Effect Of Subgingival Scaling Research Articles

Effect of Subgingival Scaling and Root Planing-assisted Occlusal Adjustment Scheme on Periodontitis

Effect of Subgingival Scaling and Root Planing-assisted Occlusal Adjustment Scheme on Periodontitis

The Effectiveness of Subgingival Scaling and Root Planing: An Evaluation of Therapy With and Without the Use of the Periodontal Endoscope

A fiber-optic periodontal endoscope was developed to aid in the visualization of subgingival structures and to improve the diagnosis and management of periodontal diseases. The purpose of this study was to determine whether use of the periodontal endoscope with scaling and root planing (SRP) resulted in a decrease in residual calculus compared to SRP alone. Fifteen subjects with 50 tooth pairs participated in this study. Each tooth per pair was randomized to receive SRP with or without the endoscope. Teeth were extracted, and a stereomicroscope and digital image analysis was used to determine percent residual calculus present in a masked fashion. There was 2.14% (P < 0.001) more residual calculus at control versus test sites. At buccal/lingual and interproximal surfaces, mean differences in residual calculus were 1.30% (P <0.015) and 2.93% (P < 0.001), respectively. Test treatment time decreased significantly as operator experience increased. There were no statistically significant differences between residual calculus for test and control teeth at shallower probing depths; however, at deeper probing depths, the use of the endoscope resulted in significantly less residual calculus. The use of the periodontal endoscope resulted in a statistically significant overall improvement in calculus removal during SRP, which was most evident in deeper probing depths. The clinical significance of this level of improvement is unknown.

EFFECT OF HANDEDNESS ON LEARNING SUBGINGIVAL SCALING WITH CURETTES: A STUDY ON MANIKINS

The aim of the present study was to evaluate the influence of systematic manikin–head training and the effectiveness of subgingival scaling applied with hand instruments (curettes) by right- and lefthanded dental students on dental chairs (traditional) designed for right handers. A questionnaire focusing on handedness was administered to 69 voluntary dental students in the third class at the School of Dentistry during preparticipation examination. Handedness was assessed using the Turkish version of the Edinburgh Handedness Inventory. Then, 18 dental students- were specially selected in 2 equal groups according to hand preference: consistent right handers with Geschwind Scores of–100 (5 female- and 4 male) and consistent left handers with Geschwind Scores of 100 (5 female and 4 male). These two untrained dental student groups received 10 weeks manikin head training. Subgingival scaling was performed with hand instruments (Gracey curettes) in manikin head mounted on right sided dental chairs. At 6 test days each dental student had to instrument 12 test teeth. Effectiveness of subgingival scaling was evaluated- by adoption of a grading system. This system had scores from 0 to 3 and was defined by illustrated and described criteria. Statistical analysis- was carried out with SPSS. Two groups were statistically compared on all test days. The yet untrained left handed dental students begin with a relatively high the mean score of 2.25, compared to the yet trained righthanded dental students with 1.93, which was statistically signi-ficant- (p > .05). The right handed dental students reached the mean score of 0.53, whereas the left anded dental students reached the mean score of 0.87 on test day 6. Significant differences in the mean scores were found between the two groups for overall surfaces (p < .05), the distal surfaces (p < .01), lingual surfaces (p < .01), and each group of teeth (p < .05). But there was no statistically significant difference between the 2 groups of students on all test day except for test day 3 in terms of the mean scores for the facial and mesial surfaces (p > .05). Learning success was observed a high level in both groups through –systematical training (p <.0001). The present study has documented that the left handed dental students were less successful than the righ thanded dental students in subgingival scaling, except for mesial and facial surfaces. However although training on right sided chairs, they were quite similar to their right handed counterparts in terms of learning- success.

Effect of subgingival scaling during supportive therapy

This prospective study was designed to investigate the rôle of root débridement at 3 month intervals for patients with periodontitis whose disease had persisted following the completion of conventional periodontal treatment. 39 maintenance patients with at least 4 pockets at least 4 mm deep were assigned to coronal scaling (CS) and subgingival scaling (SS) groups. Probing depths (PD), bleeding on probing (BOP) and relative attachment levels (RAL) were recorded at all eligible sites at baseline and 3, 6, 9 and 12 months later. Plaque index scores were recorded at the 12-month visit. At every visit, following data collection, both groups received a coronal scaling and the SS group, in addition, received a thorough subgingival débridement. In the CS group, subgingival débridement was performed only for 'loser' sites which inhibited loss of attachment > or = 2 mm relative to baseline values. Due to low compliance, only 31 patients completed the study. Thus, data analyses were carried out for 130 sites in 17 CS group patients and 146 sites in 14 SS group patients. During the course of the study, 21 loser sites were identified in each group, but the difference in proportion of loser sites between groups was not significant. Furthermore, although there was a trend toward PD reduction in both groups throughout the study, mean PD, RAL and BOP values were not significantly different from baseline values at any time point, and there were no significant differences between groups with respect to these variables. Mean plaque scores measured at the 12-month visit revealed no significant differences between groups. These findings call into question the value of performing repeated subgingival scaling at 3-month intervals for patients with persistent disease.

