A randomized four-years study of periodontal therapy

Area of Science:

• Periodontology
• Oral Health
• Regenerative Medicine

Background:

• Periodontitis is a chronic inflammatory disease affecting the gums and supporting bone.
• Effective treatment is crucial to prevent tooth loss and systemic health complications.
• Long-term comparative effectiveness of surgical versus non-surgical periodontal therapy remains an area of interest.

Purpose of the Study:

• To compare the long-term effectiveness of scaling and root planing (SRP) alone versus SRP followed by periodontal surgery.
• To evaluate treatment outcomes in patients with moderate to advanced periodontitis over a 4-year period.

Main Methods:

• Seventeen subjects with moderate to advanced periodontitis underwent SRP and oral hygiene instruction.
• A modified Widman flap surgical procedure was randomly performed on one-half of each subject's dentition.
• Subjects were followed for 4 years with regular prophylaxis and oral hygiene reinforcement.

Main Results:

• Both SRP alone and SRP with surgery reduced probing depths and improved attachment levels for pockets 4-6 mm and ≥7 mm.
• Pockets ≥7 mm showed the greatest reduction in depth and gain in attachment level.
• Gingivitis was reduced, and calculus was removed by both treatment modalities; no difference in plaque retention was observed.
• The surgical approach demonstrated a trend towards greater pocket reduction and attachment gain in deeper pockets.

Conclusions:

• Both SRP alone and SRP with periodontal surgery are effective in managing moderate to advanced periodontitis.
• Periodontal surgery may offer additional benefits for deeper periodontal pockets, leading to greater reduction and attachment gain.
• Long-term maintenance and oral hygiene are critical for sustained treatment success in periodontitis management.