Several indices have been developed that use bleeding and color changes as indicators of early gingival pathology. In the presence of gingivitis, vascular proliferation and reduction of keratinization owing to increase redness in gingiva. Descriptions of healthy gingiva are numerous, ranging from pale pink and coral pink to deep red and violet. This terms are not objective. Because of perception of color depends on a lot of factors such as light source, object, observer and so on. It is difficult to make an objective expression. Therefore the using of mechanical equipment is recommended to exclude these variables and observer's vias. The purpose of this study was to evaluate gingival color change after scaling & subgingival root planing. The other purpose of this study was to research the correlation of pocket depth, P.B.I. score and gingival color change. After photo-taking and storaging the image of gingival color into a computer, color change was examine with an image analysis program. Results were as follow; 1. Color of healed gingiva after scaling & subgingival root planing was significantly differ from color of inflamed gingiva(p<0.01). 2. Color of healed gingiva after scaling was similar to color of healed gingiva after subgingival root planing(p<0.05). 3. There was statistically significant correlation between color change of red component and pocket depth after scaling & subgingival root planing(p<0.01). 4. There was no correlation between color change of green, blue component and pocket depth after scaling & subgingival root planing(p<0.01). 5. There was statistically significant correlation between between color change of red component and P.B.I. score after scaling & subgingival root planing(p<0.01). 6. There was no correlation between color changes of green, blue component and P.B.I. score after scaling & subgingival root planing(p<0.01). 7. Increase of pocket depth and P.B.I. score were significantly correlated to the amount of color change(p<0.01). 8. P.B.I. score had a higher correlation with color change than pocket depth(p<0.01).
The quality of periodontal instrument cutting edge is a basic element of effective root planing procedure. Using instruments, the sharp edge is changed into blunt or beveled edge. With the blunt instrument, the periodontal treatment can't be carried into accuracy and effective. The study on the wear of periodontal curet is insufficient, there are few publications about the change of sharpness of cutting egde after using instrument and a certen reports were published on the study of scanning electron microscope(SEM) examination. In this study, to declare the number of strokes for sharpening of instruments, the changes of cutting edge is measured by the clinical methods, tactile sensitivity examination and refraction light-white line test after scaling strokes and root planing strokes. SEM test was added for defined the changes of cutting edges. The 7/8 Gracey curets that have been never used was tested. Maxillary molars which were extracted from the School of Dental Medicine, Dankook University was used. Subjected teeth had attachment loss more than 6 mm in bucca-lingual surface and sufficient calculus of a band type in cervical area. The strokes of curet were executed 3, 5, 7, 9, 11, 13 times on scaling stroke and 10, 15, 20, 25, 30, 35 times on root planing stroke. A resident has periodontal experience over 3 years carried out the clinical examinations those tactile sensitivity examination and refraction light-white line test 5 times. The case there being tactile sensitivity certenly is 2, the case being felt tactile sensitivity is 1, and the case there not being tactile sensitivity is 0. The visual examination was recorded as following. The case that refracted white line is not recognised is 2, the case that uncerten is 1, and the case that acknowledged is 0. The results were obtained as follows. 1. After scaling strokes, the tactile sensitivity was reduced after 11 strokes and disappeared in 13 strokes. 2. In tactile sensitivity after root planing procedures, sensitivity was reduced after 25 strokes and disappeared in 35 strokes. 3. In case of visual examination, the detection of refracted white line was increased after 9 strokes of scaling procedures and the accuracy of wear wasn't showed after root planing procedures. 4. In SEM, metal projection was observed on new periodontal curet cutting edge and it was disappeared after scaling procedures. 5. In SEM, the cutting edge was showed changing linear into an aspect of the surface after 5 strokes of scaling procedures and 10 strokes of root planing procedures and showed beveled edge in 11 strokes of scaling procedures, 25 strokes of root planing procedures. The results of 3-type examination indicated that the sharpening of curet should be performed after 11 strokes of scaling procedures and 25 strokes of root planing procedures.
