Effect of quadrantwise versus full-mouth subgingival instrumentation on clinical and microbiological parameters in periodontitis patients: A randomized clinical trial

IF 3.4 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontal research Pub Date : 2024-04-26 DOI:10.1111/jre.13279

Gaetano Isola, Alessandro Polizzi, Simona Santonocito, Angela Alibrandi, Paolo Pesce, Thomas Kocher

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引用次数: 0

Abstract

Aim

This study evaluated the efficacy of quadrantwise subgingival instrumentation (Q-SI) versus one-stage full-mouth subgingival instrumentation (FM-SI) on probing depth and periodontal pathogen reduction over a 6-month follow-up period, as well as whether baseline periodontal pathogens influenced the impact of periodontal treatment protocols on outcomes.

Methods

Patients with periodontitis were randomized to receive Q-SI (n = 43) or FM-SI (n = 45). Patients were instructed and motivated to maintain optimal oral hygiene during the treatment sessions. Clinical (probing pocket depth [PPD], clinical attachment loss [CAL], and bleeding on probing [BOP]) and periodontal pathogens were assessed at baseline and after 30, 90, and 180 days. Total bacterial load and periodontal pathogens were analysed via real-time PCR.

Results

At the 6-month follow-up, the median PPD decreased from 4.8 mm (interquartile range [IQR]: 4.3–5.2) to 2.6 mm (IQR: 2.3–2.9) in FM-SI patients and from 4.7 mm (IQR: 4.1–5.2) to 3.2 mm (IQR: 2.4–3.5) in Q-SI patients (p < .001). At 6 months, FM-SI was more effective at reducing the median proportions of Porphyromonas gingivalis (Pg), Aggregatibacter actinocomyctemcomitans, and Tannerella forsythia (Tf) (p < .001 for each value). Multilevel linear regression analysis demonstrated that high baseline PPD (p = .029), Pg (p = .014), and Tf (p < .001) levels and the FM-SI protocol (p < .001) were statistically significant predictors of PPD reduction at 6 months. Furthermore, PPD reduction was significantly greater in the FM-SI group when lower baseline Pg levels were detected.

Conclusion

The FM-SI was more effective than the Q-SI in reducing the mean PPD and number of periodontal pathogens in periodontitis patients over a 6-month follow-up period. Higher baseline PPD and Pg levels had a negative impact on PPD reduction at 6 months after FM-SI.

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四面龈下器械治疗与全口龈下器械治疗对牙周炎患者临床和微生物参数的影响：随机临床试验。

目的本研究评估了四次龈下器械治疗（Q-SI）与一次全口龈下器械治疗（FM-SI）在6个月随访期内对探诊深度和牙周病原体减少的疗效，以及基线牙周病原体是否会影响牙周治疗方案对疗效的影响。方法牙周炎患者被随机分配接受Q-SI（43人）或FM-SI（45人）治疗。在治疗过程中，指导并鼓励患者保持最佳口腔卫生。在基线和 30、90 和 180 天后，对临床（探诊袋深度 [PPD]、临床附着丧失 [CAL] 和探诊出血 [BOP]）和牙周病原体进行评估。结果在 6 个月的随访中，FM-SI 患者的中位 PPD 从 4.8 mm（四分位距 [IQR]：4.3-5.2）降至 2.6 mm（IQR：2.3-2.9），Q-SI 患者的中位 PPD 从 4.7 mm（IQR：4.1-5.2）降至 3.2 mm（IQR：2.4-3.5）（p < .001）。在 6 个月时，FM-SI 能更有效地减少牙龈卟啉单胞菌（Pg）、放线杆菌（Aggregatibacter actinocomyctemcomitans）和连翘唐纳菌（Tf）的中位比例（每个值的 p < .001）。多层次线性回归分析表明，高基线 PPD（p = .029）、Pg（p = .014）和 Tf（p < .001）水平以及 FM-SI 方案（p < .001）对 6 个月后 PPD 的减少有显著的统计学预测作用。此外，当检测到基线 Pg 水平较低时，FM-SI 组的 PPD 下降幅度明显更大。结论在 6 个月的随访期间，FM-SI 比 Q-SI 更能有效降低牙周炎患者的平均 PPD 和牙周病原体数量。基线PPD和Pg水平较高对FM-SI治疗6个月后PPD的降低有负面影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of periodontal research 医学-牙科与口腔外科

CiteScore

6.90

自引率

5.70%

发文量

103

审稿时长

6-12 weeks

期刊介绍： The Journal of Periodontal Research is an international research periodical the purpose of which is to publish original clinical and basic investigations and review articles concerned with every aspect of periodontology and related sciences. Brief communications (1-3 journal pages) are also accepted and a special effort is made to ensure their rapid publication. Reports of scientific meetings in periodontology and related fields are also published. One volume of six issues is published annually.