title: Clinical and microbiological benefits of strict supragingival plaque control as part of the active phase of periodontal therapy.
abstract: OBJECTIVE
  To compare the clinical and microbiological effects of scaling and root planing (SRP) alone or combined with mechanical [professional plaque control (PPC)] or chemical [chlorhexidine rinsing (CHX)] control of supragingival plaque in the treatment of chronic periodontitis.
  
  
  METHODS
  Sixty subjects were randomly assigned to receive SRP alone or combined with PPC (twice a week) or with CHX rinsing (twice a day). The adjunctive treatments began with SRP and were continued for 42 days. Clinical and microbiological examinations were performed at baseline, 2 and 6 months post-therapy. Subgingival plaque samples were analysed for 38 bacterial species by checkerboard DNA-DNA hybridization.
  
  
  RESULTS
  The two test treatments were more effective in improving probing depth and clinical attachment level (CAL) than SRP alone, even in intermediate and deep sites. CAL gain was better maintained in the CHX group. The most beneficial microbiological changes were observed in CHX-treated subjects, who showed a significant reduction in the proportions of red and orange complexes, as well as an increase in the proportions of the host-compatible bacterial species.
  
  
  CONCLUSIONS
  Strict plaque control performed during and after SRP improves periodontal treatment outcomes. The greatest microbiological and clinical benefits were observed with the use of CHX rinsing.
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil. mferes@ung.br
authors.forename: Magda
authors.initials: M
authors.lastname: Feres
authors.forename: Lauren Christine
authors.initials: LC
authors.lastname: Gursky
authors.forename: Marcelo
authors.initials: M
authors.lastname: Faveri
authors.forename: Claudia Ota
authors.initials: CO
authors.lastname: Tsuzuki
authors.forename: Luciene Cristina
authors.initials: LC
authors.lastname: Figueiredo
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001419:Bacteria / Q000145:classification; D002710:Chlorhexidine / Q000627:therapeutic use; D055113:Chronic Periodontitis / Q000628:therapy*; D015169:Colony Count, Microbial; D045424:Complex Mixtures / Q000627:therapeutic use; D004269:DNA, Bacterial / Q000032:analysis; D003773:Dental Plaque / Q000382:microbiology / Q000517:prevention & control*; D003777:Dental Prophylaxis; D012534:Dental Scaling; D003802:Dentifrices / Q000627:therapeutic use; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D005884:Gingival Hemorrhage / Q000628:therapy; D054884:Host-Pathogen Interactions; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D009693:Nucleic Acid Hybridization; D009910:Oral Hygiene; D017622:Periodontal Attachment Loss / Q000628:therapy; D010514:Periodontal Pocket / Q000628:therapy; D010919:Placebos; D016745:Root Planing; D012824:Silicic Acid; D014100:Toothpastes; D016896:Treatment Outcome; D014260:Triclosan / Q000627:therapeutic use
chemical_list: D000891:Anti-Infective Agents, Local; D045424:Complex Mixtures; D004269:DNA, Bacterial; D003802:Dentifrices; D009067:Mouthwashes; D010919:Placebos; D014100:Toothpastes; C546060:hydrated silica gel-based toothpaste; D012824:Silicic Acid; D014260:Triclosan; D005459:Fluorides; D002710:Chlorhexidine
references.citation: J Clin Periodontol. 2005 Apr;32(4):406-11
references.pmid: 15811059
references.citation: J Clin Periodontol. 1998 Feb;25(2):134-44
references.pmid: 9495612
references.citation: J Clin Periodontol. 2004 Aug;31(8):609-14
references.pmid: 15257736
references.citation: J Clin Periodontol. 1982 Mar;9(2):115-28
references.pmid: 7042768
references.citation: J Periodontol. 2001 Mar;72(3):374-82
references.pmid: 11327066
references.citation: Periodontol 2000. 2002;28:12-55
references.pmid: 12013340
references.citation: Biotechniques. 1994 Oct;17(4):788-92
references.pmid: 7833043
references.citation: J Clin Periodontol. 2006 Sep;33(9):639-47
references.pmid: 16856902
references.citation: J Clin Periodontol. 2003 Jul;30(7):644-54
references.pmid: 12834503
references.citation: J Clin Periodontol. 1984 Mar;11(3):193-207
references.pmid: 6368611
references.citation: Ann Periodontol. 1999 Dec;4(1):1-6
references.pmid: 10863370
references.citation: J Periodontol. 2006 Sep;77(9):1539-46
references.pmid: 16945032
references.citation: J Clin Periodontol. 2006 Nov;33(11):819-28
references.pmid: 16965522
references.citation: J Clin Periodontol. 1976 Feb;3(1):38-53
references.pmid: 767366
references.citation: J Periodontol. 2003 Dec;74(12):1736-40
references.pmid: 14974813
references.citation: J Clin Periodontol. 2000 Sep;27(9):637-47
references.pmid: 10983597
references.citation: J Periodontol. 2007 Nov;78(11):2127-34
references.pmid: 17970679
references.citation: Clin Oral Implants Res. 2008 Oct;19(10):975-82
references.pmid: 18828812
references.citation: J Clin Periodontol. 1975 Apr;2(2):80-6
references.pmid: 1094035
references.citation: J Clin Dent. 2008;19(3):85-94
references.pmid: 19301514
references.citation: Int Dent J. 2003;53 Suppl 3:191-9
references.pmid: 12875308
references.citation: J Clin Periodontol. 2004 Dec;31(12):1070-6
references.pmid: 15560807
references.citation: Oral Microbiol Immunol. 2008 Jun;23(3):196-205
references.pmid: 18402605
references.citation: J Clin Periodontol. 2000 Oct;27(10):722-32
references.pmid: 11034118
references.citation: J Clin Periodontol. 1991 Nov;18(10):766-75
references.pmid: 1661305
references.citation: J Clin Periodontol. 1983 Mar;10(2):148-56
references.pmid: 6573341