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Résultats initiauz et effets à long terme des traitements chirurgicaux et non chirurgicaux de la maladie parodontale avancée
Author(s) -
Serino G.,
Rosling B.,
Ramberg P.,
Socransky S. S.,
Lindhe J.
Publication year - 2001
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1034/j.1600-051x.2001.028010910.x
Subject(s) - medicine , scaling and root planing , dental alveolus , dentistry , oral hygiene , periodontitis , periodontal disease , clinical trial , surgery , chronic periodontitis
Aim: A clinical trial was performed to determine (i) the initial outcome of non‐surgical and surgical access treatment in subjects with advanced periodontal disease and (ii) the incidence of recurrent disease during 12 years of maintenance following active therapy. Material and Methods: Each of the 64 subjects included in the trial showed signs of (i) generalized gingival inflammation, (ii) had a minimum of 12 non‐molar teeth with deep pockets (6 mm) and with 6 mm alveolar bone loss. They were randomly assigned to 2 treatment groups; one surgical (SU) and one non‐surgical (SRP). Following a baseline examination, all patients were given a detailed case presentation which included oral hygiene instruction. The subjects in SU received surgical access therapy, while in SRP non‐surgical treatment was provided. After this basic therapy, all subjects were enrolled in a maintenance care program and were provided with meticulous supportive periodontal therapy (SPT) 3–4 times per year. Sites that at a recall appointment bled on gentle probing and had a PPD value of 5 mm were exposed to renewed subgingival instrumentation. Comprehensive re‐examinations were performed after 1, 3, 5 and 13 years of SPT. If a subject between annual examinations exhibited marked disease progression (i.e., additional PAL loss of 2 mm at 4 teeth), he/she was exited from the study and given additional treatment. Results: It was observed that (i) surgical therapy (SU) was more effective than non‐surgical scaling and root planing (SRP) in reducing the overall mean probing pocket depth and in eliminating deep pockets, (ii) more SRP‐treated subjects exhibited signs of advanced disease progression in the 1–3 year period following active therapy than SU‐treated subjects. Conclusion: In subjects with advanced periodontal disease, surgical therapy provides better short and long‐term periodontal pocket reduction and may lead to fewer subjects requiring additional adjunctive therapy.