Efficacy of full-mouth disinfection vs quadrant root planing

This article addresses the capability of full-mouth disinfection, full-mouth root planing, and partial-mouth disinfection to improve periodontal health. A basic premise of full-mouth therapy (full-mouth disinfection or full-mouth root planing) is to eradicate or diminish bacterial reservoirs in the mouth that could impede optimal healing or initiate periodontal disease or disease progression. Several investigations conducted at one university indicated that full-mouth disinfection and full-mouth root planing achieved greater therapeutic improvements compared with partial-mouth disinfection regarding decreased probing depths, gained clinical attachment, diminished bleeding from probing, and reduced subgingival microflora. In contrast, other studies from 2 treatment centers demonstrated that there were no statistically significant differences when the effectiveness of quadrant-by-quadrant root planing was compared with full-mouth root planing and full-mouth disinfection regarding probing depth reduction, gains of clinical attachment, and impact on the magnitude and quality of the immune response. Theoretically, full-mouth therapy could decrease the number of patent visits and allow more efficient use of treatment time. Furthermore, no major adverse reactions to full-mouth root planing with or without adjunctive chemotherapy are evident. Nevertheless, small study populations and noncorroborating data from different treatment centers indicate that more clinical trials are required to determine whether full-mouth therapy provides clinically relevant improvements compared with partial-mouth disinfection.