Premium
Clinical trials in periodontal therapy
Author(s) -
Lindhe Jan,
Nyman Stare
Publication year - 1987
Publication title -
journal of periodontal research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 83
eISSN - 1600-0765
pISSN - 0022-3484
DOI - 10.1111/j.1600-0765.1987.tb01572.x
Subject(s) - periodontium , medicine , gingival recession , dentistry , clinical trial , periodontitis , debridement (dental) , cementum , treatment modality , gingival and periodontal pocket , endodontic therapy , molar , orthodontics , surgery , root canal , pathology , dentin
The success of periodontal therapy is evaluated not only after the termination of the comparatively short active treatment phase, but also at regular intervals during the extended maintenance phase. The main objectives of the active treatment include: (1) elimination of the inflammatory lesions present in the periodontium (2) reduction of probing pocket depth and (3) improvement of attachment levels, while the aim of the maintenance phase of therapy is the prevention of disease recurrence. Elimination of the inflammatory lesions in the periodontium is accomplished by meticulous plaque and calculus removal performed either as a single measure or combined with one of several different surgical treatment modalities. Findings from clinical trials have demonstrated that it is not the technique ‐ nonsurgical‐surgical ‐ used during basic therapy, but the degree of root debridement accomplished that seems to be the determining factor for success in terms of resolution of periodontitis. Furcation involved premolars/molars constitute a problem with respect to effectiveness of therapy. Reliable research data describing treatment effects in the furcation regions of multirooted teeth are scarce. As a result of the elimination of the inflammatory lesions the periodontal tissues will offer more resistance to probing. This is clinically identified as probing pocket depth reduction, attachment level imrpovements and recession of the marginal gingiva. Research findings reveal that surgical and nonsurgical methods are almost equally effective in these respects. The concept that surgical methods which include resective measures will cause more gingival recession than non‐resective measures should be questioned. Long‐term clinical trials have demonstrated that patients who, following active treatment, are enrolled in carefully supervised plaque control programs only occasionally show signs of disease recurrence, while in this respect non‐monitored patients frequently display signs of recurrent disease. It is suggested that the long‐term effect of periodontal therapy is more related to the quality of the maintenance care program than the techniques utilized during active therapy.