Predictive value of clinical and microbiological parameters for the treatment outcome of scaling and root planing.
OBJECTIVE
To compare the clinical and microbiological outcome of non-surgical periodontal therapy after 6 months with data obtained after hygienic phase or 6 weeks after completion of non-surgical therapy, in order to evaluate the value of clinical and microbiological parameters to predict treatment success.


METHODS
Clinical and microbiological data were available from 271 sites in 10 systemically healthy non-smokers with moderate-to-advanced chronic periodontal disease (24-32 sites per individual). Subgingival plaque samples were tested for the presence of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Tannerella forsythensis and Treponema denticola using RNA probes.


RESULTS
Stepwise multiple linear regression analysis revealed a significant impact of the number of sites with visible plaque index >1 after hygienic phase on the bleeding tendency of a subject at month 6 (p<0.01). Furthermore, an association could be demonstrated between the number of residual pockets (PD>3 mm) 6 months after therapy and the number of bleeding sites and suppurating sites after hygienic phase (p=0.016). Six weeks after therapy, the mean total bacterial loads had a significant impact on the bleeding tendency of a subject at month 6 (p<0.01). Although the average numbers of sites with persisting P. gingivalis, A. actinomycetemcomitans, T. forsythensis and T. denticola seemed to be very similar 6 weeks and 6 months after therapy, large variations were noted between subjects, and therefore the microbiological status of a subject at week 6 could not predict the status at month 6.


CONCLUSIONS
The present study showed a limited potential of microbiological tests, performed after hygienic phase or shortly after non-surgical periodontal therapy, to predict the clinical outcome 6 months later, but confirmed the importance of an establishment of perfect oral hygiene before non-surgical therapy.
Brochut
P F
PF
School of Dental Medicine, University of Geneva, CH-1211 Geneva 4, Switzerland. patrick.brochut@medecine.unige.ch
Marin
I
I
Baehni
P
P
Mombelli
A
A
D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D001439:Bacteroides / Q000302:isolation & purification; D015169:Colony Count, Microbial; D003773:Dental Plaque / Q000382:microbiology*; D012534:Dental Scaling; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000382:microbiology* / Q000628:therapy*; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D011237:Predictive Value of Tests; D011379:Prognosis; D012329:RNA, Bacterial / Q000032:analysis; D016896:Treatment Outcome; D048373:Treponema denticola / Q000302:isolation & purification
D012329:RNA, Bacterial