IADR Abstract Archives
Quadrant-Wise vs. Full-Mouth Periodontal Treatment Impact on Parameters in Periodontitis
Objectives: The present randomized-controlled clinical trial assessed the efficacy of quadrant-wise subgingival instrumentation (Q-SI) versus one-stage full-mouth subgingival instrumentation (FM-SI) on probing depth and periodontal bacteria reduction after 6 months of follow-up, as well as the influence of baseline levels of periodontal bacteria on the effectiveness of periodontal treatment protocols on outcomes.
Methods: Subjects with periodontitis were randomly allocated to receive Q-SI (n=43) or FM-SI (n=45) and they were instructed and motivated on oral hygiene maintenance during the treatment sessions. Periodontal indices (probing pocket depth [PPD], clinical attachment loss [CAL], and bleeding on probing [BOP]) as well as oral pathogens were assessed at baseline and after 30, 90, and 180 days. Periodontal pathogens and total bacterial load were assessed through real-time PCR.
Results: After 6 months, the median PPD improved from 4.8 mm (interquartile range [IQR]: 4.3-5.2) to 2.6 mm (IQR: 2.3-2.9) in FM-SI group and from 4.7 mm (IQR: 4.1-5.2) to 3.2 mm (IQR: 2.4-3.5) in Q-SI group (p<0.001). At 6 months, FM-SI resulted more effectively in reducing the median levels of Porphyromonas gingivalis (Pg), Aggregatibacter actinocomyctemcomitans, and Tannerella forsythus (Tf) (p<0.001 for each value). Multilevel linear regression analysis showed that high baseline PPD (p=0.029), Pg (p=0.014), and Tf (p<0.001) levels and the FM-SI protocol (p<0.001) were significant predictors of PPD reduction after 6 months. Moreover, PPD reduction was significantly higher in the FM-SI group when lower baseline Pg levels were detected.
Conclusions: The FM-SI resulted more effectively compared to the Q-SI in improving the mean PPD and number of periodontal pathogens in patients with periodontitis after 6 months. Moreover, greater baseline PPD and Pg negatively impacted PPD reduction after 6 months in FM-SI group.
Methods: Subjects with periodontitis were randomly allocated to receive Q-SI (n=43) or FM-SI (n=45) and they were instructed and motivated on oral hygiene maintenance during the treatment sessions. Periodontal indices (probing pocket depth [PPD], clinical attachment loss [CAL], and bleeding on probing [BOP]) as well as oral pathogens were assessed at baseline and after 30, 90, and 180 days. Periodontal pathogens and total bacterial load were assessed through real-time PCR.
Results: After 6 months, the median PPD improved from 4.8 mm (interquartile range [IQR]: 4.3-5.2) to 2.6 mm (IQR: 2.3-2.9) in FM-SI group and from 4.7 mm (IQR: 4.1-5.2) to 3.2 mm (IQR: 2.4-3.5) in Q-SI group (p<0.001). At 6 months, FM-SI resulted more effectively in reducing the median levels of Porphyromonas gingivalis (Pg), Aggregatibacter actinocomyctemcomitans, and Tannerella forsythus (Tf) (p<0.001 for each value). Multilevel linear regression analysis showed that high baseline PPD (p=0.029), Pg (p=0.014), and Tf (p<0.001) levels and the FM-SI protocol (p<0.001) were significant predictors of PPD reduction after 6 months. Moreover, PPD reduction was significantly higher in the FM-SI group when lower baseline Pg levels were detected.
Conclusions: The FM-SI resulted more effectively compared to the Q-SI in improving the mean PPD and number of periodontal pathogens in patients with periodontitis after 6 months. Moreover, greater baseline PPD and Pg negatively impacted PPD reduction after 6 months in FM-SI group.