Cml. Bollen et al., FULL-MOUTH VERSUS PARTIAL-MOUTH DISINFECTION IN THE TREATMENT OF PERIODONTAL INFECTIONS - A PILOT-STUDY - LONG-TERM MICROBIOLOGICAL OBSERVATIONS, Journal of clinical periodontology, 23(10), 1996, pp. 960-970
A standard periodontal treatment consists of 4 to 6 scalings and root-
planings at a 1- to 2-week interval, which allows reinfection of a pre
viously disinfected area before completion of the treatment. The prese
nt pilot study aims to examine the microbiological long-term effects o
f a full-mouth disinfection. 10 patients with advanced chronic periodo
ntitis were randomly allocated to a test and control group. The patien
ts from the control group received scaling and root-planing and oral h
ygiene instructions at a 2-week interval. The full-mouth disinfection
(test group) consisted of a full-mouth scaling and rootplaning in 2 vi
sits within 24 h in combination with: tongue brushing with 1% chlorhex
idine gel for 1 min, mouth rinsing with 0.2% chlorhexidine solution fo
r 2 min and subgingival irrigation of all pockets (3x in 10 min) with
1% chlorhexidine gel. The patients of the test group were instructed t
o rinse 2x daily with 0.2% chlorhexidine. Plaque samples were taken at
baseline and after 1, 2, 4 and 8 months. Differential phase-contrast
microscopy showed a significantly larger reduction of spirochetes and
motile organisms in the test group up to month 2 for the single-rooted
and up to month 8 for the multi-rooted teeth. Furthermore, the cultur
e data supported the effectiveness of the new treatment strategy. In b
oth groups, the number of anaerobic CFU decreased 1 log around single-
and 0.5 log around multi-rooted teeth. The number of anaerobic CFU re
mained low in the test group, in contrast to the control group. At 1 m
onth, the test group harboured a significantly (p<0.01) lower proporti
on of pathogenic organisms, but this difference disappeared with time.
Moreover, the test sites showed a significantly higher (p<0.02) incre
ase in the proportion of beneficial micro-organisms up to 4 months. Th
ese findings suggest that a full-mouth disinfection leads to a signifi
cant microbiological improvement up to 2 months, which could be consol
idated, although not significant, for the next 6 months.