The effectiveness of subgingival scaling and root planing via closed approach in calculus removal

【This study presents an evaluation of the effectiveness of nonsurgical subgingival scaling and root planing related to initial pocket depth, type of teeth, and individual root surfaces. A total of 110 teeth designated for periodontal surgery in 67 patients with marginal periodontitis were selected and received thorough scaling and root planing with standard rigid Gracey curettes. After a healing period of 4 to 8 weeks, residual calculus was assessed at the time of periodontal surgery following the reflection of mucoperiosteal flap. The results demonstrated a high correlation between the percentage of residual calculus and initial pocket depth. It was further noted that tooth type and involved root surface also influenced the rate of calculus remnant. The results of this study suggest that complete removal of subgingival calculus utilizing conventional instrumentation via closed approach is rare.】

The Effectiveness of Subgingival Scaling and Root Planing I. Clinical Detection of Residual Calculus

This study evaluated the ability of clinicians to detect residual calculus following subgingival scaling and root planing and compared the clinical detection to the microscopic presence and surface area occupied by calculus found on teeth extracted after instrumentation. Interexaminer and intraexaminer reproducibility in clinically detecting subgingival calculus was also determined. One hundred one extracted teeth with 476 instrumented tooth surfaces were evaluated stereomicroscopically for the presence of calculus and the percent surface area with calculus was determined by computerized imaging analysis; 57% of all surfaces had residual microscopic calculus and the mean percent calculus per surface area was 3.1% (0 to 31.9%). Shallow sites had greater surface area of calculus than moderate and deep sites. The difference was not significant. The interexaminer and intraexaminer clinical agreement in detecting calculus was low. There was a high false negative response (77.4% of the surfaces with microscopic calculus were clinically scored as being free of calculus) and a low false positive response (11.8% of the surfaces microscopically free of calculus were clinically determined to have calculus). This study indicates the difficulties in clinically determining the thoroughness of subgingival instrumentation.

The Effectiveness of Subgingival Scaling and Root Planing II. Clinical Responses Related to Residual Calculus

This study related 3-month clinical changes following scaling and root planning to the presence or absence of calculus on the root surfaces detected after extraction. Seven patients provided 646 sites evaluated for plaque, bleeding upon probing (BOP), probing pocket depth (PPD), and probing attachment level (PAL) at baseline and monthly following instrumentation. The teeth were extracted and evaluated for the presence and the percent surface area of calculus. Diagnostic sensitivity and predictability values for initial and residual PPDs, loss of PAL, and BOP in detecting residual calculus were determined. Calculus was found on 376 surfaces with a mean percent surface area of 3.13%. Predictability values were similar for all PPD ranges, while sensitivity decreased with increasing PPD. Probing attachment level changes were found to be unrelated to the presence or the amount of residual calculus. Bleeding upon probing had high levels of predictability, but sensitivity values were low. None of the clinical parameters evaluated in this study provided both a high level of predictability and sensitivity in detecting residual calculus.

Effect of subgingival scaling on systemic antibody responses to oral microorganisms.

The effects of scaling and root planing treatment on systemic antibody responses were studied in patients with periodontal disease and in normal subjects. Immunoglobulin G antibody in serum to a battery of oral microorganisms was assessed in an enzyme-linked immunosorbent assay before and after treatment in 31 individuals. The majority (96%) of the diseased patients exhibited elevated antibody to one or more of the microorganisms before the scaling regime. Significant increases in antibody levels in serum were noted in 16 of 19 patients after scaling, whereas only 2 of 12 nonscaled subjects showed similar changes during monitoring intervals of up to 3 years. The bacterial specificities of the increases were found to differ among the patients; however, a significant correlation to preexisting elevated antibody levels was observed. Peak levels of responses were noted at approximately 2 to 4 months posttreatment; antibody returned to pretreatment levels by 8 to 12 months. The predominant organisms for which changes were noted included the black-pigmented Bacteroides spp., Eikenella corrodens, Campylobacter concisus, and Actinobacillus actinomycetemcomitans. In 18 of 19 instances, the homologous microorganism was detected in the subgingival plaque when elevated antibody was present after treatment. These findings indicated that specific changes in host systemic responses accompany scaling and root planing treatment of periodontal disease patients. These alterations in the host response may provide an additional means by which successful therapy can be accomplished.