Periodontal debridement as a therapeutic approach for severe chronic periodontitis: a clinical, microbiological and immunological study.
OBJECTIVE
To clinically, microbiologically and immunologically characterize periodontal debridement as a therapeutic approach for severe chronic periodontitis.


METHODS
Twenty-five patients presenting at least eight teeth with a probing pocket depth (PPD) of >or=5 mm and bleeding on probing (BOP) were selected and randomly assigned to quadrant-wise scaling and root planing or one session of full-mouth periodontal debridement. The following clinical outcomes were assessed: plaque index, BOP, position of gingival margin, relative attachment level (RAL) and PPD. Real-time PCR was used for quantitative analysis of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia. The enzyme-linked immunosorbent assay permitted the detection of IL-1beta, prostaglandin E(2), INF-gamma and IL-10 in gingival crevicular fluid (GCF). All the parameters were evaluated at baseline, and at 3 and 6 months after treatment.


RESULTS
Both the groups had similar means of PPD reduction and attachment gain over time. Besides a significant reduction in the bacterial level after treatment in both groups, microbiological analysis failed to demonstrate significant differences between them. Finally, no difference was observed between groups with respect to the levels of inflammatory mediators in GCF.


CONCLUSIONS
Periodontal debridement resulted in a similar clinical, microbiological and immunological outcome when compared with standard scaling and root planing and therefore may be a viable approach to deal with severe chronic periodontitis.
Del Peloso Ribeiro
Erica
E
Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, University of Campinas-UNICAMP, Brazil.
Bittencourt
Sandro
S
Sallum
Enilson A
EA
Nociti
Francisco H
FH
Gonçalves
Reginaldo Bruno
RB
Casati
Márcio Zaffalon
MZ
D000328:Adult; D000368:Aged; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D001439:Bacteroides / Q000302:isolation & purification; D055113:Chronic Periodontitis / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D015169:Colony Count, Microbial; D003774:Dental Plaque Index; D012534:Dental Scaling / Q000295:instrumentation / Q000379:methods*; D015232:Dinoprostone / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D005883:Gingival Crevicular Fluid / Q000276:immunology; D005884:Gingival Hemorrhage / Q000276:immunology / Q000382:microbiology / Q000628:therapy; D005889:Gingival Recession / Q000276:immunology / Q000382:microbiology / Q000628:therapy; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis; D016753:Interleukin-10 / Q000032:analysis; D053583:Interleukin-1beta / Q000032:analysis; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000276:immunology / Q000382:microbiology / Q000628:therapy; D010514:Periodontal Pocket / Q000276:immunology / Q000382:microbiology / Q000628:therapy; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D016745:Root Planing / Q000379:methods; D016037:Single-Blind Method; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation / Q000379:methods*
D053583:Interleukin-1beta; D016753:Interleukin-10; D007371:Interferon-gamma; D015232:Dinoprostone