Cml. Bollen et al., THE EFFECT OF A ONE-STAGE FULL-MOUTH DISINFECTION ON DIFFERENT INTRAORAL NICHES - CLINICAL AND MICROBIOLOGICAL OBSERVATIONS, Journal of clinical periodontology, 25(1), 1998, pp. 56-66
A treatment for periodontal infections often consists of consecutive r
ootplanings (per quadrant, at a 1- to 2-week interval), without a prop
er disinfection of the remaining intra-oral niches (untreated pockets,
tongue, saliva, mucosa and tonsils). Such an approach, could theoreti
cally lead to a reinfection of previously-treated pockets. The present
study aims to examine the effect of a full-mouth disinfection on the
microbiota in the above-mentioned niches. Moreover, the clinical benef
it of such an approach was investigated, 16 patients with severe perio
dontitis were randomly allocated to a test and a control group, The pa
tients from the control group were sealed and rootplaned, per quadrant
, at 2-week intervals and obtained oral hygiene instructions. The pati
ents from the test group received a full-mouth disinfection consisting
of scaling and rootplaning of all pockets in 2 visits within 24 h. in
combination with tongue brushing with 1% chlorhexidine gel for 1 min,
mouth rinsing with a 0.2% chlorhexidine solution for 2 min and subgin
gival irrigation of all pockets (3x in 10 min) with 1% chlorhexidine g
el. Besides oral hygiene, the test group rinsed 2x daily with 0.2% chl
orhexidine and sprayed the tonsils with a 0.2% chlorhexidine for 2 mon
ths, Plaque samples (pockets, tongue, mucosa and saliva) were taken at
baseline and after 2 and 4 months, and changes in probing depth. atta
chment level and bleeding on probing were reported, The full-mouth dis
infection resulted in a statistically significant: additional reductio
n elimination of periodontopathogens, especially in the subgingival po
ckets, but also in the other niches, These microbiological improvement
s were reflected in a statistically-significant higher probing depth r
eduction and attachment gain in the test patients. These findings sugg
est that a disinfection of all intra-oral niches within a, short time
span leads to significant clinical and microbiological improvements fo
r up to 4 months.