LONG-TERM EVALUATION OF PERIODONTAL THERAPY .1. RESPONSE TO 4 THERAPEUTIC MODALITIES

EIGHTY-TWO PERIODONTAL PATIENTS were treated in a split mouth design w ith coronal scaling (CS), root planing (RP), modified Widman surgery ( MW), and flap with osseous resection surgery (FO) which were randomly assigned to various quadrants in the dentition. Therapy was performed in 3 phases: non-surgical, surgical, and supportive periodontal treatm ent (SPT) less than or equal to 7 years. Clinical data consisted of pr obing depth (PD), clinical attachment level (GAL), gingival recession (REC), bleeding on probing (BOP), suppuration (SUP), and supragingival plaque (PL). Because of the necessity to exit many CS treated sites d ue to breakdown, data for CS were reported only up to 2 years. All the rapies produced mean PD reduction with FO > MW > RP > CS following the surgical phase for all probing depth severities. By the end of year 2 there were no differences between the therapies in the 1 to 4 mm site s. There were no differences in PD reduction between MW and RP treated sites by the end of year 3 in the 5 to 6 mm sites and by the end of y ear 5 in the greater than or equal to 7 mm sites. FO produced greater PD reduction in greater than or equal to 5 mm sites through year 7 of SPT. Following the surgical phase, FO produced a mean CAL loss and CS and RP produced a slight gain in lit mm sites. RP and MW produced a gr eater gain of CAL than CS and FO following the surgical phase in 5 to 6 mm sites, but the magnitude of difference decreased during SPT. Simi lar CAL gains were produced by RP, MW, and FO in sites greater than or equal to 7 mm. These gains were greater than that produced by CS and were sustained during SPT. Recession was produced with FO > MW > RP > CS. This relationship was maintained through out SPT. The prevalences of BOP, SUP, and PL were greatly reduced throughout the study and were comparable between sites treated by RP, MW, and FO while the CS sites had more BOP and SUP.