RELATIONSHIPS BETWEEN INITIAL PROBING DEPTH AND CHANGES IN THE CLINICAL PARAMETERS FOLLOWING NON-SURGICAL PERIODONTAL TREATMENT IN CHRONIC PERIODONTITIS

Abstract

Purpose: The aim of this study was to evaluate the relationship between initial probing depth (IPD) and changes in clinical parameters following non-surgical periodontal treatment (NPT) in chronic periodontitis patients.

Subjects and Methods: A total of 1672 periodontal pockets having 3mm≤IPD≤9mm of depth in 15 chronic periodontitis patients were included. NPT consisting of oral hygiene instructions, scaling and root planing was applied in two sessions. Probing depth (PD), clinical attachment level, gingival recessions (GR) were measured before and eight weeks after treatment. Pocket sites were grouped according to their IPD and root number as single- or multi-rooted teeth.

Results: Other than the sites having 3 mm IPD, PD reduction and GR increase were significant in all groups (p<0.001). Attachment gains (AG) were significant in all single-rooted teeth (p<0.001) again except those having IPD=3mm. However, AG was significant in multi-rooted teeth having only 7mm≤IPD≤9mm (p<0.05). Positive correlations were observed between IPD and PD reduction, GR increase and AG in single-rooted teeth (p<0.001). Furthermore, positive correlations were found between IPD and PD reduction and GR increase in multi-rooted teeth (p<0.001), but there was no correlation between IPD and AG.

Conclusion: NPT may lead to positive association between IPD and PD reduction as well as GR increase, which is independent from tooth root anatomy.

Keywords

• Chronic periodontitis,dental scaling; periodontal pocket; root planning; periodontology

References

1. Kinane DF, Attstrom R, European Workshop in Periodontology group B. Advances in the pathogenesis of periodontitis. Group b consensus report of the fifth european workshop in periodontology. J Clin Periodontol 2005;32 Suppl 6:130-131.
2. Darveau RP, Tanner A, Page RC. The microbial challenge in periodontitis. Periodontol 2000 1997;14:12-32.
3. Dentino A, Lee S, Mailhot J, Hefti AF. Principles of periodontology. Periodontol 2000 2013;61(1):16-53.
4. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999;4(1):1-6.
5. Claffey N, Polyzois I, Ziaka P. An overview of nonsurgical and surgical therapy. Periodontol 2000 2004;36:35-44.
6. Ishikawa I, Baehni P. Nonsurgical periodontal therapy--where do we stand now? Periodontol 2000 2004;36:9-13.
7. Yilmaz S, Efeoglu E, Noyan U, Kuru B, Kilic AR, Kuru L. The evolution of clinical periodontal therapy. J Marmara Univ Dent Fac 1994;2(1):414-423.
8. Badersten A, Nilveus R, Egelberg J. Effect of nonsurgical periodontal therapy. I. Moderately advanced periodontitis. J Clin Periodontol 1981;8(1):57-72.

