Clinical observations of the effects of nonsurgical periodontal therapy on human periodontal disease. II. Ultrasonic scaling and root planing for 6 months.

The purpose of this study was to examine and evaluate the short-term (six months) effects of clinical trials of nonsurgical periodontal therapy. The subjects studied included consisted of 34 patients, 24-52 years of age (836 teeth), with various degrees of advanced periodontitis. Following a baseline examination which included assessments of the gingival index (GI), plaque index (PlI), calculus index (CI), probing depth, and attachment level, the patients were subjected to nonsurgical therapy. Differences between various treatment intervals for the pockets initially measuring 1-3 mm, 4-6 mm, and 7 mm or more were analyzed by using the paired Students t-test. Following meticulous debridement of periodontal pockets with ultrasonic instrumentation, routine pocket irrigation with hydrogen peroxide (2.5-3.0%) and chlorhexidine gluconate solutions (0.12%) was performed by the authors as well as by the patients at sites with moderate to deep pockets and furcation involvement. Furthermore, the patients were supervised under a maintenance care program which provided patient motivation, the teaching of oral hygiene procedures, and offered regular recall for six months. The results demonstrated that non-surgical therapy resulted in a prominent reduction of gingival inflammation, dental plaque and calculus formation, and finally increased gingival recession. Also, for sites with an initial probing depth of 1-3 mm, there was a slight loss (0.1 mm) of the attachment level, 3 and 6 months after therapy. For sites with an initial probing depth of 4-6 mm, there was some attachment gain (0.31 mm and 0.69 mm) at 3 and 6 month post-treatment intervals. For pockets 7 mm or more in depth, a pronounced gain (0.49 mm and 1.00 mm) of attachment was noted following 3 and 6 month intervals. Generally, an obvious reduction of probing depth was constantly observed after nonsurgical treatment in each of the three initial pocket groups mentioned above. The changes of probing depths between baseline and at 3 or 6 months after treatment were 0.17 and 0.23, 1.23 and 1.75, and 1.83 and 2.63 mm, respectively. With the exception of attachment loss for the pockets initially measuring 1-3 mm, the difference of GI, PlI, CI, probing depth, and attachment level between baseline and 3 or 6 months after treatment were found statistically significant in each of the three initial pocket groups when analyzed individually by ANOVA.