Repeated scaling versus surgery in young adults with generalized advanced periodontitis.
BACKGROUND
Residual probing depth (PD) after subgingival scaling can be treated with repeated scaling or periodontal surgery. Ambiguous results about the additional clinical benefit of a second scaling procedure exist. Therefore, we performed a prospective study comparing the clinical results of repeated subgingival scaling versus periodontal surgery in 30- to 40-year-old subjects with generalized advanced periodontitis.


METHODS
Twenty-six subjects (mean age, 37 +/- 3 years) were treated after an initial examination (t(1)), initial subgingival scaling, and baseline examination (t(2)) with a randomly assigned second subgingival scaling (test) and periodontal surgery (control) in a split-mouth design. The final examination (t(3)) took place 6 months postoperatively. Intraindividual comparisons of mean PD and clinical attachment level (CAL) were analyzed.


RESULTS
PD was reduced from 4.1 +/- 0.2 mm initially (t(1)) to 3.1 +/- 0.1 mm at baseline (t(2)), and to 2.9 +/- 0.1 mm at the end of the study (t(3)) for the test sites; and from 4.5 +/- 0.2 mm (t(1)) to 3.5 +/- 0.1 mm (t(2)), and 3.1 +/- 0.1 mm (t(3)) for the control sites. The total PD decrease from t(1) to t(3) was significant (P <0.001) for both therapies. PD reduction from t(2) to t(3) was only significant (P <0.001) for control sites, resulting in a significant (P = 0.010) difference between test and control at the final examination. CAL increased 0.2 +/- 0.1 mm (t(2)) plus 0.3 +/- 0.1 mm (t(3)) for the test sites and 0.2 +/- 0.1 mm (t(2)) plus 0.2 +/- 0.1 mm (t(3)) for the control sites. Total CAL gain was statistically significant for the test and control sites. CAL gain from t(2) to t(3) was only significant (P = 0.022) for the test sites.


CONCLUSIONS
Both treatments reduced PD and increased CAL. A second subgingival scaling resulted in significant additional CAL gain and reduced the need for surgery.
Unit of Periodontology, School of Dentistry, University of Greifswald, Greifswald, Germany. jorgen.konig@orebroll.se
Jörgen
J
König
Christian
C
Schwahn
Jutta
J
Fanghänel
Jutta
J
Plötz
Thomas
T
Hoffmann
Thomas
T
Kocher
D000328:Adult; D012534:Dental Scaling; D005889:Gingival Recession / Q000628:therapy; D006801:Humans; D019647:Oral Surgical Procedures; D017622:Periodontal Attachment Loss / Q000628:therapy; D010512:Periodontal Index; D010518:Periodontitis / Q000601:surgery* / Q000628:therapy*; D011446:Prospective Studies; D019233:Retreatment