Clinical and microbiological benefits of strict supragingival plaque control as part of the active phase of periodontal therapy.
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.
Feres
Magda
M
Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil. mferes@ung.br
Gursky
Lauren Christine
LC
Faveri
Marcelo
M
Tsuzuki
Claudia Ota
CO
Figueiredo
Luciene Cristina
LC
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
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
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