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...
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.
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.
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제안 방법
A questionnaire was given to the patients after one week of treatment in the upper right quadrant to determine if there were any adverse effects after treatment. In the experimental group, one patient reported an increase in body temperature and three patients with a prior medical history reported herpes labialis.
Adverse effects, such as an increase in body temperature, and herpes labialis were determined from a questionnaire given one week after the procedure in the upper right quadrant.
Although the additional effects of chlorhexidine use cannot be excluded, a full-mouth root planing (Frp) group, which carried out SRP without using chlorhexidine within 24 hours, was excluded from this experiment in order to compare the effect. A previous study reported no significant clinical and microbiological difference between Frp and Fdis but early stage healing i.
The control group, after one week of supragingival scaling, received subgingival S RP by quadrants with one week intervals under local anesthesia using curettesand ultrasonic instrument. For both groups, tooth brushing instruction and oral prophylaxis were carried out at the baseline, three months and six months after the upper right quadrant SRP.
1% chlorhexidine solution were performed within three times for 10 minutes. Over a two week period after the procedure, the patients were instructed to perform a pharynx-rinse twice daily for 30 seconds. In order to improve the cooperation, the patients were encouraged to record the daily mouth-washing time.
USA) was used for statistical analysis. Repeated measures ANOVA was used to determine the changes in the clinical studies in 1, 3 and 6 months for each group. A t-test was used for the group difference in the changes at a specific point (1, 3, 6-month) if the measured values showed a normal distribution.
The clinical indices were measured one week after S RP, before subgingival S RP (baseline), and at one month, three months and six months after Fdis or cSRP at the upper right quadrant. Considering the accessibility of repeated measurement, the sulcus bleeding index (SBI), gingival recession (GR), probing depth (PD) and clinical attachment level (CAL) were measured at 6 sites in each tooth of the upper right quadrant.
In order to improve the cooperation, the patients were encouraged to record the daily mouth-washing time. The control group, after one week of supragingival scaling, received subgingival S RP by quadrants with one week intervals under local anesthesia using curettesand ultrasonic instrument. For both groups, tooth brushing instruction and oral prophylaxis were carried out at the baseline, three months and six months after the upper right quadrant SRP.
One week later, the patients were divided into the control and experimental group according to their preferences and received treatment as follows. The experimental group received a modified protocol of Quirynen et al.6); 30 seconds of mouth-rinsing with a 0.1% chlorhexidine solution (Hexamedin, Bukwang, Seoul, Korea) before the procedure and an additional 10 seconds of pharynx-rinsing by bending the neck backward to hold the solution in the pharyngeal area. The patients were instructed to brush the dorsal surface of their tongues for 60 seconds.
They called it full-mouth disinfection6). The method consists of 1-minute brushing of the dorsal surface of the tongue with a chlorhexidine gel (1%), 1-minute mouth irrigation with a chlorhexidine solution (0.2%) with pharynx in contact with the solution for the last 10 seconds of the rinse. After the completion of each SRP, all pockets should be irrigated subgingivally with a chlorhexidine gel (1%) three times within 10 minutes with the irrigation being repeated after one week.
After the completion of each SRP, all pockets should be irrigated subgingivally with a chlorhexidine gel (1%) three times within 10 minutes with the irrigation being repeated after one week. The patient is instructed to mouth-wash with 10ml of a chlorhexidine solution (0.2%) twice daily for 1 minute over a 2-week period.
In this study, supragingival full-mouth scaling was administered in advance. The subgingival treatment was performed one week after scaling while c S RP was carried out by quadrant at one-week intervals. Fdis showed significant improvement compared with cS RP.
2%) are not available in Korea. Therefore, in this study of generalized moderate to severe chronic periodontitis patients, a chlorhexidine solution (0.1%), which can be purchased over-the-counter and has few side-effects, was used in the modified Fdis that was designed to be simple to apply after SRP. In addition, the clinical effects of Fdis were compared with the conventional SRP over a 6-month period.
This study compared the clinical effects of modified Fdis after scaling using a chlorhexidine solution (0.1%) with those of conventional SRP in the treatment of moderate to severe generalized chronic periodontitis after a 6 month follow-up. After Fdis for the treatment of moderate to severe generalized chronic periodontitis, there was a reduction of gingival inflammation, plaque level, and probing depth, a smaller increase in gingival recession, and attachment gain in the teeth with an initial pocket depth of a moderate level (4~6 mm) and multi-roots, and larger attachment gain in the proximal surface compared with the bucco-lingual surface.
This study compared the clinical effects of modified Fdis after scaling using a chlorhexidine solution (0.1%) with those of conventional SRP in the treatment of moderate to severe generalized chronic periodontitis for 6 months.
대상 데이터
Among the patients at the department of periodontology, Chonnam National University Hospital, those who satisfied the conditions below were included in the experiment.
Overall, 42 sites per patient were measured. The plaque index (PI) was measured at 4 sites in each tooth of the upper right quadrant including the bucco-lingual and mesio-distal surfaces, making 28 sites per patient.
데이터처리
Repeated measures ANOVA was used to determine the changes in the clinical studies in 1, 3 and 6 months for each group. A t-test was used for the group difference in the changes at a specific point (1, 3, 6-month) if the measured values showed a normal distribution. A Mann-Whitney inspection was used if the values showed an abnormal distribution.
성능/효과
Many studies have reported the clinical and microbiological effects of full-mouth disinfection (Fdis). After 2 months of Fdis, chronic periodontitis patients showed a significant decrease in the sulcus bleeding index and plaque index. After 8 months, clinical improvements are particularly noticeable in the deep pockets7).
Fdis also has an advantage to systematically healthy periodontitis patients. In this study of Fdis, medication was prescribed only once by instructing the patients to take antibiotics and antiphlogistic agent for only 3 days while medication was prescribed on the completion of each quadrant in cSRP, which increases the time and cost of medication.
In this study, the probing depth in the area of the initial pocket depth of 4~6 mm decreased 1.4 mm after cSRP and 1.7 mm after Fdis. KnӦfler et al.
Overall, this study revealed modified Fdis is more effective than cS RP 6 months after treatment for generalized moderate to severe chronic periodontitis.
One examiner took charge of the clinical oral examination for all patients. The intra-examiner repeatibility for three patients was 99.2% for the sulcus bleeding index, 98.8% for the plaque index, 98.4% for gingival recession, 99.0% for the probing depth. All the clinical indices were recorded as the average and standard deviation for each patient by period according to the treatment method.
The reported effects of Fdis are not consistent, and some parts of this study showed little improvement compared with the conventional SRP. However, overall, Fdis was reported to show more improvement than cSRP.
There were significant decreases in the sulcus bleeding index, plaque index and probing depth, and a significant increase in gingival recession as well as significant attachment gain at six months after both treatments (Table 2).
This study reported that S BI and PI were reduced leading to more effective removal of gingival inflammation and plaque in the early stages after the modified Fdis than the conventional method. Even when the measured PI was higher after Fdis than the conventional method, the gingival index was lower after Fdis than the conventional method, which means that Fdis is more effective in controlling gingival inflammation9).
When the clinical indices were compared according to period, the experimental group showed a significantly larger decrease in the SBI and PI at 1, 3 and 6 months, less gingival recession and significant attachment gain than the control group (P<0.05).
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