Recolonization of the Subgingival Microflora After Scaling and Root Planing in Human Periodontitis

Abstract

The purpose of this study was to evaluate the recolonization patterns of the subgingival microflora of adult Periodontitis patients after a single session of scaling and root planing. In each of eight patients, three clinically diseased sites were investigated microbiologically by darkfield microscopy and cultural analysis. After initial clinical and microbiological parameters were determined, each subject received a single session of scaling and root planing but no oral hygiene instructions. Clinical indices were measured and microbial parameters were reassessed 7, 21, and 60 days after treatment in a manner such that each of the test sites was sampled only once after treatment. Recolonization was evaluated by matching any single site with its own preoperative site. A significant improvement in probing depth was noted for up to 60 days after treatment, while the gingival index did not change markedly during the course of the study. The microbial composition of treated sites 7 days after scaling and root planing, as determined by both cultural and darkfield data, was similar to that of periodontally healthy sites. Differences between cultural and darkfield data became apparent at the 21 day sampling point. The darkfield data showed that the sites consisted of cocci with few spirochetes. Cultural data demonstrated that the majority of the cocci were anaerobic, namely Streptococcus intermedius, Veillonella párvula, and Peptostreptococcus micros. At 60 days, there was no significant variation in any of the parameters from pretreatment levels. The most prevalent anaerobic rods prior to and 60 days after therapy were Fusobacterium nucleatum, Bacteroides gingivalis, and B. intermedius. These results indicate that a single session of scaling and root planing is clearly insufficient to maintain a healthy subgingival microflora. The conflicting findings between darkfield microscopy and cultural microbiology and between darkfield microscopy and clinical gingival inflammation suggest that darkfield microscopy is inadequate to identify a pathogenic microflora.

In Vivo Killing of Porphyromonas gingivalis by Toluidine Blue-Mediated Photosensitization in an Animal Model

“…It is an inflammatory process of periodontal tissues caused by bacterial infection which results in the destruction of periodontal connective tissue and resorption of alveolar bone. Porphyromonas gingivalis is believed to be one of the major pathogens in the etiology of adult periodontitis (5,37,38). Conventional mechanical debridement (i.e., scaling and root planing) can achieve a temporary decrease in the subgingival levels of P. gingivalis together with other pathogens (38).…”

Relationship Between Initial Probing Depth and Residual Pockets Following Mechanical Periodontal Treatment

“…Rezidüel cep böl-geleri periodontal patojenler için rezervuar görevi yaparak, periodontal hastalıkla ilişkili mikrobiyal floranın tekrar oluş-masına zemin hazırlayabilir (8,14,16). Bu yüzden, MPT sonrası rezidüel ceplerin tespiti ve bu ceplerin eliminasyonu periodontal tedavinin başarısında önem taşımaktadır.…”

“…Conclusion: Within limitations of this study, our results suggest that applied treatment had improved the periodontal parameters and the periodontal pockets of multi-rooted teeth in CP patients remained as residual pockets in a high percentage and the deeper IPD the higher probability of residual pockets. Key words: Dental scaling, root planing, periodontal pocket MÜSBED 2015;1(1): [15][16][17][18][19][20] Araştırma / Original Paper GİRİŞ Periodontal hastalıklar, patojen mikroorganizmalara karşı dişetinde gelişen enfeksiyonun dişeti bağ dokusu, periodontal ligament ve alveol kemiğine ilerlemesiyle dişin destek dokularında yıkım ve buna bağlı olarak diş kaybı ile sonuçlanabilen, kronik enflamatuvar hastalıklardır (1). Periodontal yıkım, diş yüzeyinde ve çevresinde biriken biyofilm yapısındaki mikrobiyal dental plak içinde kolonize olan patojen mikroorganizmalar ve bu mikroorganizmalara karşı periodontal dokularda gelişen savunma cevabı arasındaki ilişkiler sonucu meydana gelmektedir (2).…”

"Avaliação da cooperação com os retornos de controle e manutenção periodontal dos pacientes da clínica de pós-graduação da FOUSP"

“…Sendo assim, seu tratamento inclui principalmente a remoção da placa bacteriana, o que resulta na grande maioria dos casos em saúde periodontal (LÖE;THEILADE;JENSEN, 1965;NYMAN, 1975). A região subgengival pode ser recolonizada em alguns meses após a raspagem e aplanamento radicular (MOUSQUÈS; LISTGARTEN; PHILIPS, 1980;HELLDEN, 1978;SLOTS et al, 1979;MAGNUSSON et al, 1984), o que suporta a necessidade de visitas periódicas para os pacientes que foram submetidos ao tratamento periodontal (SBORDONE et al, 1990).…”

“…Por outro lado, a ausência de um controle de placa bacteriana adequado pode resultar na recolonização da região subgengival por microorganismos patogênicos (MOUSQUÈS;PHILIPS, 1980;HELLDEN, 1978;SLOTS et al, 1979;MAGNUSSON et al, 1984;SHILOAH;PATTERS, 1996;SBORDONE et al, 1990), comprometendo o estado de saúde obtido com o tratamento (VAN WINKELHOF; VAN DER VELDEN;DE GRAAFF, 1987).…”