9. Aljateeli M, Koticha T, Bashutski J, Sugai JV, Braun TM, Giannobile WV, Wang HL. Surgical periodontal therapy with and without initial scaling and root planing in the management of chronic periodontitis: A randomized clinical trial. J Clin Periodontol 2014;41(7):693-700.
10. Magnusson I, Lindhe J, Yoneyama T, Liljenberg B. Recolonization of a subgingival microbiota following scaling in deep pockets. J Clin Periodontol 1984;11(3):193-207.
11. Mousques T, Listgarten MA, Phillips RW. Effect of scaling and root planing on the composition of the human subgingival microbial flora. J Periodontal Res 1980;15(2):144-151.
12. Segelnick SL, Weinberg MA. Reevaluation of initial therapy: When is the appropriate time? J Periodontol 2006;77(9):1598-1601.
13. Mousques T, Listgarten MA, Stoller NH. Effect of sampling on the composition of the human subgingival microbial flora. J Periodontal Res 1980;15(2):137-143.
14. Drisko CH. Nonsurgical periodontal therapy. Periodontol 2000 2001;25:77-88.
15. Suvan JE. Effectiveness of mechanical nonsurgical pocket therapy. Periodontol 2000 2005;37:48-71.
16. Van der Weijden GA, Timmerman MF. A systematic review on the clinical efficacy of subgingival debridement in the treatment of chronic periodontitis. J Clin Periodontol 2002;29 Suppl 3:55-71; discussion 90-51.
17. Claffey N, Loos B, Gantes B, Martin M, Egelberg J. Probing depth at re-evaluation following initial periodontal therapy to indicate the initial response to treatment. J Clin Periodontol 1989;16(4):229-233.
18. Cobb CM. Clinical significance of non-surgical periodontal therapy: An evidence-based perspective of scaling and root planing. J Clin Periodontol 2002;29 Suppl 2:6-16.
19. Sanz I, Alonso B, Carasol M, Herrera D, Sanz M. Nonsurgical treatment of periodontitis. J Evid Based Dent Pract 2012;12(3 Suppl):76-86.
20. Tunkel J, Heinecke A, Flemmig TF. A systematic review of efficacy of machine-driven and manual subgingival debridement in the treatment of chronic periodontitis. J Clin Periodontol
21. ;29 Suppl 3:72-81; discussion 90-71.
22. Drisko CL. Scaling and root planing without overinstrumentation: Hand versus power-driven scalers. Curr Opin Periodontol 1993, 78-88.
23. Silness J, Loe H. Periodontal disease in pregnancy. Ii. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand 1964;22:121-135.
24. Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963;21:533-551.
25. Albandar JM, Rams TE. Global epidemiology of periodontal diseases: An overview. Periodontol 2000 2002;29:7-10.
26. Oliver RC, Brown LJ, Loe H. Periodontal treatment needs. Periodontol 2000 1993;2:150-160.
27. Caula AL, Lira-Junior R, Tinoco EM, Fischer RG. The effect of periodontal therapy on cardiovascular risk markers: A 6-month randomized clinical trial. J Clin Periodontol 2014;41(9):875-882.
28. Jeffcoat MK, Jeffcoat RL, Gladowski PA, Bramson JB, Blum JJ. Impact of periodontal therapy on general health: Evidence from insurance data for five systemic conditions. Am J Prev Med 2014;47(2):166-174.
29. Cobb CM. Non-surgical pocket therapy: Mechanical. Ann Periodontol 1996;1(1):443-490.
30. Drisko CL. Periodontal debridement: Still the treatment of choice. J Evid Based Dent Pract 2014;14 Suppl:33-41 e31.
31. Haffajee AD, Cugini MA, Dibart S, Smith C, Kent RL, Jr., Socransky SS. The effect of srp on the clinical and microbiological parameters of periodontal diseases. J Clin Periodontol 1997;24(5):324-334.
32. Lavanchy DL, Bickel M, Baehni PC. The effect of plaque control after scaling and root planing on the subgingival microflora in human periodontitis. J Clin Periodontol 1987;14(5):295-299.
33. Badersten A, Nilveus R, Egelberg J. Effect of nonsurgical periodontal therapy (viii). Probing attachment changes related to clinical characteristics. J Clin Periodontol 1987;14(7):425-432.
34. Loos B, Nylund K, Claffey N, Egelberg J. Clinical effects of root debridement in molar and non-molar teeth. A 2-year follow-up. J Clin Periodontol 1989;16(8):498-504.
35. Miremadi SR BH, Steyaert H, Princen K, Cosyn J. . A randomized controlled trial comparing surgical dna non-surgical periodontal therapy: A 3-year clinical and cost-effectiveness analysis. J Clin Periodontol 2015;42(8):748-755.
36. Adriaens PA, Adriaens LM. Effects of nonsurgical periodontal therapy on hard and soft tissues. Periodontol 2000 2004;36:121-145.
37. Caton JG, Zander HA. The attachment between tooth and gingival tissues after periodic root planing and soft tissue curettage. J Periodontol 1979;50(9):462-466.
38. Caton J, Nyman S, Zander H. Histometric evaluation of periodontal surgery. Ii. Connective tissue attachment levels after four regenerative procedures. J Clin Periodontol 1980;7(3):224-231.