This study presents an evaluation of the effectiveness of nonsurgical subgingival scaling and root planing related to initial pocket depth, type of teeth, and individual root surfaces. A total of 110 teeth designated for periodontal surgery in 67 patients with marginal periodontitis were selected and received thorough scaling and root planing with standard rigid Gracey curettes. After a healing period of 4 to 8 weeks, residual calculus was assessed at the time of periodontal surgery following the reflection of mucoperiosteal flap. The results demonstrated a high correlation between the percentage of residual calculus and initial pocket depth. It was further noted that tooth type and involved root surface also influenced the rate of calculus remnant. The results of this study suggest that complete removal of subgingival calculus utilizing conventional instrumentation via closed approach is rare.
20 Subjects with clinical diagnosis of adult periodontitis with sites having average pocket depth of 4mm were selected for the study. After scaling and root planing of those sites, 30% minocycline-HCI contained in biodegradable device were inserted in one group, scaling and root planing was carried out in another group and the last group was without any periodontal treatment. the difference between the group was detemined by pocket dept, bleeding on prbing, attachment level, distribution of subgingval plaque bacteria. Conclusion was made for the comparisons between baseline and 4 week and the groups. 1. In analysis of pocket depth, there was significant sifference in scaling and root planing group only. 2. Both the scaling and root planing group and minocycline group showed significant decrease in bleeding on probing. 3. There was significant increase in the attachment level in scaling and root planing group, but no difference was foundbetween the groups. 4. There was significant decrease in the total number of subgingival bacteria in all groups and the number of motile bacteria decreased significantly in the minocycline group. These result indicate that insertion of Minocycline-HCI at the base of periodntal pocket was useful as an additional aid of mechanical trarment at the point of periodontal pocket, bleeding on probing, attachment level, microbial distribution.
The purpose of this study was to compare effects of demineralization of citric acid and tetracycline HCI on periodontally involved root surface. Twelve periodontally involved single rooted teeth were used. After scaling and root planing, root conditioning with citric acid and tetracycline HCI were carried and the teeth were processed scanning electron microscopic observation.The results were as follows: The scaled root surface was covered by much debris and calculus. The effect of demineralization of citric acid and tetracycline HCI was more reduced on scaling group than root planing group, because of hypermineralization of cementum surface and demineralization effect on root surface of tetracycline HCI showed tendency to reduction. The root planed group displayed more smooth root surface than scaling group, the surface was covered by smear layer, thus no exposure of dentinal tubule opening and collagen fiber, especially after root planing, citric acid and tetracycline HCl treated group showed exposure of dentinal tubule and collagen fiber, thus it was thought that new connective tissue attachment could be acquired.
The purpose of this study was to assess the recolonization of the subgingival microflora following scaling and root planing on single and multiroot teeth with periodontal pockets which were above 5mm. 7 patients with deep pockets were selected for this study. They had not taken antibiotics for 6 months and no history of dental treatment for 6 months before the study. After initial clinical(plaque index, gingival index, probing pocket depth), microbiological and BANA test were determined, each subject received a single session of scaling and root planing, but they were not received oral hygiene instructions. Clinical indices, microbial parameters and BANA test were reassessed 1, 2, and 4 weeks after treatment. The results were as follows : 1. Plaue index, gingival index and pocket depth were not significantly when compared single root group with multiroot group, both groups were siginficantly reduced at 2weeks in plaque index and 2, 4 weeks in gingival index(P<0.05), probing pocket depth was siginificantly changed at 2, 4weeks in multiroot teeth group and 4 weeks in single root teeth group(P<0.05). 2. Percentage of cocci was significantly increased at 4weeks in single root teeth group(P<0.05), motile rod was significantly changed at 4weeks in both group(P<0.05), spirochetes and nonmotile rods were not significantly changed. 3. BANA test was significantly reduced at 1 and 2 weeks (P<0.05) in single root teeth group, multiroot teeth group was not significantly all weeks. This results were suggested that clinical and microbiological effect following scaling and root planing on periodontal disease.
