J Clin Periodontol 2000; 27: 30–36 Copyright C Munksgaard 2000

Printed in Denmark . All rights reserved

ISSN 0303-6979

M. A. Cugini1, A. D. Haffajee1,
The effect of scaling and root C. Smith1, R. L. Kent2 Jr. and
S. S. Socransky1

planing on the clinical and Departments of 1Periodontology and

2
Biostatistics, The Forsyth Institute, Boston,
MA, USA

microbiological parameters of
periodontal diseases:
12-month results
Cugini MA, Haffajee AD, Smith C, Kent Jr. RL, Socransky SS: The effect of scaling
and root planing on the clinical and microbiological parameters of periodontal dis-
eases: 12-month results. J Clin Periodontol 2000; 27: 30–36. C Munksgaard, 2000.

Abstract
Background/aims: Previously, we reported that SRP resulted in a decrease in
mean pocket depth and attachment level and reduced prevalence and levels of
Bacteroides forsythus, Porphyromonas gingivalis, and Treponema denticola at 3
and 6 months post-SRP in 57 subjects with adult periodontitis. 32 of the 57
subjects were monitored at 9 and 12 months. Thus, the purpose of the present
investigation was to evaluate the microbial and clinical effects of SRP in 32 (mean
age 48∫11) subjects over a 12-month period.
Method: Clinical assessments of plaque, gingival redness, suppuration, bleeding
on probing, pocket depth and attachment level were made prior to SRP and at
3, 6, 9, and 12 months post-therapy. Subgingival plaque samples were taken at
each visit and analyzed using the checkerboard DNA-DNA hybridization tech-
nique for the presence and levels of 40 subgingival species. Each subject also
received maintenance scaling at each of the subsequent monitoring visits. Differ-
ences in clinical parameters and prevalence and levels of bacterial species were
analyzed pre- and post-therapy using the Wilcoxon signed ranks test. The
Quade test for related samples was used for analysis of multiple visits.
Results: Mean pocket depth (mm∫SEM) decreased from 3.2∫0.3 at baseline to
2.9∫0.3 at 12 months (p∞0.01). Mean attachment level showed significant re-
duction at 6 months, but did not diminish further. Bleeding on probing and
plaque were significantly reduced at 12 months (p∞0.001, p∞0.05, respectively).
P. gingivalis, B. forsythus and T. denticola decreased in prevalence and levels up
to the 6-month visit and remained at these lower levels at 9 and 12 months. Signifi-
cant increases in levels and prevalence were noted at 12 months for Actinomyces
naeslundii genospecies 2, Actinomyces odontolyticus, Fusobacterium nucleatum ss
polymorphum, Streptococcus mitis, Capnocytophaga sp, and Veillonella parvula. Key words: periodontal diseases;
periodontitis; treatment; SRP; microbiology;
Conclusions: The data suggest that the maintenance phase of therapy may be maintenance
essential in consolidating clinical and microbiological improvements achieved
as a result of initial therapy. Accepted for publication 19 March 1999

Scaling and root planing (SRP) is one
of the most commonly utilized pro-
cedures for the treatment of peri-
odontal diseases and has been used as
the ‘gold’ standard therapy against
which other therapies have been com-
pared (Pihlstrom et al. 1983, Lindhe et
al. 1984, Ramfjord et al. 1987, Good-
son et al. 1990, Newman et al. 1994,
Drisko et al. 1995, Radvar et al. 1996).
Numerous studies have reported bene-
ficial results from this treatment in both
clinical and microbial parameters (for
review see Kaldahl et al. (1993)). Most
of the beneficial effects of SRP ap-

