A 7-month study of sulcular fluid flow in the assessment of healing after debridement of deep pockets.

The purpose of this investigation was to assess the value of sulcular fluid flow (SFF) measurements in evaluation of the healing of deep periodontal pockets after scaling and root planing. Fourteen adult patients with advanced periodontal disease received supragingival prophylaxis and instructions in oral hygiene. Immediately after baseline examination, meticulous scaling and root planing were performed. One to five selected pockets per patient were monitored on Days 0, 30, 120 and 210. Subgingival microbial proportions, sulcular fluid flow, probing depth, Gingival Index and bleeding after probing were assessed and recorded. The subgingival microbial proportions were determined with darkfield microscopy. The periodontal conditions were markedly improved by Day 210 as depicted by the microbial proportions. The proportion of motile micro-organisms was reduced from 51% at baseline to 9% on Day 30. This result was sustained until Day 210. Healing was also evident from the changes in Gingival Index scores and bleeding after probing. Probing depth was reduced from a mean of 8.3 to 4.5 mm. Correlations between the individual means recorded for the clinical parameters and bacterial proportions were calculated for the pooled data of all four examinations. Sulcular fluid flow did not correlate with the clinical parameters. Gingival Index, bleeding after probing or probing depth. The latter three parameters correlated significantly with the microbial proportions and each other. When the pooled tooth surface recordings of Days 30, 120 and 210 were divided into two groups according to the proportion of motile bacteria (the groups with less than 18% of spirochetes and motile rods and the groups with greater than 18% of spirochetes and motile rods), a significant difference in the mean amount of sulcular fluid flow (P less than 0.01) and mean probing depth (P less than 0.001) could be demonstrated between the two groups.