Effectiveness of Supragingival Plaque Control on the Development of Subgingival Plaque and Gingival Inflammation in Patients With Moderate Pocket Depth

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Abstract
Supragingival plaque control, subgingival plaque development and their effects on gingival health were evaluated in 12 patients having periodontal pockets of 4 to 6 mm depth. Gingival inflammation was assessed using the Löe and Silness index. A thorough scaling, root planing and polishing were then performed on three quadrants in each patient. Following initial treatment, each quadrant was assigned a modality for plaque control. One quadrant received a daily professional supragingival plaque removal; a second was maintained by the patient with specific brushing and flossing instructions. No plaque control methods were performed on the third quadrant. The initially untreated fourth quadrants were divided into three equal groups and each group was assigned one of the aforementioned modalities. At the end of the 14 day experimental period, a second gingival index was recorded. Supra- and subgingival plaque were then collected separately, lyophilized and weighed. Mean dry weights for each quadrant were recorded in milligrams per millimeter squared. Data were evaluated statistically and the following conclusions were drawn: (1) the control of supragingival plaque, either by daily professional prophylaxis or by the patient, reduces but does not completely eliminate the reformation of subgingival plaque; (2) although daily supragingival plaque control significantly reduces gingival inflammation, the gingival score does not reach the zero level; (3) only in the absence of plaque control is there a positive correlation between the amount of supra- and subgingival plaque present; (4) only by making the tooth surface accessible to cleaning is it prossible for the patient to maintain a plaque-free dentition.