One stage full- versus partial-mouth disinfection in the treatment of chronic adult or generalized early-onset periodontitis. II. Long-term impact onmicrobial load

Background: Recent studies showed the clinical benefits of a one stage full -mouth disinfection, when compared to the worldwide standard treatment stra tegy of consecutive root planings per quadrant without proper disinfection of the remaining intraoral niches. The purpose of this study was to investi gate the microbiological benefits of such a one stage full-mouth disinfecti on with special attention to all intraoral niches for periodontopathogens a nd to evaluate the perception by the patients of the new treatment strategy . Methods: Sixteen patients with early-onset periodontitis and 24 patients wi th severe adult periodontitis were randomly assigned to test and control gr oups. The control group was scaled and root planed, per quadrant, at 2-week intervals and given oral hygiene instructions. The test group received the one stage full-mouth disinfection treatment. At baseline and after 1, 2, 4 , and 8 months, microbiological samples were taken from all niches (tongue, mucosa, saliva, and pooled samples from single- and multi-rooted teeth). T he samples were cultured on selective and non-selective media. Patient perc eption of the treatment was evaluated using a questionnaire. Results: In comparison to the standard therapy, the one stage full-mouth di sinfection resulted in significant additional microbial improvements. The t est group showed larger reductions in the proportions of spirochetes and mo tile organisms in the subgingival flora, and more significant reductions in the density of key pathogens, with even the eradication of P. gingivalis. The beneficial effects. in the other niches were primarily restricted to th e number of colony-forming units/ml of black-pigmented bacteria, especially on the mucosa and in the: saliva and to a lesser extent on the tongue. Bot h treatments were well tolerated by the patients and the overall severity r ating for both therapies was comparable, although 4 quadrants were treated within 24 hours in the test group ver; sus only 1 in the control group. The full-mouth disinfection approach resulted more frequently in a slight incr ease of body temperature, especially after the second day. Conclusions: These findings support the benefit of a one stage full-mouth d isinfection in the treatment of patients with either chronic adult or early -onset periodontitis.