Kim, Sang-Jun;Um, Heung-Sik;Chang, Beom-Seok;Lee, Jae-Kwan
Journal of Periodontal and Implant Science
/
v.39
no.1
/
pp.37-44
/
2009
Purpose: Tetracycline and its chemically modified non-antibacterial analogues can inhibit certain host-derived tissue destructive collagenases such as matrix metalloproteinases. The purpose of this study was to evaluate clinical and microbiologic effects of the subantimicrobial dose of doxycycline(SDD) in conjunction with scaling and root planing. Materials and methods: A total of 30 patients with chronic periodontitis who were going to receive scaling and root planing were randomly allocated to receive either a doxycycline hyclate for 3 months or nothing. Clinical probing depth, clinical attachment level, gingival recession, and bleeding on probing were measured by one periodontist. After a periodontal examination, microbial samples were collected using sterile paper points. The effect of SDD in conjunction with scaling and root planing on alterations of the periodontal pathogens (Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Porphyromonas gingivalis) were also assessed using l6S rRNA polymerase chain reaction. Results: During the treatment period, clinical parameters for both treatment group and control group were improved. After 3 months, reductions in probing depth and gains in clinical attachment level were significantly greater for the SDD group than control group. Microbial analysis showed that there was no alteration of the periodontal pathogens and no difference between the groups. Conclusion: This study suggested that the subantimicrobial dose of doxycycline as an adjunct therapy with scaling and root planing might be effective and safe in the management of chronic periodontitis.
Rapidly progressive periodontitis is known to be usually associated with systemic problems and improved with antibiotic therapy. Recent experiments in which bioresorbable polycaprolactone was polymerized with minocycline has shown that the system released effective antibiotic concentration during the 7 days' period. This clinical trial was to compare the efficacy of a minocycline film(poly-caprolactone+polyglycol+10% minocycline) insertion plus supragingival scaling(MS) or subgingival scaling & root planing(MSRP) with the scaling(S) or subgingival scaling & root planing alone(SRP), at improving the periodontal condition in RPP. Fifteen patients were examined for plaque accumulation, gingival inflammation, probing depth and attachment loss at baseline, then 1, 2, 4 and 8 weeks after 4 treatment regimens were randomly undergone in 4 comparable sites(PD>5mm, LA>3mm) in each subject. Results revealed statistically significant treatement effect with a reduction in a probing depth in SRP(2.0mm), MS(1.8mm), and MSRP(2.1mm). There was no significant reduction in the supragingival scaling alone group(0.6mm). Similarly, attachment levels were significantly improved in the SRP(1.5mm), MS(2.0mm) and MSRP(2.0mm) groups. Net % BOP reduction at 8 week compared to baseline was 6.7% (S), 26.7% (MS), 26.7% (SRP), and 33.3% (MSRP). MSRP produced the greatest improvement in BOP at 8 week. This data suggests that a subgingival minocycline delivery system as a adjunct to scaling alone or scaling & root planing may produce significant clinical benefits over scaling alone in rapidly progressive periodontitis patients.
Sinn, Ho-Beom;Yun, Chang-Yup;Kim, Sang-Mok;Kim, Byung-Ock;Han, Kyung-Yoon
Journal of Periodontal and Implant Science
/
v.31
no.1
/
pp.233-242
/
2001
In the treatment of chronic adult periodontitis, scaling and root planing have been generally performed prior to periodontal flap surgery. The purpose of this study was to evaluate the clinical significance of nonsurgical periodontal therapy prior to periodontal flap surgery in patients with chronic adult periodontitis. Fifty six molars showing bilateral bony defects and 4-6mm periodontal pocket in twelve patients with chronic adult periodontitis were selected. By randomized split-mouth design, in one side, flap operation was performed 4 weeks after scaling and root planing, in the other group, flap operation was only performed without scaling and root planing. Probing pocket depth, gingival recession, clinical attachment level, gingival index, plaque index, and tooth mobility were measured at baseline, before flap operation and post-operation
The purpose of this study is to examine the influence of 5% tetracycline(Tc) gel on healing of gingival tissue and change of diseased root surface when used with nonsurgical procedure. 7 patients with advanced periodontitis were received thorough scaling and root planning, followed by saline irrigation on 10 randomly selected control teeth and Tc gel application for 5 minutes with specifically designed plastic instrument of 10 test teeth in contralateral side. At 0, 1, 7, 14, and 21 days after treatment, biopsy and extraction were carried out. At day 7, Tc group showed decreased inflammation and delayed proliferation of pocket epithelium in comparison with control group which was continued for all experimental days. Scanning electron microscopic finding revealed demineralized and cleaned root surface with exposed dentinal tubules in Tc gel group. In the present study, clinically successful result is expected with combined use of nonsurgical periodontal therapy and intrapocket application of Tc gel.
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