Table 1. Baseline clinical characteristics of suject group (nΩ32)
age (years)
no. missing teeth
% males
mean pochet depth (mm)
mean attachment level (mm)
% sites with:
plaque
red
BOP
suppurtion
pocket depth ∞4 mm
pocket depth 4–6 mm
pocket depth ±6 mm
attchment level ∞4 mm
attachment level 4–6 mm
attachment level ∞6 mm
peared to occur within the first 3
months with mean attachment levels
and pocket depths remaining relatively
unchanged at later time points. Thus,
available data imply a 2 stage process in
which the majority of the clinical and
perhaps the microbial benefit occurs
within a short time frame followed by a
period of stability aided by mainten-
ance scaling and home care procedures.
A number of studies have evaluated
the effect of SRP on selected subgingi-
val taxa (Sbordone et al. 1990, Ali et al.
1992, Sato et al. 1993, Mombelli et al.
1994, Gunsolley et al. 1994, Shiloah &
Patters 1994, Nieminen et al. 1995).
Short-term reductions in the levels or
proportions have been reported for Tre-
ponema denticola and Porphyromonas
gingivalis (Simonson et al. 1992, Shi-
loah & Patters 1994, Lowenguth et al.
1995). Longer-term studies have also re-
ported a decrease in the levels and
prevalence of certain species. For ex-
ample, Shiloah & Patters (1996) found
a decrease in the prevalence of P. gingi-
valis, Actinobacillus actinomycetem-
comitans and Prevotella intermedia 12
months post SRP in the absence of sup-
portive periodontal therapy. Gunsolley
et al. (1994) monitored a population of
young adults with periodontitis for 12
months post SRP and surgery with
maintenance therapy. In that study
mean levels of P. gingivalis and A. acti-
nomycetemcomitans remained constant
at 3, 6 and 9 months, but a significant
increase in P. gingivalis was seen at the
12-month time-point in sites exhibiting
attachment loss. Rawlinson and co-
workers (1993) examined 30 sites in 15
adult periodontitis subjects by culture
12 months post SRP and found de-
Maintenance therapy 31
ance phase. Thus, the purpose of the
Mean (∫SD) Range present investigation was to evaluate the
microbial and clinical effects of SRP in
48∫11 29–71
2.5∫2.6 0–8
32 subjects who were followed for a 12-
38 month period and received periodontal
3.2∫0.3 2.6–3.9 maintenance scaling and oral hygiene
3.0∫0.9 1.4–4.9 instruction every 3 months.
73∫80 0–100 Material and Methods
68∫31 0–100 Subject selection
63∫38 3–100
3∫6 0–22 Subjects were selected according to the
69∫13 45–92 protocol previously described (Haffajee
29∫13 7–55 et al. 1997a). Briefly, subjects were ±20
2∫2 0–11 years of age, had at least 20 natural teeth
75∫22 22–99
and at least 8 sites with pocket depth ±4
20∫16 1–58
5∫7 0–24
mm and/or attachment level ±3 mm.
Subjects were excluded from partici-
pation if they had any systemic con-
dition which would affect the progress of
creases in the counts of Prevotella inter- periodontal disease or the nature of the
media, Porphyromonas asaccharolytica, therapy and if they needed to be pre-
and Prevotella veroralis/buccalis. medicated for dental treatment and
Previously, Haffajee et al. (1997a) re- monitoring. Subjects were also excluded
ported clinical and microbiological re- if they were pregnant, had received peri-
sults at 3 and 6 months post SRP in 57 odontal and/or antibiotic therapy in the
subjects with adult periodontitis. In previous 3 months, had evidence of lo-
that study, SRP decreased pocket depth calized juvenile periodontitis, or necrot-
and attachment level; reduced the izing ulcerative gingivitis.
prevalence and levels of Bacteroides for- A total of 57 subjects were included
sythus, P. gingivalis, and T. denticola, in the original study (Haffajee et al.
but none of the other 37 species tested. 1997a). Those subjects exhibiting a loss
Subsequently, it was demonstrated that of attachment of ±2.5 mm at any site
subjects with a poor response to SRP or an overall mean attachment level loss
did not harbor these species in high at any of the maintenance visits were
numbers pre-therapy (Haffajee et al. exited from the study and received
1997b). 32 of the subjects evaluated in further treatment. Thus, the results re-
these studies continued to be monitored ported are for the 32 subjects for whom
at 9 and 12 months post SRP providing data were available at each time point
the opportunity to examine clinical and and who successfully completed the 12-
microbial changes during the mainten- month study.
Fig. 1. Bar chart of the mean clinical parameters (∫SEM) at baseline and 12 months post
SRP (n subjectsΩ32). The significance of differences between pre and post therapy visits was
determined using the Wilcoxon signed ranks test. Note that the y-axis does not start at 0.
32 Cugini et al.

