Enhanced root planing and systemic metronidazole administration improve clinical and microbiological outcomes in a two-step treatment procedure.

Abstract

BACKGROUND:

Recently we described a non-surgical two-step treatment concept, in which we distinguished between a first scaling and root planing step (SRP) and an additional second enhanced root planing step (ERP). Until now it is difficult to determine how often a root surface should be instrumented during ERP.

METHODS:

The aim of the present study was to investigate the outcomes after different root planing intensities during ERP in 37 patients with aggressive periodontitis after SRP. During ERP a full-mouth root planing was performed. The patients were randomly assigned to one of two root planing regimens (group 1, N = 12 and group 2, N = 11), based on number of curet strokes per root surface (instrumentation frequency, IF) and probing depth. Group 1: PD 1 to 3.5 mm, 4 IF (for group 2, 8 IF); PD 4 to 6 mm, 8 IF (group 2, 14 IF); PD 6.5 to 9 mm, 12 IF (group 2, 20 IF); and PD >9 mm, 16 IF (group 2, 24 IF). Group 3 patients (controls; N = 14) received only the initial SRP. All three groups received the same adjunctive systemic antibiotic treatment.

RESULTS:

In all groups, the results showed statistically significant differences in PD and clinical attachment level (CAL) after 6 and 24 months compared to baseline data. Compared with the controls, a significant reduction in PD was observed in groups 1 and 2. The reduction in mean PD was distinctly greater in group 2 (higher IF). Furthermore, Porphyromonas gingivalis (Pg) and Actinobacillus actinomycetemcomitans (Aa) were completely suppressed in group 2 after 24 months.

CONCLUSIONS:

The present results show that the extent of root planing has a distinct influence on treatment outcomes. Patients treated with the highest instrumentation frequency showed the best long-term results.

• Authors: Bernd W Sigusch, Arndt Güntsch, Anne Pfitzner, Eike Glockmann
• Journal: Journal of periodontology (J Periodontol) Vol. 76 Issue 6 Pg. 991-7 (Jun 2005) ISSN: 0022-3492 [Print] United States
• PMID: 15948696 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Infective Agents
• Metronidazole

Topics

• Adult
• Anti-Infective Agents (administration & dosage)
• Combined Modality Therapy
• Female
• Humans
• Male
• Metronidazole (administration & dosage)
• Periodontal Attachment Loss
• Periodontitis (drug therapy, microbiology)
• Root Planing (methods)
• Statistics, Nonparametric
• Time Factors
• Treatment Outcome