J Korean Acad Periodontol.  2009 Aug;39(Suppl):239-251.

The clinical effects of modified full-mouth disinfection in the treatment of moderate to severe chronic periodontitis patients

• Lee SH
• Kim YJ
• Chung HJ
• Kim OS

Abstract

PURPOSE: Full-mouth disinfection enables to reduce the probability of cross contamination from untreated pockets to treated ones, for completing the entire SRP under local anesthesia with chlorhexidine as a mouth wash in two visits within 24 hours. This study aimed to compare the clinical effects of modified full-mouth disinfection (Fdis) after 6 months with those of conventional SRP (cSRP).
METHODS
Thirty non-smoking chronic periodontitis subjects were randomly allocated two groups. The Fdis group underwent the entire SRP under local anesthesia in two visits within 24 hours, a week after receiving supragingival scaling. A chlorhexidine (0.1%) solution was used for rinsing and subgingival irrigation for Fdis. The cSRP group received SRP per quadrant under local anesthesia at one-week intervals, one week after they had received scaling. Clinical parameters were recorded at baseline, after 1, 3 and 6 months.
RESULTS
There are significant (P< 0.05) decreases in the sulcus bleeding index, and plaque index, and the increases in gingival recession were significantly smaller with Fdis after six months compared with cSRP. There was significant improvement in the probing depth and clinical attachment level for initially medium-deep pockets (4-6mm) after Fdis compared with cSRP. Multi-rooted teeth showed significantly larger attachment gain up to six months after Fdis. Single-rooted teeth showed significantly more attachment gain, 1 and 6 months after Fdis.
CONCLUSIONS
Fdis has more beneficial effects on reducing gingival inflammation, plaque level, probing depth, gingival recession and improving clinical attachment level over cSRP.

Keyword

chlorhexidine; dental scaling; disinfection; root planing.

MeSH Terms

Anesthesia, Local
Chlorhexidine
Chronic Periodontitis
Dental Scaling
Disinfection
Gingival Recession
Hemorrhage
Humans
Inflammation
Mouth
Tooth
Chlorhexidine

Figure

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  Figure 1 Mean PD and CAL for the sites treated by cSRP or Fdis according to single- or multi-rooted tooth. PD: probing pocket depth (mm), CAL: clinical attachment level (mm), control: conventional SRP, Fdis: full-mouth disinfection *: significant difference in parameters from the baseline in each treatment at P<0.05.

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  Figure 2 Mean PD and CAL for the sites treated by cSRP or Fdis according to BL or IP sites. PD: probing pocket depth (mm), CAL: clinical attachment level (mm). BL: buccolingual, IP: interproximal *: significant difference in parameters from the baseline in each treatment at P<0.05.

Reference

1. Quirynen M, De Soete M, Dierickx K, Van Steenberghe D. The intra-oral translocation of periodontopathogens jeopardises the outcome of periodontal therapy. A review of the literature. J Clin Periodontol. 2001. 28:499–507.

2. Bollen CML, Mongardini C, Papaioannou W, Van Steenberghe D, Quirynen M. The effect of a one-stage full-mouth disinfection on different intra-oral niches. Clinical and microbiological observations. J Clin Periodontol. 1998. 25:56–66.

3. Cobb CM. Non-surgical pocket therapy. Annals Periodontol. 1996. 1:443–490.

4. Goodson JM, Tanner A, McArdle S, Dix K, Watanabe SM. Multicenterevaluation of tetracycline fiber therapy. III. Microbiological response. J Periodontal Res. 1991. 26:440–451.

5. Harper DS, Robinson PJ. Correlation of histometric, microbial, and clinical indicators of periodontal disease status before and after root planing. J Clin Periodontol. 1987. 14:190–196.

6. Quirynen M, Bollen CML, Vandekerckhove BNA, et al. Full-versus partial-mouth disinfection in the treatment of periodontal infections: short-term clinical and microbiological observations. J Periodontal Res. 1995. 74:1459–1467.

7. Quirynen M, Mongardini C, De Soete M, et al. The role of chlohexidine in the one-stage full-mouth disinfection treatment of patients with advanced adult periodontitis. Long-term clinical and microbiological observations. J Clin Periodontol. 2000. 27:578–589.

8. Bollen CML, Vandekerckhove BNA, Papaioannou W, Van Eldere J, Quirynen M. Full- versus partial-mouth disinfection in the treatment of periodontal infections. A pilot study: long-term microbiological observations. J Clin Periodontol. 1996. 23:960–970.