Clinical procedures

Clinical parameters were assessed at 6

sites per tooth at each time point.
Plaque, gingival redness, bleeding on
probing (BOP) and suppuration were
recorded as present or absent (0/1).
Pocket depths and attachment levels
were measured twice at each visit using
a North Carolina periodontal probe,
and the mean of each pair of measure-
ments computed for each site.
After baseline clinical and microbio-
logical assessments, subjects received 4
quadrants of SRP under local anes-
thesia. SRP was completed within 1
month. Subjects were monitored clin- Fig. 2. Plot of mean clinical parameters (∫SEM) at baseline, 3, 6, 9, and 12 months post SRP
ically and microbiologically at 3, 6, 9, for the 32 subjects. Significance of differences for the mean clinical parameters at different
and 12 months post therapy. At each time points was evaluated using the Quade test. Note that values on the y-axis in the left
post-therapy monitoring time point, panel present pocket depth on the left and attachment level on the right, and neither axis
subjects received full mouth periodontal starts at 0.
maintenance scaling and instruction in
home care procedures.

Microbiological assessment

After removal of supragingival plaque,

subgingival plaque samples were taken
from the mesiobuccal aspect of each
tooth in each subject using individual
sterile Gracey curettes. Counts of 40
subgingival species were determined in
each plaque sample using a modification
(Haffajee et al. 1997a) of the checker-
board DNA-DNA hybridization tech-
nique (Socransky et al. 1994). The
samples were placed in separate Eppen-
dorf tubes containing 0.15 ml TE (10
mM Tris-HCl, 1 mM EDTA, pH 7.6)
and 0.15 ml of 0.5 M NaOH was added. Fig. 3. Plot of mean pocket depth and attachment level (∫SEM) at baseline, 3, 6, 9, and 12
months post SRP at sites with initial pocket depths of ∞4, 4–6 and ±6 mm. Significance of
The samples were lysed and the DNA
differences for the mean clinical parameters at different time points was evaluated using the
placed in lanes on a nylon membrane Quade test. Note that the y-axis does not start at 0.
using a Minislot device (Immunetics,
Cambridge, MA). After fixation of the
DNA to the membrane, the membrane
was placed in a Miniblotter 45 (Im- the concentration of each DNA probe. Southfield, MI, USA) in the detection
munetics, Inc.) with lanes of DNA at 90æ This procedure was carried out in order step. Over 92% of all probes:heterolog-
angles to the lanes of the device. Digoxi- to provide the same sensitivity of detec- ous species reactions did not exhibit
genin-labeled whole genomic DNA tion for each species. Failure to detect a cross-reactions under the conditions of
probes to 40 subgingival species were hy- signal was recorded as zero, although the assay. Some probes such as those to
bridized in individual lanes of the Minib- conceivably, counts in the 1 to 1000 B. forsythus, P. gingivalis, T. denticola,
lotter. After hybridization, the mem- range could have been present. Signals and Selenomonas noxia did not exhibit
branes were washed at high stringency were evaluated visually by comparison cross-reactions with any heterologous
and the DNA probes detected using with the standards for the test species. species tested. When cross-reactions
antibody to digoxigenin conjugated with They were recorded as 0, not detected; 1, were observed, they were always within
alkaline phosphatase and chemilumi- ∞105 cells; 2, ∂105; 3, 105 to 106; 4, the same genera and the level limited
nescence detection. Signals were de- ∂106; and 5, ±106 cells. (Socransky et al. 1998).
tected using Reflection NEF film (Du- The specificity of the probes was
pont, Boston, MA). 2 lanes in each run examined using a Storm Fluorimager
Statistical analysis
contained standards at concentrations (Molecular Dynamics, Sunnyvale, CA,
of 105 and 106. The sensitivity of this as- USA) and Attophos (Amersham Life The % of sites that exhibited gingival
say was adjusted to permit detection of Science, Arlington Heights, IL, USA) redness, plaque, BOP and suppuration
104 cells of a given species by adjusting instead of Lumiphos 530 (Lumigen, were computed for each subject for

