Comparison of four methods of assessing root surface debridement

Background: While there is great interest in measuring the efficacy of root surface debridement, there is little consensus on how this might be best a chieved. The aim of this study was therefore to compare four different meth ods of assessing root surface debridement in their ability to discriminate between ultrasonically instrumented root surfaces and non-instrumented cont rol surfaces. Methods: Single-session subgingival root debridement was performed by an ex perienced operator on 30 teeth prior to their extraction. Following extract ion, efficacy of root surface debridement was measured by percentage of rem aining calculus, instrument efficiency, modified instrument efficiency, and percentage apical plaque border. In addition, the effect of probing depth landmark (apical plaque border versus connective tissue attachment) on outc omes was assessed. Results: The results indicated that percentage apical plaque border demonst rated highly statistically significant differences between instrumented and control surfaces (P = 0.02). No other assessment method was able to discri minate between instrumented and non-instrumented surfaces, and this may be a function of the low amount of root surface calculus in the experimental s ample. In addition, choice of probing depth landmark had a notable effect o n the outcomes for instrument efficiency and modified instrument efficiency . Ninety-five percent limits of agreement of interexaminer reproducibility were found to be much higher than intra-examiner measurement for all four m ethods of assessment. Conclusions: Percentage apical plaque border appeared to be potentially mor e useful than other methods for assessing the efficacy of debridement of pe riodontally involved root surfaces, particularly for measuring instrument p enetrability.