Prognostic criteria for the efficiency of nonsurgical therapy in advanced periodontitis
The aim of the present study was to evaluate which clinical radiographic or microbiological variables can be used as prognostic criteria for the commonly used initial treatment protocol comprising scaling and root planing and instructions in oral hygiene in advanced adult periodontitis. Forty-six volunteers with advanced and untreated adult periodontitis were examined. Recordings were taken of plaque, gingival and calculus indices, pocket depths, bleeding on probing probing attachment levels, and furcation involvements. Panorex were also taken. Three separate bacterial samples were obtained from each patient from the deepest pockets. After completion of nonsurgical therapy (three months), the healing was evaluated clinically and 33 of the patients were assigned to further periodontal treatment. The remaining 13 patients participated in a maintenance program. Evaluation of the baseline clinical and radiological data showed a significantly higher amount of > 6 mm pockets, surfaces with suppuration, and sites with subgingival calculus, as well as higher numbers of infrabony lesions, in patients who received further treatment than in the patients who went to the maintenance program. No statistically significant differences were seen in the detection frequency or proportions of either A. achtinomycetemcomitans or P. gingivalis between the two groups before or after treatment.
The authors suggest that the results of the present study indicate that nonsurgical, mechanical periodontal treatment comprising instruction on and control of oral hygiene as well as meticulous root debridement was successful in decreasing the extent of clinical inflammation, reducing probing depths, and arresting the progression of periodontitis at several sites.
Nieminen, A., E. Siren, J. Wolf, and S. Asikainen, J Clin Periodont, 22:153, 1995