Fig. 4. Prevalence and levels of 40 subgingival species prior to and 12 months after SRP in
32 subjects (n samplesΩ1622). The left panel summarizes pre-therapy values and the right
panel post therapy values. The total length of each bar stack indicates the % of sites colonized,
i.e. the prevalence of species. The different shadings within each stack indicate the % of sites
colonized by different levels of species. The significance of differences in levels between pre and
post therapy visits was determined using the Wilcoxon signed ranks test (*p∞0.05, **p∞0.01,
***p∞0.001).
each monitoring visit and averaged
across subjects for that visit. The means
of each pair of pocket depth and
attachment level measurements at each
site were averaged within subjects and
then averaged across subjects for each
time point. The % of sites colonized by
each test species was determined for
each subject and was averaged across
subjects for each time point. For some
analyses the percent of the DNA probe
count was computed by converting the
ranks of each species at each site to ab-
solute counts, summing the values and
computing the proportion that each
species comprised of the total DNA
probe count at each site. The mean %
DNA probe count was computed by av-
eraging values for each species within a
subject and then across subjects at each
time point. The significance of differ-
ences between the baseline and 12
month data was determined using the
Wilcoxon signed ranks test. Significance
of differences at multiple time points
was computed using the Quade test.
Results
Baseline clinical parameters of the 32
subjects in the study are described in
Table 1. Average pocket depth and
attachment level for the group at base-
line was 3.2∫0.3 mm and 3.0∫0.9 mm,
respectively.
The effects of SRP on the clinical
parameters at 12 months are shown in
Fig. 1. Significant decreases post SRP
were seen for pocket depth (p∞0.001),
BOP (p∞0.001), and plaque (p∞0.05).
Fig. 2 presents mean values for each
clinical parameter at each visit. Pocket
Maintenance therapy 33
depth and BOP showed a continued de-
crease over the 12-month period.
Attachment level showed a significant
decrease at 3 months post SRP but
failed to reach significance at the 12-
month time point (pΩ0.059), although
stabilization of attachment level was
demonstrated. The effect of SRP at dif-
ferent initial pocket depths is shown
in Fig. 3. Deeper pockets (±6 mm)
showed the greatest decrease in both
pocket depth and attachment level. In-
termediate sites (4–6 mm) showed mod-
erate improvement in pocket depth
while shallow sites exhibited the least
amount of change.
The levels and prevalence of 40 sub-
gingival species examined at baseline
and 12 months are shown in Fig. 4. Sig-
nificant increases in levels and preva-
lence were seen for Actinomyces naes-
lundii genospecies 2, Actinomyces odon-
tolyticus, Capnocytophaga sp., Fuso-
bacterium nucleatum ss polymorphum,
Streptococcus mitis and Veillonella par-
vula while B. forsythus, P. gingivalis and
S. noxia decreased significantly.
Fig. 5 presents the species that dif-
fered significantly as a % of the total
DNA probe count at 12 months post
SRP. The proportion of the total DNA
probe count that B. forsythus, P. gingi-
valis, T. denticola and Streptococcus
constellatus comprised was significantly
decreased at 12 months while other spe-
cies including V. parvula, A. naeslundii
genospecies 2 and F. nucleatum ss poly-
morphum increased in proportion.
The effect of SRP on pocket depth,
as well as prevalence and % DNA probe
count for B. forsythus and P. gingivalis
at each time point is presented in Fig.
6. Both species declined in prevalence
until 6 months and showed a slight in-
crease at 9 and 12 months post therapy
whereas proportions continued to de-
crease. The decline in proportion of
these species paralleled the decrease in
pocket depth. Fig. 7 highlights the re-
lationship between pocket depth and B.
forsythus. The Pearson product mo-
ment correlation between mean pocket
depth and mean % of DNA probe
count for B. forsythus at the 5 visits was
0.96 (p∞0.01). This decline in the pro-
portion of B. forsythus and other spe-
cies was accompanied by an increase in
% of DNA probe count for other mem-
bers of the subgingival microbiota in-
cluding A. naeslundii genospecies 2 (Fig.
8). This pattern was seen at both shal-
low (∞4 mm) and deeper sites (>4
mm).
34 Cugini et al.

