Clinical Effect of Quadrant-wise Non-surgical Periodontal Treatment on Patients with Stage III Grade B and C Periodontitis

Clinical Effect of Quadrant-wise Non-surgical Periodontal Treatment on Patients with Stage III Grade B and C Periodontitis

Objective: The aim of this study was to evaluate clinical effects of quadrant-wise non-surgical periodontal treatment in patients with stage-III grade-B and grade-C periodontitis. Methods: Forty-five non-smoker individuals who were systemically healthy, including 15 peri- odontally healthy, 15 stage-III grade-B periodontitis participant, and 15 stage-III grade-C peri- odontitis participant, were involved in this study. At baseline, plaque index, gingival index, probing depth, clinical attachment level, and bleeding on probing were evaluated for all participants, and in periodontitis groups, probing depth measurements were categorized as intermediate (4-6 mm) and deep (>6 mm), and the percentages of all categorized probing depths were calcu- lated. Quadrant-wise non-surgical periodontal treatment was performed in both periodontitis groups, and clinical measurements were performed again 1 and 3 months after quadrant-wise non-surgical periodontal treatment. Results: At baseline, periodontitis was higher in stage-III grade-C group than stage-III grade-B group (P < .05), whereas plaque index, gingival index, bleeding on probing, and clinical attach- ment level were similar between 2 groups (P > .05). All clinical parameters improved from base- line to 1 and 3 months in all periodontitis groups (P > .05). The reduction of percentage of the regions with probing depth of 4-6 mm from baseline to 3 months was higher in stage-III grade-B group than stage-III grade-C group (P < .05). As compared to the stage-III grade-B group at 1 and 3 months, the percentage of sites with probing depth ≥ 5 mm and BOP+(%) was higher in the stage-III grade-C group (P < .05). Conclusion: According to residual probing depth and deep periodontal pockets, the clinical response of quadrant-wise non-surgical periodontal treatment was superior in stage-III grade-B periodontitis group than stage-III grade-C periodontitis group, and there was a need for peri- odontal surgical treatment after quadrant-wise non-surgical periodontal treatment in the stage- III grade-C periodontitis group Keywords: Dental scaling, periodontitis, root planing

