A comparison between conventional gingivectomy and a non-surgical regime in the treatment of periodontitis.

The treatment of periodontitis by scaling and oral hygiene instruction was compared with the same regime augmented by conventional gingivectomy. The procedures were allocated randomly to contralateral sides of the maxillary arches of 28 patients. Following both regimes there was significant reduction in Plaque Index, Gingival Index, crevicular fluid and depths of pockets. There was slight gain in attachment on the non-surgical sides, and a minor loss of attachment on the surgical sides. Comparing the two regimes, over the second half of the study there was no significant difference in Plaque Index or crevicular fluid; however, on the surgical sides there was significantly greater reduction in Gingival Index and depths of pockets. Residual pockets after either technique were associated with more inflammation than where sulcus depths were less than 2 mm. Retrospective comparisons of the initial depths of pockets with the final gingival status indicated that, when initial depths of pockets had been 3 mm or over, surgical treatment was more effective than non-surgical in reducing the final values of both depths of pockets and inflammation; this finding was statistically significant for some, but not all of the parameters. Treatment of shallow pockets by either technique was more effective than the treatment of deep pockets. Final Plaque Index values of zero were associated with significantly less inflammation and pocketing than where plaque deposits could be detected.