Nonsurgical and surgical periodontal therapy in single-rooted teeth

The purpose of this study was to compare the effect of tooth related and patient related factors on the success of non-surgical and surgical periodontal therapy. In 41 patients (22 female) with untreated and/or recurrent periodontitis, no therapy, scaling and root planing (SRP), or access flap (AF) were assigned according to probing pocket depth (PPD). PPD and vertical relative attachment level (RAL-V) were obtained initially, 3 and 6 months after therapy. Baseline data were compared according to therapy, jaw, tooth type, and site. Factors influencing clinical parameters were identified using multilevel analyses. Baseline PPDs were deeper interproximally, in the maxilla and at premolars compared to buccal/oral sites, mandibular, and anterior teeth. At 6 months, PPD reduction and RAL-V gain were significantly greater at sites receiving SRP and AF as compared to untreated sites (p < 0.001). PPD reduction and RAL-V gain were significantly less (p < 0.005) in smokers as compared to nosmokers and at interproximal sites (p < 0.0001) as compared to buccal/oral sites. RAL-V gain was less in aggressive periodontitis, and PPD reduction was less in the maxilla (p < 0.001). In sites with greater bone loss and infrabony defects, a poorer response was observed regarding RAL-V gain or PPD reduction, respectively. The conclusions of the study are the following: (1) Nonsurgical and surgical periodontal therapies are effective in single-rooted teeth; (2) severe interproximal bone loss and infrabony defects deteriorate clinical results; and (3) there seem to be more defect-associated (tooth, site) factors influencing treatment outcome than patient-associated factors

Nd:YAG (1064 nm) laser for the treatment of chronic periodontitis: a pilot study

AIM: To evaluate the clinical and microbiological effects of neodymium: yttrium-aluminum-garnet laser therapy as an adjunct to scaling and root planing during the hygienic phase. METHODS: In eight patients, sites with a mean probing pocket depth (PPD) of ≥5 mm were treated by either scaling and root planing (n=28) (control) or by scaling and root planing and adjunctive laser therapy (n=28) (power: 5W). Re-evaluation was at 4-6 weeks. Thereafter, remaining pockets (mean PPD ≥5 mm) were eliminated by either laser surgery (power: 7 W) or gingivectomy (control). RESULTS: At baseline, the mean PPD of sites originally presenting with a mean PPD ≥4 mm were 4.69 and 4.73 mm in the test and control sites, respectively. Six months following surgery, there was a similar average mean PPD reduction in the test (1.18 mm, P<0.01) and control sites (1.35 mm, P<0.01). Also, the reduction in bleeding on probing in both groups was statistically significant (P<0.01, paired t-tests). No statistically-significant differences between the test and control sites were found for any clinical or microbiological parameters at baseline, after initial, and 3 or 6 months' post-surgical therapy. CONCLUSION: During the hygienic phase, neodymium: yttrium-aluminum-garnet (1064 nm) laser treatment yielded no superiority in clinical efficacy compared to conventional debridement. Laser gingivectomy resulted in similar treatment outcomes (mean PPD and bleeding on probing reduction), as did conventional gingivectomy