Periodontology Literature Review

DELIVERY BY IRRIGATION

Wennstrom, JL., G. Dahlen, K. Grondahl, and L. Heijl: Periodic subgingival antimicrobial irrigation of periodontal pockets. II. Microbiological and radiographical observations. J Clin Perio, 14:573, 1987.

Purpose:

This study was done in order to evaluate the effect of professionally performed periodic subgingival irrigation of deep periodontal pocket alone as well as combined with mechanical debridement on a subgingival microflora associated with periodontal disease, and to study alterations in the status of the periodontal tissues using subtraction radiography.

Methods and materials:

A total of 10 patients with moderate to severe periodontal destruction (probing depths of 6 or more mm and bleeding on probing) participated in the study. During the first phase of the treatment, the pockets were periodically irrigated with 0.2% chlorhexidine gluconate, 3% hydrogen peroxide, saline, or nothing (every 2nd-3rd day during weeks 1-2 and 5-6) with no mechanical instrumentation of the roots. During the 2nd phase subgingival scaling and root planing were performed in conjunction with subgingival irrigation of the pockets. Patients' plaque control was supervised during the experiment. Microbiologic samples were taken before and after the first and second treatment phases and 3 months after the end of the active treatment. Plaque sample were subject to dark field microscopy. Radiographs were taken at the start of each treatment phase and 3 months after the termination of the study and analyzed by the subtractive technique.

Results:

Irrigation alone had limited and transient effects on the subgingival microflora. Repeated irrigation with CHX or H2O2 did not induce any changes in total viable counts, anaerobes, rods, black-pigmented Bacteroides, B. gingivalis or motile rods and spirochetes when compared to the sites irrigated with saline.

No radiographical changes were observed among the treatment groups.

Conclusions:

The results of this study suggest that periodic subgingival irrigation with CHX or hydrogen peroxide alone or in combination with mechanical instrumentation has only limited effect on the subgingival microflora of deep periodontal pockets.

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