Scaling and Root Planing with Concomitant Subgingival Curettage

Non-surgical therapy is still an important technique in periodontal treatment. In this study, scaling and root planing(SRP) with or without concomitant subgingival curettage were compared clinically and microbiologically. 14 moderate adult periodontitis patients were included in this study. After 2 weeks from screening visit, with split mouth design, one quadrant was treated by SRP, and the opposite side was treated by SRP with subgingival curettage. Clinical measurement and microbiological analysis was taken at baseline, 1 month, 3 month post-treatment. Clinical parameters used in this study was probing depth, gingival recession, gingival index, bleeding on probing, plaque index, tooth mobility(Periotest Value). Microbiological analysis consisted of determination of the percentages of 4 bacterial groups according to morphologic type with phase-contrast microscope and measuring Black-pigmented Bacteroides after anaerobic culture. 1. There were significant changes in probing depth and gingival recession at 1 month(P<0.05), and these changes remained through 3 month. However, no significant differences were observed between two groups(P<0.05). 2. There were also significant reductions in gingival index and bleeding on probing at 1 month(P<0.05),and these reduced levels were maintained through 3 month with no significant differences between two groups(P<0.05). 3. In both groups, motile bacteria decreased significantly at 1 months(P<0.05), but increased nearly to baseline level at 3 month. 4. The percentages of Black-pigmented Bacteroides, in both groups, decreased significantly at 1 month(P<0.05), and in the subgingival curettage group, significant more reductions were observed than in the root planing group(P<0.05). At 3 month, significant reduction was found in subgingival curettage group only(P<0.05). According to these results, we surmised that concomitant subgingival curettage and root planing give some advantageous effect on bacterial recolonization.