Effects of Subgingival Irrigation on Bacteremia Following Scaling and Root Planing

Abstract

The purpose of this study was to determine the effects of professional subgingival irrigation, together with subsequent patient administered home marginal irrigation, on the incidence of bacteremia after scaling and root planing (Sc/RP). A total of 60 periodontal maintenance patients were assigned to either Group 1: subgingival irrigation, with 0.12% CHX and daily marginal irrigation with 0.04% CHX; Group 2: subgingival irrigation with 0.12% CHX and daily marginal irrigation with water; Group 3: subgingival and daily marginal irrigation with water; Group 4: Non‐irrigation (control). Patients entered the study after receiving a thorough periodontal maintenance appointment including a complete examination, Sc/RP, and standard oral hygiene instruction. Blood samples were taken at the 3‐month visit before and after Sc/RP. Microbiological culturing was done using the Septi‐Chek system, selective and non‐selective media. Results from 54 patients showed that bacteremia was detected prior to Sc/RP in 2 patients and after Sc/RP in 10 patients. No significant effect by treatment regimens on post Sc/RP bacteremia could be detected. The organisms isolated included Eubacterium lentum, Propionibacterium acnes, Streptococcus species, Neisseria species, Candida albicans, Staphylococcus species, and un‐identified Gram‐negative rods. J Periodontol 1990; 61:405– 411.

Microbiology of Odontogenic Bacteremia: beyond Endocarditis

“…Waki and his group (141) found no significant decline in the incidence of bacteremia due to this supplementary procedure, nor was there a significant relationship with the quality of the irrigation fluid used, whether sterile water, clean water, or antiseptics (77,106). However, there is some evidence that the bacteremic incidence does drop with continuous and regular rinsing with chlorhexidine or povidone-iodine irrigation of gingival sulci (5,102).…”

“…Various degrees of bacterial dissemination are associated with periodontal probing (27,28), scaling (22,68), root planing, and subgingival irrigation (5,77,106,141). The presence of inflammation in the periodontal site is an important contributory factor to bacterial dissemination, as shown by the increased incidence of bacteremia in subjects with periodontitis compared to those with gingivitis (where the degree of inflammation is considered less severe) and those with healthy periodontium (48).…”

Morphological Alterations of Periodontal Pocket Epithelium Following Nd:YAG Laser Irradiation

“…7,[40][41][42][43][44][45][46][47] When the tip of the ultrasonic scaler is inserted between the tooth and gingiva, the junctional epithelium and periodontal ligaments are ruptured; bacteria in the sulcus may enter the bloodstream, causing transient bacteremia. Prophylactic management is now indicated for patients who are at risk before such dental procedures.…”

Periodontal therapy: a novel acute inflammatory model

“…Periodontitis is a prototype chronic low-grade infection caused primarily by anaerobic gram negative bacteria. Its treatment relies upon the mechanical removal of the bacterial biofi lm and sub-gingival calculus deposits [2] which, however, results in an intense transient bacteraemia as well as signifi cant gingival soft tissue damage [3,4]. We therefore intended to ascertain whether periodontal therapy might represent a valid and reliable experimental model to study human infl ammation in vivo.…”