One Stage Full‐ Versus Partial‐Mouth Disinfection in the Treatment of Chronic Adult or Generalized Early‐Onset Periodontitis. I. Long‐Term Clinical Observations

Abstract

Background: A standard treatment strategy for periodontal infections often consists of 4 consecutive sessions of scaling and root planing (per quadrant, at 1‐ to 2‐week intervals), without proper disinfection of the remaining intra‐oral niches for periodontopathogens. This could theoretically lead to a reinfection of previously disinfected pockets by bacteria from an untreated region/niche. This study aimed to investigate, over an 8‐month period, the clinical benefits of a one stage full‐mouth disinfection in the control of severe periodontitis. Methods: Sixteen patients with early‐onset periodontitis and 24 patients with severe adult periodontitis were randomly assigned to test and control groups. The control group was scaled and root planed, per quadrant, at 2‐week intervals and given standard oral hygiene instructions. A one stage full‐mouth disinfection (test group) was sought by scaling and root planing the 4 quadrants within 24 hours in combination with the application of chlorhexidine to all intra‐oral niches for periodontopathogens. Besides oral hygiene, the test group also rinsed twice daily with a 0.2% chlorhexidine solution and sprayed the tonsils with a 0.2% chlorhexidine spray, for 2 months. The plaque index, gingival index, probing depth, bleeding on probing, gingival recession, and clinical attachment level were recorded at baseline and at 1, 2, 4, and 8 months afterwards. Results: The one stage full‐mouth disinfection resulted, in comparison to the standard therapy, in a significant (P J Periodontol 1999;70:632‐645.