DNA probe analyses of the survival of selected periodontal pathogens following scaling, root planing, and intra-pocket irrigation

J. Shiloah, M. R. Patters

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

This clinical study evaluated the survival rates of Actinobacillus actinomycetem comitans, Porphyromonas gingivalis, and Prevotella intermedia in periodontal pockets following scaling and root planing and intra-pocket irrigation with antimicrobial agents in patients with moderate and severe periodontitis. The number of target organisms was determined utilizing DNA probes. Adult periodontitis patients were selected on the basis that the subgingival flora contained at least one of the target organisms. Forty-eight (48) inflamed pockets ≥5 mm in depth with probing attachment loss and containing at least one of the target species were then selected in 7 adult patients who harbored these bacteria. Following baseline clinical and bacterial examination, all patients received thorough scaling and root planing. In addition, 1 or 2 teeth in each patient which harbored the target flora at baseline were randomly assigned to each of the following 4 treatment modalities: 1) control group, no irrigation; 2) saline group, irrigation with 2 cc of physiologic saline; 3) tetracycline group, irrigation with 2 cc of aqueous tetracycline hydrochloride, 50 mg/ml (5%); and 4) chlorhexidine group, irrigation with 2 cc 0.12% chlorhexidine. All selected sites (5 to 8 per patient) were nonadjacent teeth. Clinical parameters and microbial analysis were recorded again at one week, and one month postirrigation. The survival rate of the target microorganisms was determined and the effect of irrigation with antimicrobial agents on this microflora was compared with the control groups (1 and 2). This investigation, although conducted on a small group of patients, indicated that: 1) thorough scaling and root planing was very effective in reducing the target bacteria below the detectable level (< 6,000 cells/site) at the majority of sites and 2) the addition of antimicrobial irrigation did not significantly augment the results obtained from scaling and root planing alone. These results suggest that the effects of short term single professional subgingival irrigation with antimicrobial agents does not result in major adjunctive benefits in reduction of subgingival pathogens beyond that achieved by thorough scaling and root planing. Repeat applications or slow release of topical antimicrobials, may be necessary to achieve adjunctive antimicrobial effects. Furthermore studies with larger groups of subjects may be necessary to show differences between scaling and root planing and adjunctive professional subgingival irrigation.

Original languageEnglish (US)
Pages (from-to)568-575
Number of pages8
JournalJournal of Periodontology
Volume65
Issue number6
DOIs
StatePublished - Jan 1 1994

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Root Planing
DNA Probes
Survival Analysis
Anti-Infective Agents
Chlorhexidine
Tetracycline
Tooth
Survival Rate
Actinobacillus
Prevotella intermedia
Periodontal Pocket
Bacteria
Chronic Periodontitis
Porphyromonas gingivalis
Control Groups
Periodontitis

All Science Journal Classification (ASJC) codes

  • Periodontics

Cite this

DNA probe analyses of the survival of selected periodontal pathogens following scaling, root planing, and intra-pocket irrigation. / Shiloah, J.; Patters, M. R.

In: Journal of Periodontology, Vol. 65, No. 6, 01.01.1994, p. 568-575.

Research output: Contribution to journalArticle

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abstract = "This clinical study evaluated the survival rates of Actinobacillus actinomycetem comitans, Porphyromonas gingivalis, and Prevotella intermedia in periodontal pockets following scaling and root planing and intra-pocket irrigation with antimicrobial agents in patients with moderate and severe periodontitis. The number of target organisms was determined utilizing DNA probes. Adult periodontitis patients were selected on the basis that the subgingival flora contained at least one of the target organisms. Forty-eight (48) inflamed pockets ≥5 mm in depth with probing attachment loss and containing at least one of the target species were then selected in 7 adult patients who harbored these bacteria. Following baseline clinical and bacterial examination, all patients received thorough scaling and root planing. In addition, 1 or 2 teeth in each patient which harbored the target flora at baseline were randomly assigned to each of the following 4 treatment modalities: 1) control group, no irrigation; 2) saline group, irrigation with 2 cc of physiologic saline; 3) tetracycline group, irrigation with 2 cc of aqueous tetracycline hydrochloride, 50 mg/ml (5{\%}); and 4) chlorhexidine group, irrigation with 2 cc 0.12{\%} chlorhexidine. All selected sites (5 to 8 per patient) were nonadjacent teeth. Clinical parameters and microbial analysis were recorded again at one week, and one month postirrigation. The survival rate of the target microorganisms was determined and the effect of irrigation with antimicrobial agents on this microflora was compared with the control groups (1 and 2). This investigation, although conducted on a small group of patients, indicated that: 1) thorough scaling and root planing was very effective in reducing the target bacteria below the detectable level (< 6,000 cells/site) at the majority of sites and 2) the addition of antimicrobial irrigation did not significantly augment the results obtained from scaling and root planing alone. These results suggest that the effects of short term single professional subgingival irrigation with antimicrobial agents does not result in major adjunctive benefits in reduction of subgingival pathogens beyond that achieved by thorough scaling and root planing. Repeat applications or slow release of topical antimicrobials, may be necessary to achieve adjunctive antimicrobial effects. Furthermore studies with larger groups of subjects may be necessary to show differences between scaling and root planing and adjunctive professional subgingival irrigation.",
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