Periodontology Literature Review

DELIVERY BY IRRIGATION

James B. Fine et al: Short-Term Microbiological and Clinical effects of Subgingival Irrigation with an Antimicrobial Mouth rinse. J Perio, 65:30-36, 1994.

Purpose:

To investigate the effects of professional subgingival irrigation with antiseptic followed by daily subgingival irrigation at home on the clinical and microbiological status of periodontal pockets.

Materials and methods:

A total of 50 patients with adult periodontitis with at least 2 pockets with probing depths (PD) 4-6 mm and bleeding on probing (BOP) were included in this study. The study designe was a split mouth design; 2 sites were chosen for each half of the mouth, subgingival plaque was sampled from each site. The patients received a scaling and prophylaxis (half mouth) and were randomly assigned to; irrigation with antimicrobial, or irrigation with sterile colored water. Irrigation was performed by a hygienist. The patients were provided with irrigation system. Test sites were examined and sampled on days 7, 21, and 42. PD and attachment levels were measured on day 42 for selected sites.

Results:

No differences between the test and the control in regards to PD, attachment levels, and BOP. Sites irrigated with antimicrobial showed a significant plaque reduction when compared to placebo at all examination periods. The antimicrobial produced a significant decrease in plaque compared to control. The antimicrobial also showed reduction in gingival redness and BOP. There was no significant difference between the site scaled and the non scaled site. At 7 days, test scaled and test unscaled had less % of spirochetes than the control. There was a greater reduction relative to baseline in the scaled sites. The proportions of spirochetes rebounded at 21 days and decreased at 42 days. Both treatments decreased the motile rods but test had greater decrease at 7 days. Non motile rods remained approximately the same. 21-27% scaled and unscaled treated groups increased coccoid proportions significantly at 7 days returning to baseline at 21-42 days. Fusobacterium decreased in all groups Antimicrobial groups exhibited a greater decrease. Antimicrobial group showed a drop in Capnocytophaga Sp at 7 days, greater in scaled vs. non scaled. BPS were depressed in the antimicrobial mouth rinse group (93-98%) at 7 days and remained depressed at 42 days.

Conclusion:

Irrigation with antimicrobial mouth rinse resulted in plaque reduction. Irrigation following a dental prophylaxis resulted in significant improvement in gingivitis. Irrigation can provide incremental benefit when used as an adjunct in treatment of gingivitis.

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