FULL-VS PARTIAL-MOUTH DISINFECTION IN THE TREATMENT OF PERIODONTAL INFECTIONS - SHORT-TERM CLINICAL AND MICROBIOLOGICAL OBSERVATIONS

In a standard periodontal treatment strategy with consecutive root pla nings (per quadrant at a one- to two-week interval), re-infection of a disinfected area might occur before completion of the treatment. This study examines, both clinically and microbiologically, whether a full -mouth disinfection within 24 hours significantly improves the outcome of periodontal treatment. Ten patients with advanced chronic periodon titis were randomly allocated to a test and a control group. The patie nts from the control group received scalings and root planings as well as oral hygiene instructions per quadrant at two-week intervals. Full -mouth disinfection in the test group was sought by the removal of all plaque and calculus (in two visits within 24 hours). In addition, at each of these visits, the tongue was brushed with a 1% chlorhexidine g el for one min and the mouth rinsed with a 0.2% chlorhexidine solution for two min. Furthermore, subgingival chlorhexidine (1%) irrigation w as performed in all pockets. The recolonization of the pockets was ret arded by oral hygiene and 0.2% chlorhexidine rinses during two weeks. The clinical parameters were recorded, and plaque samples were taken f rom the right upper quadrant at baseline and after one and two months. The test group patients showed a significantly higher reduction in pr obing depth for deep pockets at both follow-up visits (p < 0.05). At t he one-month visit, differential phase-contrast microscopy revealed si gnificantly lower proportions of spirochetes and motile rods in the te st group (p = 0.01). Culturing showed that the test group harbored sig nificantly fewer pathogenic organisms at one month (p = 0.005). At two months, the same sites harbored significantly more ''beneficial'' bac teria (p = 0.02). Moreover, all sites of the test group initially harb oring P. gingivalis (6/10) became negative after treatment. These find ings suggest that it is possible to achieve a significant improvement of the treatment outcome (both microbiologically and clinically) with a one-stage full-mouth disinfection.