Prognostic criteria for the efficiency of non‐surgical periodontal therapy in advanced periodontitis

Abstract

The aim of the study was to find out which clinical, radiographic and microbiological variables can be used as prognostic criteria for the efficiency of the commonly used initial treatment protocol comprising scaling, root planing and instruction on oral hygiene in advanced adult periodontitis. 46 patients (mean age 48 years) with untreated, advanced periodontitis volunteered for the study. The clinical examination included recordings of plaque, gingival and calculus indices, probing pocket depths, bleeding and suppuration after probing, probing attachment levels and furcation involvements. Infrabony and furcation lesions were assessed from panoramic radiographs. Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis were cultured from the deepest, most inflamed periodontal pockets, from surface of the tongue and from saliva. 3 months after the completion of non‐surgical treatment comprising meticulous scaling and root planing and instruction on oral hygiene, the healing was assessed clinically, and 13 patients were assigned to a maintenance care programme (MC) and 33 to further treatment procedures (FT). Evaluation of the baseline clinical and radiographic data showed a significantly higher %s of 6 mm deep periodontal pockets, surfaces with suppuration, and sites with subgingival calculus, as well as higher numbers of infrabony lesions, in FT‐patients than in MC‐patients. Subgingival A. actinomycetemcomitans was isolated at baseline in 55% of the FT‐patients and in 38% of the MC‐patients, and P. gingivalis in 27% and 23%, respectively. A. actinomycetemcomitans was eradicated by non‐surgical treatment from only one patient. P. gingivalis was detected in 15% of the patients in both groups after treatment. Combining of the clinical and the microbiological baseline data demonstrated that simultaneous presence of multiple deep periodontal pockets (6 mm at 10% of the sites) and subgingival A. actinomycetemcomitans alone or concomitant with P. gingivalis was significantly more prevalent in the FT‐group than in the MC‐group. This simultaneous presence anticipated insufficient response to initial non‐surgical therapy. The results suggest that a treatment regimen more efficient than the traditional one is needed without delay in the treatment of A. actinomycetemcomitans infected generalized, severe periodontal disease in adults.

A Short‐Term Clinical and Microbial Evaluation of Periodontal Therapy Associated With Amalgam Overhang Removal

“…Studies using dark‐field and phase contrast microscopy reported significant reductions in the percentage of motile rods and spirochetes after scaling and root planing and a concomitant increase in the percentage of cocci and non‐motile microorganisms 33‐35 . Other investigations noted minimal effects of scaling and root planing on the subgingival microbiota, especially for species such as A. actinomycetemcomitans 36,37 . In the present study, at T2, the number of test and control teeth positive for A. actinomycetemcomitans showed a decrease, whereas positive samples for S. mutans showed an increase.…”

Characteristics of Periodontal Microflora in Acute Myocardial Infarction

“…20,27,[33][34][35][36][37][38][39][40][41] Additionally, the present sampling method was adjusted to the restrictions due to the study population. 20,27,[33][34][35][36][37][38][39][40][41] Additionally, the present sampling method was adjusted to the restrictions due to the study population.…”

Smoking Affects Diagnostic Salivary Periodontal Disease Biomarker Levels in Adolescents

“…The clinical examination was carried out by only one researcher (AMH) and smoking status of the participant was unknown to the examiner. The oral health indices recorded were visible plaque index (VPI), bleeding on probing (BOP), 30 root calculus (RC), probing depth (PD), and attachment loss (AL), which was considered normal at values <2 mm 31‐33 . VPI and RC were recorded from index teeth, and BOP and PD were measured from all teeth and at four sites.…”