Varying responses to periodontal treatment in different extent of plaque-induced gingivitis: a prospective cohort study.

Objectives: To compare the clinical response to periodontal treatment in localized and generalized gingivitis using periodontal variables and patient-reported outcomes (PROs).

Materials and methods: Sixty participants (30 with localized gingivitis, 30 with generalized gingivitis) underwent scaling, polishing, and oral hygiene instruction at baseline and monthly follow-ups until periodontal health was restored. Periodontal variables (bleeding on probing [BOP], gingival index [GI], and plaque index [PLI]) along with PROs on oral hygiene practices and the Self-Efficacy Scale for Self-Care (SESS) were assessed.

Results: At 1-month follow-up, generalized gingivitis showed significantly greater improvements in BOP (p < 0.001) and GI (p < 0.001) versus localized gingivitis, with no intergroup difference in PLI reduction (p = 0.747). Periodontal health was achieved in 80% of localized cases versus 30% of generalized cases after single-session therapy (p < 0.001), with 70% of generalized cases requiring multiple re-treatments. Unresolved generalized cases had higher baseline BOP (p = 0.014) but similar baseline PLI (p = 0.322) and no significant differences in treatment-induced BOP (p = 0.137) or PLI changes (p = 0.563). SESS scores improved significantly in both groups, with greater SE-D score improvement in localized cases. Localized gingivitis had higher baseline prolonged brushing rates (> 2 min: 66.7% vs. 33.3%), but post-intervention oral hygiene did not differ between groups.

Conclusions: Localized gingivitis responded well to single-session therapy, whereas generalized gingivitis required multiple treatments due to higher baseline inflammation, emphasizing the need for distinct clinical strategies.

Clinical relevance: This study supports subtype-specific management in gingivitis, advocating single-session therapy for localized cases and staged interventions for generalized cases to optimize outcomes and reduce overtreatment.