Significance of frequency of professional tooth cleaning for healing following periodontal surgery

Abstract

The present investigation was undertaken to study the significance of frequently repeated professional tooth cleaning for healing results following periodontal surgery. 24 patients suffering from moderately advanced periodontal disease were selected for the study. Following a Baseline examination comprising assessment of oral hygiene status, gingival conditions, probing depths and attachment levels, all patients were given detailed instruction in proper oral hygiene measures. They were then subjected to periodontal surgery using the modified Widman flap procedure. During the initial 6 months after surgery all patients were enrolled in a maintenance care program which included measures such as scaling and professional tooth cleaning. The patients were randomly distributed into 3 different maintenance care groups. 8 patients (Group 1) received maintenance care once every 2 weeks, another 8 patients (Group 2) received a similar treatment once every 4 weeks while the remaining 8 patients (Group 3) were recalled once every 12 weeks. Following a reexamination at the termination of this 6month period the recall program was changed. Thus, during the subsequent 18 months of maintenance (the maintenance phase) all 24 patients were recalled for prophylaxis once every 3 months. A final reexamination was performed 24 months after completion of active therapy.The reexamination performed 6 months after surgery revealed that while patients who had been recalled for professional tooth cleaning once every 2 weeks had low numbers of inflamed gingival units and deep (>3 mm) periodontal pockets, test subjects recalled less frequently exhibited an increasing number of inflamed gingival units and deep pockets. In addition, the frequency of sites exhibiting attachment loss of > 1 mm was closely related to the frequency of maintenance care. Patients recalled once every 12 weeks for maintenance therapy had 3 times the number of sites with attachment loss (>1 mm) as compared to those who were recalled once every 2 weeks. With the use of regression analysis critical probing depth values were calculated. This analysis showed that while the critical probing depth value was Sow in patients frequently recalled during the healing phase, this parameter adopted gradually increasing values in patients recalled with less frequent intervals. Between the 6‐ and 24‐month reexaminations there were no significant alterations of the oral hygiene status, the gingival condition or the probing depth and attachment level data in any of the 3 groups of patients.