Full-mouth Disinfection vs. Quadrant-wise Therapy in the Management of Periodontitis

Objectives: To determine the clinical and microbiological effects of full-mouth disinfection in the treatment of chronic periodontitis compared to conventional quadrant-wise therapy. Methods: Thirty six systemically healthy, non-smoking subjects (23 females and 13 males, mean age: 50.39 ± 8.4 years) with chronic periodontitis, were included in this study, after obtaining informed consent. The subjects were randomly allocated to three treatment groups - conventional quadrant-wise ultrasonic debridement (QMD), one-stage full-mouth disinfection with povidone iodine as irrigant (FMD) and full-mouth ultrasonic debridement with water as irrigant (FRP). Full-mouth measurements of clinical parameters such as plaque percentage (Pl), bleeding on probing (BOP), probing pocket depth (PPD) and probing attachment level (PAL) were performed at baseline, one month, three months and six months post-treatment by a blinded examiner. Subgingival plaque and saliva samples were also collected from the patients at these visits for quantitative microbiological analysis. Results: At baseline, there were no differences in the demographic features or clinical parameters between groups. After treatment, all treatment groups showed significant improvement in clinical parameters (p<0.0001). The full-mouth treatments resulted in greater, but not significant, improvements in full-mouth mean plaque and bleeding percentages, probing depths and attachment levels than conventional therapy. In initially deep and moderate pockets also, there was no difference between groups in the probing depth reduction or attachment gains. However, the total treatment time was significantly shorter in the full-mouth groups (p < 0.001). Regarding the microbiological findings, all treatment protocols resulted in reduction of periodontal bacteria. Although Porphyromonas gingivalis was reduced to a greater extent in the full-mouth disinfection group, there appeared to be no statistical difference between the groups. Conclusion: One-stage full-mouth disinfection may result in similar clinical and microbiological benefits as conventional quadrant-wise therapy in the treatment of chronic periodontitis. However, the treatment could be completed in a shorter time.