Effectiveness of oral hygiene with and without root planing in treating subjects with chronic periodontitis

The extent to which patients with chronic periodontitis could improve their condition by oral hygiene without instrumentation was investigated. Ten subjects were assessed, instructed in a subgingivally-directed oral hygiene technique (OH) twice a week until plaque was present at less than 20% of sites on two occasions and reassessed after 6 weeks when half the mouth was root planed. A final assessment took place after a further 6 weeks. At six weeks the mean number of sites with bleeding on probing (BOP) was significantly reduced (P < 0.001), the percentage of sites with BOP falling from 59% to 34%. In addition, an increase in gingival recession (P < 0.001) was accompanied by a reduction in mean probing depths (PD) (P < 0.05). The mean percentage reduction in sites with BOP was greatest for sites with probing depths less than 4 mm at baseline but even at sites with PD of 6 mm or more the mean BOP reduced from 81% to 57% of sites. Root planing at 6 weeks resulted in further significant reductions at 12 weeks in both BOP (to 10% of all sites) and in PD (P < 0.001), but there was little further change for the sites receiving OH alone. There was some evidence that this adjunctive effect of root planing was also present at sites with a PD less than 4 mm at baseline and at sites without retention factors at or below the gingival margin. The results indicate that patients with chronic periodontitis can improve their periodontal condition by OH alone even in deep pockets.(ABSTRACT TRUNCATED AT 250 WORDS)