THE EFFECT OF SUPRAGINGIVAL PLAQUE CONTROL ON THE SUBGINGIVAL MICROFLORA IN HUMAN PERIODONTITIS

The aim of the present trial was to study if carefully practiced supra gingival plaque control influenced the subgingival microbiota at perio dontal sites with suprabony, infrabony, or furcation pockets. 12 subje cts, 5 males and 7 females aged 44 to 69 years (mean age 55 years) par ticipated in the study. None of the participants had during the last 1 2 months received periodontal therapy, and none of the subjects had us ed antibiotics during a 3-month period preceding the study. Following a screening examination, 6 to 8 sites per subject were selected which had a probing depth of greater than or equal to 5 mm. Among these site s, 1-3 sites had a suprabony location, 1-3 sites had an infrabony loca tion, and 1-3 sites were associated with a furcation defect. The selec ted sites were exposed to a baseline examination at which the followin g parameters were recorded: plaque, gingivitis, probing pocket depth a nd probing attachment level. A bacterial sample was obtained from each of the selected sites: 2 sterile paper points were inserted into the pocket and kept in place for 30 seconds. The paper point samples were removed, placed in a vial containing an anaerobically prepared transpo rt medium, and processed using routine procedures. Following the basel ine examination, each subject was given a case presentation, received thorough supragingival scaling and was instructed to practice proper p laque control with the use of toothbrush and dentifrice. During the su bsequent 30 weeks they were recalled 2-3xper week for professional too th cleaning. Each session was handled by a dental hygienist and requir ed about 15 min. Re-examinations were performed after 30 weeks. The fi ndings indicated that professionally delivered and frequently repeated supragingival tooth cleaning, combined with careful self-performed pl aque control had a marked effect on the subgingival microbiota of mode rate to deep periodontal pockets. Thus, at sites with suprabony and in frabony pockets, as well as at furcation sites, the meticulous and pro longed supragingival plaque removal reduced the total number of microo rganisms that could be harvested, as well as the % of sites with P. gi ngivalis.