Supragingival treatment as an aid to reduce subgingival needs: a 450-day investigation.

Sabrina Carvalho Gomes,Patrícia Daniela Melchiors Angst,Paula Chiattone Corvello,Rachel Romagna,Vanessa Rossi

doi:10.1590/s1806-83242014.50000004

Sabrina Carvalho Gomes, Patrícia Daniela Melchiors Angst + Show 3 more

Open Access

https://doi.org/10.1590/s1806-83242014.50000004

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Abstract

This study investigated the clinical effects of using a supragingival biofilm control regimen (SUPRA) as a step prior to scaling and root planing (SRP). A split-mouth clinical trial was performed in which 25 subjects with periodontitis (47.2 ± 6.5 years) underwent treatment (days 0–60) and monitoring (days 90–450) phases. At Day 0 (baseline) treatments were randomly assigned per quadrant: SUPRA, SRP and S30SRP (SUPRA 30 days before SRP). The full-mouth visible plaque index (VPI), gingival bleeding index (GBI), periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) were examined on days 0, 30, 60, 90, 120, 270, and 450. Baseline data were similar among all groups. From days 0 to 60, the groups showed similar significant decreases in VPI and GBI. Reductions in PPD for the SRP (3.39 ± 0.17 to2.42 ± 0.16 mm) and S30SRP (3.31 ± 0.11 to 2.40 ± 0.07 mm) groups were greater (p < 0.05) than those for the SUPRA group. This pattern was also observed for BOP. Attachment gain was similar and greater for the SRP (3.34 ± 0.28 to 2.58 ± 0.26 mm) and S30SRP (3.25 ± 0.21 to 2.54 ± 0.19 mm) groups compared to the SUPRA group. Results were maintained from day 90 forward. Overall, the S30SRP treatment reduced the subgingival treatment needs in 48.16%. Performance of a SUPRA step before SRP decreased subgingival treatment needs and maintained the periodontal stability over time.

Highlights

Subgingival biofilm control is a sine qua non condition for successful periodontal treatment.[1,2] supragingival biofilm control has been strongly associated with the long-term maintenance of subgingival treatment outcomes.[3,4] Some authors have noted the importance of the supragingival condition in modulating the subgingival area.[5,6] the exact mechanisms underlying this relationship are not completely understood.Therapies focused solely on supragingival control[7,8] have been demonstrated to significantly reduce subgingival inflammatory markers, such as bleeding on probing (BOP) and periodontal probing depth (PPD)
This study evaluated the effect of a supragingival control regimen as a step performed as a prior intervention to scaling and root planing (SRP)
The present study describes the results from treatment and monitoring phases of 3 periodontal treatment modalities in patients with chronic periodontitis

Summary

Introduction

Subgingival biofilm control is a sine qua non condition for successful periodontal treatment.[1,2] supragingival biofilm control has been strongly associated with the long-term maintenance of subgingival treatment outcomes.[3,4] Some authors have noted the importance of the supragingival condition in modulating the subgingival area.[5,6] the exact mechanisms underlying this relationship are not completely understood. Therapies focused solely on supragingival control[7,8] have been demonstrated to significantly reduce subgingival inflammatory markers, such as bleeding on probing (BOP) and periodontal probing depth (PPD). Use of a supragingival biofilm control regimen (SUPRA) reduced the PPD by an average of 2.4 mm in sites with 6.6 mm of PPD initially.[7] This reduction is somewhat comparable or even greater than those achieved by sub-

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Conclusion