M Farman1, R I Joshi. 1. Department of Adult Dental Care, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield.
Abstract
BACKGROUND AND AIMS: Non-surgical periodontal therapy has been proven to be an effective treatment for patients with chronic periodontitis. Conventional non-surgical therapy by debridement of the root surfaces is performed on a quadrant basis with 1-2 week intervals. This time interval may result in re-colonisation by the bacteria of the instrumented pockets and impair healing. Therefore, a new approach of full-mouth non-surgical therapy to be completed within two consecutive days with (full-mouth disinfection) or without (full-mouth debridement) use of oral antiseptics has been suggested. The aim of this review was to compare the clinical outcomes of the three modalities of non-surgical therapy (full-mouth disinfection [FMD], full-mouth debridement [FRp], quadrant scaling and root planing [Q]). METHODS: Standard searches of Medline and Embase databases and appropriate hand searching provided the published studies, which were then assessed against pre-determined inclusion criteria. Meta-analysis was performed wherever possible using Review Manager 4.2 software. RESULTS: Seven randomised controlled trials (RCTs) were included in the review and these failed to show any statistically significant differences between the FRp and Q approaches. Further studies are required to reach conclusion regarding the advantages of FMD approach. PRACTICAL IMPLICATIONS: Mechanical debridement is an important component of treatment for chronic periodontitis and this review suggests that both the traditional quadrant approach and the newer the full-mouth debridement could be equally effective.
BACKGROUND AND AIMS: Non-surgical periodontal therapy has been proven to be an effective treatment for patients with chronic periodontitis. Conventional non-surgical therapy by debridement of the root surfaces is performed on a quadrant basis with 1-2 week intervals. This time interval may result in re-colonisation by the bacteria of the instrumented pockets and impair healing. Therefore, a new approach of full-mouth non-surgical therapy to be completed within two consecutive days with (full-mouth disinfection) or without (full-mouth debridement) use of oral antiseptics has been suggested. The aim of this review was to compare the clinical outcomes of the three modalities of non-surgical therapy (full-mouth disinfection [FMD], full-mouth debridement [FRp], quadrant scaling and root planing [Q]). METHODS: Standard searches of Medline and Embase databases and appropriate hand searching provided the published studies, which were then assessed against pre-determined inclusion criteria. Meta-analysis was performed wherever possible using Review Manager 4.2 software. RESULTS: Seven randomised controlled trials (RCTs) were included in the review and these failed to show any statistically significant differences between the FRp and Q approaches. Further studies are required to reach conclusion regarding the advantages of FMD approach. PRACTICAL IMPLICATIONS: Mechanical debridement is an important component of treatment for chronic periodontitis and this review suggests that both the traditional quadrant approach and the newer the full-mouth debridement could be equally effective.