Prognostic criteria for the efficiency of non-surgical periodontal therapy in advanced periodontitis.

The aim of the study was to find out which clinical, radiographic and microbiological variables can be used as prognostic criteria for the efficiency of the commonly used initial treatment protocol comprising scaling, root planning and instruction on oral hygiene in advanced adult periodontitis. 46 patients (mean age 48 years) with untreated, advanced periodontitis volunteered for the study. The clinical examination included recordings of plaque, gingival and calculus indices, probing pocket depths, bleeding and suppuration after probing, probing attachment levels and furcation involvements. Infrabony and furcation lesions were assessed from panoramic radiographs. Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis were cultured from the deepest, most inflamed periodontal Pockets, from surface of the tongue and from saliva. 3 months after the completion of non-surgical treatment comprising meticulous scaling and root planing and instruction on oral hygiene, the healing was assessed clinically, and 13 patients were assigned to a maintenance care programme (MC) and 33 to further treatment procedures (FT). Evaluation of the baseline clinical and radiographic data showed a significantly higher %s of > or = 6 mm deep periodontal pockets, surfaces with suppuration, and sites with subgingival calculus, as well as higher numbers of infrabony lesions, in FT-patients than in MC-patients. Subgingival A. actinomycetemcomitans was isolated at baseline in 55% of the FT-patients and in 38% of the MC-patients, and P. gingivalis in 27% and 23%, respectively. A. actinomycetemcomitans was eradicated by non-surgical treatment from only one patient. P. gingivalis was detected in 15% of the patients in both groups after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)