Short‐term effects of initial, nonsurgical periodontal treatment (hygienic phase)

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Abstract
Longitudinal studies have reported the effect of various modalities of periodontal surgery on pocket depth and attachment levels related to pretreatment measurements. Possible changes in these measurements as a result of scaling, oral hygiene improvements and occlusal adjustment during the hygienic phase were not considered. The short-term effect of treatment of the hygienic phase in 90 patients with some pockets extending 4 mm or more apically to the CEJ [cementum-enamel junction] is examined. Pretreatment pocket depths and attachment levels related to the CEJ were measured by a thin probe in 5 sites at all 2355 teeth in the sample. Scaling, root planning, instruction in oral hygiene and occlusal adjustment were completed during 4-6 sessions for each patient. Four weeks after completion of the hygienic phase, all variables were recorded. Mean measurements for pocket depths 1-3 mm, 4-6 mm and .gtoreq. 7 mm prior to treatment were compared to their posttreatment scores. Pocket depth decreased significantly for pockets extending 4 mm or more apically to the FGM [free gingival margin]. For pockets 4-6 mm there was a mean difference in pocket depth of 0.96 .+-. 0.47 mm (P < 0.0001) between pretreatment and posttreatment observations. For pockets 7 mm or greater the mean difference was 2.22 .+-. 1.35 mm (P < 0.0001). Reduction in depth of pocket and improvement in attachment levels were related to the initial level of severity. Pocket reduction was in part due to the improvement in attachment levels. The clinical severity of periodontitis is apparently reduced significantly 1 mo. following the hygienic phase of periodontal therapy. The need for surgical pocket treatment apparently cannot be assessed properly until completion of the hygienic phase of treatment.