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Gingival bleeding on probing: relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse
Author(s) -
Gonzalez S.,
Cohen C. L.,
Galván M.,
Alonaizan F. A.,
Rich S. K.,
Slots J.
Publication year - 2015
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/jre.12219
Subject(s) - bleach , sodium hypochlorite , bleeding on probing , medicine , gingival and periodontal pocket , dentistry , periodontitis , mouth rinse , scaling and root planing , chronic periodontitis , chemistry , organic chemistry
Background and Objective This study evaluated the potential of gingival bleeding on probing to serve as a predictor of future periodontal breakdown. It also assessed the ability of 0.25% sodium hypochlorite twice‐a‐week oral rinse to convert periodontal pockets showing bleeding on probing to nonbleeding sites. Material and Methods The study was performed as a randomized, single‐blinded, clinical trial in parallel groups. Seven periodontitis patients rinsed twice‐weekly for 3 mo with 15 mL of a fresh solution of 0.25% sodium hypochlorite, and five periodontitis patients rinsed with water. The 12 study patients received no subgingival or supragingival scaling. Clorox ® R egular‐ B leach was the source of sodium hypochlorite. At baseline and 3‐mo visits, gingival bleeding was assessed within 30 s after probing to full pocket depth using an approximate force of 0.75 N . Results A total of 470 (38%) of 1230 periodontal pockets in the bleach‐rinse group revealed bleeding on probing at the initial visit but not at the 3‐mo visit; only 71 (9%) of 828 pockets in the control group became bleeding‐negative during the study ( p < 0.001). Bleeding on probing in 4‐ to 7‐mm‐deep pockets decreased by 53% in the bleach‐rinse group but increased by 6% in the water‐rinse group ( p < 0.001). Ninety‐seven pockets showed depth increases of ≥ 2 mm after 3 mo: 60 (62%) of those pockets exhibited bleeding on probing at both the initial and the 3‐mo visits; 24 (25%) bled at only one of the two visits; and 13 (13%) never demonstrated gingival bleeding ( p < 0.001). Conclusions Persistent gingival bleeding on probing was associated with an increased risk for periodontal breakdown, and the absence of gingival bleeding seemed to be a useful, although not perfect, indicator of disease stability. Twice‐weekly oral rinsing with dilute bleach (0.25% sodium hypochlorite) produced a significant reduction in bleeding on probing, even in deep unscaled pockets. Sodium hypochlorite constitutes a valuable antiseptic in periodontal self‐care.