Scaling and root planing effectiveness: the effect of root surface access and operator experience

This study investigated two variables associated with scaling and planning (S&RP): operator experience level and root surface access. One hundred and fourteen periodontally involved, single-rooted teeth designated for extraction were randomly distributed among four operators of various experience levels for either an open or closed session of S&RP. Immediately after treatment, the teeth were extracted, washed, and scored for residual calculus in a blind manner. Results showed that there was no difference in S&RP effectiveness for experience level or type of procedure in shallow (1-3 mm) pockets. However, in moderate (4-6 mm) and deep (greater than 6 mm) periodontal pockets, S&RP combined with an open flap procedure was more effective than S&RP alone for both experience levels. Also, the more experienced operators produced a significantly greater number of calculus-free root surfaces than the less experienced operators in periodontal pockets with moderate and deep probing depths. Clinical application of these results suggests that surgical access is associated with thorough surface debridement in periodontal pockets with moderate-to-advanced probing depths. However, more experienced operators could be expected to render more effective soft surface debridement.