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

Area of Science:

• Dentistry
• Periodontology

Background:

• Scaling and root planing (S&RP) is a fundamental procedure in periodontal therapy.
• Operator experience and surgical access are potential factors influencing S&RP effectiveness.

Purpose of the Study:

• To evaluate the impact of operator experience and root surface access (open vs. closed procedures) on the effectiveness of scaling and root planing (S&RP).

Main Methods:

• 114 periodontally involved teeth were treated by four operators with varying experience levels using either open or closed S&RP.
• Teeth were extracted post-treatment and blindly scored for residual calculus.
• Statistical analysis compared effectiveness based on pocket depth, operator experience, and procedure type.

Main Results:

• No significant difference in S&RP effectiveness was found for shallow pockets (1-3 mm) regardless of experience or procedure type.
• In moderate (4-6 mm) and deep (>6 mm) pockets, open flap S&RP was significantly more effective than closed S&RP for all operators.
• More experienced operators achieved significantly cleaner root surfaces in moderate and deep pockets compared to less experienced operators.

Conclusions:

• Surgical access (open flap procedure) improves S&RP effectiveness in moderate to deep periodontal pockets.
• Operator experience is a critical factor for achieving thorough root surface debridement, particularly in advanced periodontal disease.
• These findings support the use of surgical interventions for comprehensive calculus removal in deeper periodontal pockets.