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  • 1. Offenbacher S. Periodontal diseases: Pathogenesis. Ann Periodontol. 1996;1(1):821-878. [CrossRef]
  • 2. Papapanou PN, Sanz M, Buduneli N, et al. Periodontitis: Consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and condi- tions. J Periodontol. 2018;89(suppl 1):S173-S182. [CrossRef]
  • 3. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of peri- odontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018;89(suppl 1):S159-S172. [CrossRef]
  • 4. Heitz-Mayfield LJ, Trombelli L, Heitz F, Needleman I, Moles D. A sys- tematic review of the effect of surgical debridement vs. non-surgical debridement for the treatment of chronic periodontitis. J Clin Peri- odontol. 2002;29(suppl 3):92-102; discussion 160. [CrossRef]
  • 5. Cobb CM. Non-surgical pocket therapy: Mechanical. Ann Periodon- tol. 1996;1(1):443-490. [CrossRef]
  • 6. Drisko CL. Periodontal debridement: Still the treatment of choice. J Evid Based Dent Pract. 2014;14(suppl):33-41.e1. [CrossRef]
  • 7. D'Aiuto F, Ready D, Parkar M, Tonetti MS. Relative contribution of patient-, tooth-, and site-associated variability on the clinical out- comes of subgingival debridement. I. Probing depths. J Periodontol. 2005;76(3):398-405. [CrossRef]
  • 8. Tomasi C, Wennström JL. Is the use of differences in the magnitude of CAL gain appropriate for making conclusions on the efficacy of non-surgical therapeutic means? J Clin Periodontol. 2017;44(6):601- 602. [CrossRef]
  • 9. Sanz-Sánchez I, Montero E, Citterio F, Romano F, Molina A, Aimetti M. Efficacy of access flap procedures compared to subgingival debride- ment in the treatment of periodontitis. A systematic review and meta-analysis. J Clin Periodontol. 2020;47(suppl 22):282-302. [CrossRef]
  • 10. Morrison EC, Ramfjord SP, Hill RW. Short-term effects of initial, non- surgical periodontal treatment (hygienic phase). J Clin Periodontol. 1980;7(3):199-211. [CrossRef]
  • 11. Chapple ILC, Mealey BL, Van Dyke TE, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced perio- dontium: Consensus report of workgroup 1 of the 2017 world work- shop on the classification of periodontal and peri-implant diseases and conditions. J Periodontol. 2018;89(1):S74-S84. [CrossRef]
  • 12. Claffey N, Nylund K, Kiger R, Garrett S, Egelberg J. Diagnostic predict- ability of scores of plaque, bleeding, suppuration and probing depth for probing attachment loss. 3 1/2 years of observation following initial periodontal therapy. J Clin Periodontol. 1990;17(2):108-114. [CrossRef]
  • 13. Meseli SE, Kuru B, Kuru L. Relationships between initial probing depth and changes in the clinical parameters following non-surgical periodontal treatment in chronic periodontitis. J Istanb Univ Fac Dent. 2017;51(3):11-17. [CrossRef]
  • 14. Meseli SE, Kuru B, Kuru L. Effects of 810-nanometer diode laser as an adjunct to mechanical periodontal treatment on clinical perio- dontal parameters and gingival crevicular fluid volume of residual periodontal pockets. Niger J Clin Pract. 2017;20(4):427-432. [CrossRef]
  • 15. Ceylan M, Erbak Yilmaz H, Narin F, Tatakis DN, Saglam M. Gingival crevicular fluid lipocalin-2 and semaphorin3A in stage III periodonti- tis: Non-surgical periodontal treatment effects. J Periodont Res. 2022;57(4):724-732. [CrossRef]
  • 16. Petit C, Anadon-Rosinach V, Rettig L, et al. Influence of psychological stress on non-surgical periodontal treatment outcomes in patients with severe chronic periodontitis. J Periodontol. 2021;92(2):186-195. [CrossRef]
  • 17. Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand. 1964;22:121-135. [CrossRef]
  • 18. Löe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Odontol Scand. 1963;21(6):533-551. [CrossRef]
  • 19. Suvan J, Leira Y, Moreno Sancho FM, Graziani F, Derks J, Tomasi C. Subgingival instrumentation for treatment of periodontitis. A sys- tematic review. J Clin Periodontol. 2020;47(suppl 22):155-175. [CrossRef]
  • 20. Genco RJ, Slots J. Host responses in periodontal diseases. J Dent Res. 1984;63(3):441-451. [CrossRef]
  • 21. Bakdash B. Oral hygiene and compliance as risk factors in periodon- titis. J Periodontol. 1994;65(5)(suppl):539-544. [CrossRef] 22. Quirynen M, Bollen CM, Vandekerckhove BN, Dekeyser C, Papaioan- nou W, Eyssen H. Full- vs. partial-mouth disinfection in the treatment of periodontal infections: Short-term clinical and microbiological observations. J Dent Res. 1995;74(8):1459-1467. [CrossRef]
  • 23. Graziani F, Cei S, Orlandi M, et al. Acute-phase response following full-mouth versus quadrant non-surgical periodontal treatment: A randomized clinical trial. J Clin Periodontol. 2015;42(9):843-852. [CrossRef]
  • 24. Badersten A, Nilveus R, Egelberg J. Effect of nonsurgical periodontal therapy: II. Severely advanced periodontitis. J Clin Periodontol. 1984;11(1):63-76. [CrossRef]
  • 25. Badersten A, Nilveus R, Egelberg J. Effect of nonsurgical periodontal therapy (viii). Probing attachment changes related to clinical charac- teristics. J Clin Periodontol. 1987;14(7):425-432. [CrossRef]
  • 26. Lowenguth RA, Greenstein G. Clinical and microbiological response to nonsurgical mechanical periodontal therapy. Periodontol 2000. 1995;9(1):14-22. [CrossRef]
  • 27. Sanz M, Herrera D, Kebschull M, et al. Treatment of stage I-III perio- dontitis-The EFP S3 level clinical practice guideline. J Clin Periodon- tol. 2020;47(suppl 22):4-60. [CrossRef]
  • 28. Segelnick SL, Weinberg MA. Reevaluation of initial therapy: When is the appropriate time? J Periodontol. 2006;77(9):1598-1601. [CrossRef]
  • 29. Waerhaug J. Healing of the dentoepithelial junction following sub- gingival plaque control: I. J Periodontol. 1978;49(1):1-8. [CrossRef]
  • 30. Biagini G, Checchi L, Miccoli MC, Vasi V, Castaldini C. Root curettage and gingival repair in periodontitis. J Periodontol. 1988;59(2):124-129. [CrossRef]
  • 31. Görgülü NG, Doğan B. Effect of non-surgical periodontal treatment on salivary and serum biomarkers in Stage III Grade B and C perio- dontitis. J Periodontol. 2022;93(8):1191-1205. [CrossRef]
  • 32. Özcan E, Işıl Saygun N, Serdar MA, Umut Bengi V, Kantarcı A. Non- surgical periodontal therapy reduces saliva adipokine and matrix metalloproteinase levels in periodontitis. J Periodontol. 2016;87(8):934-943. [CrossRef]
  • 33. Yashima A, Morozumi T, Yoshie H, et al. Biological responses follow- ing one-stage full-mouth scaling and root planing with and without azithromycin: Multicenter randomized trial. J Periodont Res. 2019;54(6):709-719. [CrossRef]
  • 34. Lang NP, Joss A, Orsanic T, Gusberti FA, Siegrist BE. Bleeding on probing. A predictor for the progression of periodontal disease? J Clin Periodontol. 1986;13(6):590-596. [CrossRef]
  • 35. Ramseier CA, Kinney JS, Herr AE, et al. Identification of pathogen and host-response markers correlated with periodontal disease. J Peri- odontol. 2009;80(3):436-446. [CrossRef]
  • 36. Kinney JS, Morelli T, Braun T, et al. Saliva/pathogen biomarker signa- turesandperiodontaldiseaseprogression. JDent Res. 2011;90(6):752- 758. [CrossRef]
  • 37. Kanmaz B, Lappin DF, Nile CJ, Buduneli N. Effects of smoking on non-surgical periodontal therapy in patients with periodontitis stage III or IV, and grade C. J Periodontol. 2020;91(4):442-453. [CrossRef]
  • 38. Petit C, Anadon-Rosinach V, Tuzin N, Davideau JL, Huck O. Influence of depression and anxiety on non-surgical periodontal treatment outcomes: A 6-month prospective study. Int J Environ Res Public Health. 2021;18(17):9394. [CrossRef]
  • 39. Citterio F, Gualini G, Chang M, et al. Pocket closure and residual pock- ets after non-surgical periodontal therapy: A systematic review and meta-analysis. J Clin Periodontol. 2022;49(1):2-14. [CrossRef]
  • 40. Sanz-Sánchez I, Montero E, Citterio F, Romano F, Molina A, Aimetti M. Efficacy of access flap procedures compared to subgingival debride- ment in the treatment of periodontitis. A systematic review and meta-analysis. J Clin Periodontol. 2020;47(suppl 22):282-302. [CrossRef]