found to be 0.11043mg/l in side-I (side treated with SRP alone); 0.11042mg/l in side-II (side treated with SRP & laser) of the patient, which reduced to 0.4148 mg/L in side I and 0.3985mg/L in side II after treatment, which are highly significant according to statistical analysis but the changes between two sides were non- significant statistically. Interpretation and Conclusion: Within the limitations of this study, it can be concluded that periodontal therapy is able to reduce the GCF C reactive protein level significantly, but there was no statistically significant result in CRP level, between sides treated with SRP & SRP with laser. Key words: Chronic periodontitis, C?reactive protein, gingival crevicular fluid, Scaling and root planing, Diode laser


Author(s):  
Upendra Prasad ◽  
Abhinav Deshpande ◽  
Praneeta Kamble ◽  
Abhishek Singh ◽  
Adiya Apon ◽  
...  

Introduction: Topical chemotherapeutic agents used in treatment of chronic periodontitis are antimicrobial agents which help in plaque control. The present study evaluates the efficacy of ornidazole gel with gold standard chlorhexidine gel when used as adjunct to scaling and root planing. Material and Methods: 90 patients diagnosed as chronic periodontitis, having pocket depth ?3 mm and in good systemic health were selected by systematic sampling method and divided in 3 groups. In all 3 groups scaling and root planing was done. In group A, Ornidazole gel application was done while in Group B Chlorhexidine gel application was done while Group C was control group. Plaque Index (PI) and Gingival Index (GI) were recorded at baseline, 1 and 3 months while Probing pocket depth (PPD) and Clinical attachment level (CAL) were recorded at baseline and 3 months. Results: PI and GI showed significant reduction in all three groups after 1 and 3 months compared to baseline. On inter group comparison, both PI and GI showed no significant difference in reduction of scores after 1 month and 3 months (p>0.05). PPD and CAL values showed statistically significant reduction after 3 months when compared to baseline values. The intergroup comparison revealed statistically significant reduction in group A and B compared to control group C (p<0.05). Conclusion: Ornidazole showed comparable efficacy as Chlorhexidine when used as adjunct to scaling and root planing for treatment of chronic periodontitis.


2019 ◽  
Vol 15 (1) ◽  
pp. 10-17
Author(s):  
Pujan Acharya ◽  
Manoj Kumar ◽  
CS Saimbi

Background: Chronic periodontitis is the most prevalent form of periodontitis with a multifactorial  etiology, dental plaque being the primary etiologic agent. The removal of such etiologic factor through scaling and root planing builds the foundation of treatment. In addition, the use of an antimicrobial adjunct augments elimination of microbes leading to subsequent control of the disease. Chlorhexidine and Metronidazole have been found to be active against several periodontopathogens. In this study, the use of these antimicrobial gels has been made. To evaluate and compare the clinical efficacy of subgingival application of 1% Metronidazole, 1% Chlorhexidine and Combination gel when used as an adjunct to non-surgical therapy. Methods: A total of 120 patients, age group 30-60 years with chronic generalized periodontitis were included in the randomized, controlled, double blinded study. The patients were randomly divided into four groups and treated with scaling and root planing along with antimicrobial adjunct. The antimicrobials used were Chlorhexidine, Metronidazole, Combination of Chlorhexidine and Metronidazole, and Placebo. Clinical parameters (plaque index, gingival index, probing pocket depth and clinical attachment level) were recorded at baseline, 1 month and 3 months. Results: In all the groups, there was a statistically significant reduction in all the clinical parameters at different time intervals. Inter-group comparison with respect to clinical changes showed that Combination gel was the best. Conclusions: Long term, controlled randomized trials with more samples are suggested to further validate the efficacy of these antimicrobial drugs.  


2012 ◽  
Vol 32 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Swati Pradeep Patel ◽  
Nishanth S. Rao ◽  
A. R. Pradeep

Background: Plasma glutathione peroxidase (eGPx) is an important selenium containing antioxidant in human defense against oxidative stress. While crevicular fluid (GCF) eGPx levels and its association with periodontal disease is well documented, there is no data on correlation of GCF and serum eGPx levels in chronic periodontitis. Hence this study was undertaken to further probe into the role of oxidative stress in periodontal diseases and effect of nonsurgical periodontal therapy (NSPT) by correlating GCF and serum levels of eGPx.Materials and methods: Thirty subjects (16-Males and 14-Females; age: 30–38 years) participated in the study. The subjects were divided, based on gingival index, probing pocket depth and clinical attachment level into: Healthy (group-1,n=10), Gingivitis (group-2,n=10) and Periodontitis (group-3,n=10). Chronic periodontitis patients after NSPT constituted group 4. GCF and serum samples collected from each subject were quantified for eGPx levels using Enzyme linked Immunosorbent Assay.Results: The mean eGPx concentrations increased from health (14.01 ng/μl and 78.26 ng/ml) to gingivitis (22.86 ng/μl and 90.44 ng/ml) and then to periodontitis (29.89 ng/μl and 103.43 ng/ml), in GCF and serum respectively. After NSPT, there was statistically significant reduction in eGPx concentration in GCF and serum (19.41 ng/μl and 85.21 ng/ml). Further, all the GCF eGPx values showed a positive correlation to that of serum eGPx level.Conclusion: Thus, increased eGPx concentration in GCF can be considered as an indicator of local increase in oxidative stress. While, increase in serum eGPx levels indicates that periodontal disease can also lead to increased oxidative stress at the systemic level.


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