9. Mongardini C, Van Steenberghe D, Dekeyser C, Quirynen M. One stage full- versus partial-mouth disinfection in the treatment of chronic adult or early-onset periodontitis. I. Long-term clinical observations. J Clin Periodontol. 1999. 70:632–645.

10. Cho IH, Jung UW, Cha JH, et al. Clinical evaluation of full mouth disinfection therapy. J Korean Acad Periodontol. 2005. 35(3):597–608.

11. Apatzidou DA, Kinane DF. Quadrant root planing versus same-day full-mouth root planing. J Clin Periodontol. 2004. 31:152–159.

12. Koshy G, Kawashima Y, Kiji M, et al. Effects of single-visit full-mouth ultrasonic debridement versus quadrant-wise ultrasonic debridement. J Clin Periodontol. 2005. 32:734–743.

13. Wennström JL, Tomasi C, Bertelle A, Dellaseg E. Full-mouth ultrasonic debridement versus quadrant scaling and root planing as an initial approach in the treatment of chronic periodontitis. J Clin Periodontol. 2005. 32:851–859.

14. Knöfler GU, Purschwitz RE, Jentsch HFR. Clinical evaluation of partial- and full-mouth scaling in the treatment of chronic periodontitis. J Periodontol. 2007. 11:2135–2142.

15. Moreira RM, Feres-Filho EJ. Comparison between full-mouth scaling and root planing and quadrant-wise basic therapy of aggressive periodontitis: 6-month clinical results. J Periodontol. 2007. 9:1683–1688.

16. Armitage GC. Development of a classification system for periodontal diseases and conditions. Annals Periodontol. 1999. 4:1–6.

17. Mühlemann HR, Son S. Gingival sulcus bleeding-a leading symptom in initial gingivitis. Helvetica Odontologica Acta. 1971. 15:107–113.

18. Silness P, Löe H. Periodontal disease in pregnancy. Acta Odontologica Scandinavica. 1964. 22:121–127.

19. Van Winkelhoff AJ, Van der Velden U, De Graaff J. Microbial succession in recolonising deep periodontal pockets after a single course of supra- and subgingival debridement. J Clin Periodontol. 1988. 15:116–122.

20. Papaioannou W, Bollen CML, Van Eldere J, Quirynen M. The adherence of periodontopathogens to periodontal probes. A possible factor in intra-oral transmissions? J Periodontol. 1996. 67:1164–1169.

21. Loesche WJ, Svanberg ML, Pape HR. Intra-oral transmission of Streptococcus mutans by a dental explorer. J Periodontal Res. 1979. 58:1765–1770.

22. Preus HR, Lassen J, Ass A, Christersson LA. Prevention of transperiodontal sites during subgingival application of antibiotics. J Clin Periodontol. 1993. 20:299–303.

23. Lee SH, Kim OS, Kim YJ, Chung HJ. Clinical short-term effects of full-mouth disinfection. J Korean Acad Periodontol. 2007. 37(3):613–624.

24. Danser MM, Van Winkelhoff AJ, De Graaff J, Loos BG, Van der Velden U. Short-term effect of full-mouth extraction on periodontal pathogens colonising the oral mucous membranes. J Clin Periodontol. 1994. 21:484–489.

25. Aguillon JC, Ferreira V, Nunez E, et al. Immunomodulation of LPS ability to induce the local Schwartzman reaction. Scandinavian J Immunol. 1996. 44:551–555.

26. Jervoe-Storm PM, Semaan E, AlAhdab H, et al. Clinical outcomes of quadrant root planing versus full-mouth root planing. J Clin Periodontol. 2006. 33:209–215.

27. Vandekerckhove BNA, Bollen CML, Dekeyser C, Darius P, Quirynen M. Full- versus partial-mouth disinfection in the treatment of periodontal infection. Long-term clinical observations. J Periodontol. 1996. 67:1251–1259.

28. Quirynen M, Teughels W, Van Steenberghe D. Impact of antiseptics on one-stage, full-mouth disinfection. Letter to the editor. J Clin Periodontol. 2006. 33:49–52.

29. Gomi K, Yashim A, Nagano T, et al. Effects of full-mouth and root planing in conjunction with systemically administered azithromycin. J Periodontol. 2007. 3:422–429.