Can one stage full-mouth scaling and rootplaning prevent re-infection?

Meijer, H.F. (Henriette) (2015) Can one stage full-mouth scaling and rootplaning prevent re-infection? thesis, Dentistry.

Text MeijerH..pdf Restricted to Registered users only Download (18MB)

Abstract

Introduction Periodontal diseases are multifactorial inflammatory diseases of the gingiva in which bacteria, mostly gram-negative anaerobes, are causal. Periodontal treatment focuses on infection control, eliminating or limiting the causal and risk factors. The aim is to obtain a functional, healthy dentition, without any sign of inflammation. Initial periodontal therapy is performed, as the treatment for periodontitis, by scaling and rootplaning (SRP), per sextant or quadrant in multiple sessions at one to two weeks intervals (MS-SRP). Another strategy of initial periodontal therapy is the one stage full-mouth disinfection (FM-SRP) introduced by Quirynen et al. 1995. Aim The aim of this randomized clinical trial is to determine if FM -SRP results in reduced intraoral translocation of pathogens compared to MS-SRP and whether this results in different clinical outcomes. Study design Thirty-eight volunteers diagnosed with chronic periodontitis were randomly assigned into two groups. They needed to be medically healthy and non-smokers. The FM-SRP group received a one-stage full-mouth treatment. The MS-SRP group received quadrant therapy in three sessions at a weekly interval. In both groups, treatment started in the upper right quadrant. The periodontal pocket depth (PPD) and bleeding on probing (BoP) were recorded with a manual probe at six sites per tooth. Plaque Index (Pll) was determined by visual inspection after plaque disclosing. All clinical measurements were assessed at baseline and after 3 months. The microbiological samples were collected with a paperpoint from a single rooted teeth in each quadrant (PPD2::6mm). Samples were taken at seven time points, at baseline, immediately after treatment, after 1, 2, 7, 14 and 90 days. The microbiological samples were tested by polymerase chain reaction for the presence of: A. actinomycetemcomitans (Aa), P. gingiva/is (Pg), T. denticola (Td), F. nucleatum (Fn) and T. forsythia (Tf). Results Whole-mouth and test-quadrant clinical findings show significant reductions in PPD, BoP and Pll between baseline and 3 months (p<O.OOl). The clinical improvements in the FM-SRP and MS-SRP group are comparable and show no significant differences. FM-SRP and MS-SRP resulted in significant reductions in the number of pockets positive for Pg, Td and Tf after 3 months (p<0.05). No significant difference between both treatment groups in the reduction of Pg, Td and Tf could be observed. MS-SRP and FM-SRP failed to show a reduction in the detection of Aa and Fn. FM-SRP resulted in a significantly more successful elimination of Td compared to MS-SRP. MS-SRP resulted in significantly more "re-infection" for Td during treatment compared to FM-SRP (p<0.05). For Fn significantly more "failure" was detected in the MS-SRP group in comparison with the FM-SRP group (p<0.05). Conclusion FM-SRP can prevent re-infection, especially of Td in treated pockets. However, this does not result in improved clinical outcomes.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervisors: and Abbas, Prof.dr.F. and Department of Periodontology, Center for Dentistry and and Oral Hygiene, University Medical Center Groningen and Zijnge, Drs. V. Department of Periodontology and Hygiene, University Medical Center Groningen
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:45
Last Modified:	25 Jun 2020 10:45
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/696

Actions (login required)

View Item