Long‐Term Evaluation of Periodontal Therapy: I. Response to 4 Therapeutic Modalities

Abstract

Eighty‐two periodontal patients were treated in a split mouth design with coronal scaling (CS), root planing (RP), modified Widman surgery (MW), and flap with osseous resection surgery (FO) which were randomly assigned to various quadrants in the dentition. Therapy was performed in 3 phases: non‐surgical, surgical, and supportive periodontal treatment (SPT) ≤ 7 years. Clinical data consisted of probing depth (PD), clinical attachment level (CAL), gingival recession (REC), bleeding on probing (BOP), suppuration (SUP), and supragingival plaque (PL). Because of the necessity to exit many CS treated sites due to breakdown, data for CS were reported only up to 2 years. All therapies produced mean PD reduction with FO > MW > RP > CS following the surgical phase for all probing depth severities. By the end of year 2 there were no differences between the therapies in the 1 to 4 mm sites. There were no differences in PD reduction between MW and RP treated sites by the end of year 3 in the 5 to 6 mm sites and by the end of year 5 in the ≥ 7 mm sites. FO produced greater PD reduction in ≥ 5 mm sites through year 7 of SPT. Following the surgical phase, FO produced a mean CAL loss and CS and RP produced a slight gain in 1–4 mm sites. RP and MW produced a greater gain of CAL than CS and FO following the surgical phase in 5 to 6 mm sites, but the magnitude of difference decreased during SPT. Similar CAL gains were produced by RP, MW, and FO in sites ≥ 7 mm. These gains were greater than that produced by CS and were sustained during SPT. Recession was produced with FO > MW > RP > CS. This relationship was maintained throughout SPT. The prevalences of BOP, SUP, and PL were greatly reduced throughout the study and were comparable between sites treated by RP, MW, and FO while the CS sites had more BOP and SUP. J Periodontol 1996;67:93–102.

Clinical Outcome of Surgical Periodontal Therapy: A Short-term Retrospective Study

“…Our data, although short-term, were consistent with this finding. In a longitudinal study, Kaldahl et al 12) found no differences in PD reduction between sites treated by modified Widman and root planing by the end of year 3 in 5-to 6-mm sites and by the end of year 5 in ≥7-mm sites. It is thus important to longitudinally evaluate clinical outcomes in surgical patients.…”

Surgical Periodontal Therapy at Tokyo Dental College Suidobashi Hospital: A Statistical Profile in 2010-2011

“…In long-term observation of periodontal treatment, there is a general understanding that differences in clinical effects between conventional surgical and non-surgical periodontal therapies become small. For instance, Kaldahl et al 8) found no differences in PD reduction between sites treated by modified Widman and root planing by the end of year 3 in 5 to 6-mm sites and by the end of year 5 in Ն7-mm sites, although flap operation with osseous surgery produced greater PD reduction in Ն5-mm sites through year 7 of supportive periodontal therapy. It is thus important to longitudinally monitor clinical outcomes in surgical patients.…”

Antimicrobials in treatment of periodontal disease -A review

“…Mechanical debridement of the dental biofilm and elimination of local irritating factors are the basis of intial periodontal therapies. Longitudinal studies have been demonstrated the effectiveness of this approach, which is based on scaling ,Root planning, reinforcement of patient oral hygiene practices and regular follow up to eliminate new deposits (3,4). The concept of antibiotic periodontal therapy revolves around the drug, the pathogenic microorganisms and the host.…”