RESUMEN
AIM: To compare the clinical and microbiological effects of scaling and root planing (SRP) alone or combined with mechanical [professional plaque control (PPC)] or chemical [chlorhexidine rinsing (CHX)] control of supragingival plaque in the treatment of chronic periodontitis. MATERIAL AND METHODS: Sixty subjects were randomly assigned to receive SRP alone or combined with PPC (twice a week) or with CHX rinsing (twice a day). The adjunctive treatments began with SRP and were continued for 42 days. Clinical and microbiological examinations were performed at baseline, 2 and 6 months post-therapy. Subgingival plaque samples were analysed for 38 bacterial species by checkerboard DNA-DNA hybridization. RESULTS: The two test treatments were more effective in improving probing depth and clinical attachment level (CAL) than SRP alone, even in intermediate and deep sites. CAL gain was better maintained in the CHX group. The most beneficial microbiological changes were observed in CHX-treated subjects, who showed a significant reduction in the proportions of red and orange complexes, as well as an increase in the proportions of the host-compatible bacterial species. CONCLUSION: Strict plaque control performed during and after SRP improves periodontal treatment outcomes. The greatest microbiological and clinical benefits were observed with the use of CHX rinsing.
Asunto(s)
Periodontitis Crónica/terapia , Placa Dental/prevención & control , Adulto , Antiinfecciosos Locales/uso terapéutico , Bacterias/clasificación , Clorhexidina/uso terapéutico , Recuento de Colonia Microbiana , Mezclas Complejas/uso terapéutico , ADN Bacteriano/análisis , Placa Dental/microbiología , Profilaxis Dental , Raspado Dental , Dentífricos/uso terapéutico , Femenino , Fluoruros/uso terapéutico , Hemorragia Gingival/terapia , Interacciones Huésped-Patógeno , Humanos , Masculino , Persona de Mediana Edad , Antisépticos Bucales/uso terapéutico , Hibridación de Ácido Nucleico , Higiene Bucal , Pérdida de la Inserción Periodontal/terapia , Bolsa Periodontal/terapia , Placebos , Aplanamiento de la Raíz , Ácido Silícico , Pastas de Dientes , Resultado del Tratamiento , Triclosán/uso terapéuticoRESUMEN
OBJECTIVE: The aim of this study was to investigate the effect of tongue scraping and inter-dental flossing on morning bad breath in periodontally healthy subjects. METHODS: A four-step blind, cross-over study was conducted in 19 volunteers, divided into four groups: Group I: tooth brushing; Group II: tooth brushing and inter-dental flossing; Group III: tooth brushing and tongue scraping; and Group IV: tooth brushing, inter-dental flossing and tongue scraping. The volunteers performed these oral hygiene procedures three times a day for 7 days. Seven-day wash-out intervals were observed. Morning mouth breath was assessed organoleptically and by volatile sulphur compound concentrations. RESULTS: The highest mean organoleptic and volatile sulphur compound measurement values were found in the treatment groups in which tongue scraping was not performed and there were statistical differences between the two groups (p < 0.05). In the organoleptic evaluation (p > 0.05), inter-dental flossing did not show any statistical improvement in the effect of tongue hygiene on morning bad breath, but it significantly reduced the concentration of volatile sulphur compounds (p < 0.05). CONCLUSION: The findings suggest that tongue scraping appears to be the most important hygienic procedure to reduce morning bad breath in periodontally healthy subjects.