Discussion
The purpose of the present investiga-
tion was to evaluate the clinical and mi-
crobial changes that occurred during
the maintenance phase after an initial
therapy that consisted of meticulous
full-mouth SRP. The results indicated
that most clinical improvement and mi-
crobial changes occurred during the
first 3 months post SRP. In particular,
mean attachment level decreased sig-
nificantly at 3 months and was main-
tained during the 12 months of the
study. Other clinical parameters such as
mean pocket depth and % of sites that
bled on probing showed a marked im-
provement 3 months post SRP but also
continued to show improvement during
the maintenance period. Interestingly,
these improvements occurred in the ab-
Fig. 5. Bar chart of the mean % of DNA probe count (∫SEM) of subgingival species at sence of a significant decrease in the %
baseline and 12 months post SRP in 32 subjects. Significance of differences was determined of sites exhibiting visible plaque or gin-
using the Wilcoxon signed rank test (*p∞0.05, **p∞0.01, ***p∞0.001).
gival redness. The clinical changes were
similar to those reported in a number
of studies that described initial mean
clinical improvement followed by a
period of periodontal tissue stability
(Pihlström et al. 1983, Ramfjord et al.
1987, Kahldahl et al. 1993).
The mean clinical changes in the
present investigation were accompanied
by specific changes in mean levels of the
subgingival microbiota. Periodontal
pathogens, such as B. forsythus and P.
gingivalis and the suspected pathogens,
T. denticola and S. constellatus were sig-
nificantly reduced in prevalence, pro-
Fig. 6. Effect of SRP on mean pocket depth as well as prevalence and % of DNA probe count portions and in levels post SRP. The
(∫SEM) of B. forsythus and P. gingivalis over time. The center panel depicts pocket depth, most profound reduction occurred dur-
while the left and right panels present prevalence and % of DNA probe count, respectively. ing the first 3 months post SRP al-
Significance of differences at different time points was evaluated using the Quade test though these species were still reduced
(**p∞0.01, ***p∞0.001). significantly at 12 months when com-
pared with pre-treatment levels. Thus,
maintenance scaling appeared to be im-
portant in maintaining the initial post
therapy decreases in selected species for
prolonged periods of time.
While SRP appeared to be effective
in lowering the numbers of selected
periodontal pathogens, none of these
species was eliminated from any subject
by this therapy. Therefore if elimination
of a specific subgingival species is
thought to be essential for therapeutic
success, SRP is unlikely to be the treat-
ment of choice. Further, SRP appeared
to be effective in reducing a defined sub-
set of subgingival species, suggesting
that subjects with low numbers or none
of these species would receive limited
Fig. 7. Bar chart of the relationship between mean pocket depth and % of DNA probe count benefit from this therapy. There is a cav-
(∫SEM) of B. forsythus for 32 subjects over time (n samplesΩ4078). eat to this study, in that a number of

Fig. 8. Effect of SRP on % of DNA probe count (∫SEM) of B. forsythus and A. naeslundii
genospecies 2 over time. The left panel depicts sites with initial pocket depths ∞4 mm and the
right panel sites with initial pocket depth of ∞4 mm. n subjectsΩ32, n samplesΩ4078. Signifi-
cance of differences at different time points was evaluated using the Quade test (*p∞0.05,
***p∞0.001).
subjects who exhibited disease pro-
gression were exited to receive further
therapy. Therefore, the clinical and
microbiological data were derived from
subjects who exhibited periodontal sta-
bility for the 12-month period. The re-
sults from this group demonstrated that
SRP is an effective long-term therapy
when combined with regular mainten-
ance in a large proportion of subjects
with adult periodontitis.
One of the strongest associations seen
in the data of the current investigation
was that between decreased pocket depth
and the decreased proportion of B. for-
sythus. The relationship between pocket
depth and B. forsythus has been noted by
a number of investigators (Gmur et al.
1989, Haffajee et al. 1998, Socransky et
al. 1998). In the present investigation, it
was not clear whether a decrease in
pocket depth affected colonization by B.
forsythus, or whether a decrease in B.
forsythus led to an improved clinical out-
come. However, the prevalence of B. for-
sythus is lower at shallow sites and in
periodontally healthy and successfully
treated individuals (Haffajee et al. 1998).
Thus, the effectiveness of SRP may be
due, in part, to its ability to reduce levels
of B. forsythus which can be maintained
at these lower levels by maintenance pro-
cedures.
One of the striking findings in this
study was the increase in prevalence and
levels of certain putative beneficial spe-
cies such and V. parvula and A. naeslun-
dii genospecies 2. Clearly, a decrease in
proportion of some species, such as B.
forsythus, must be accompanied by an
increase in proportion of all or a specific
subset of subgingival species. The data
suggest that this increase was limited to
specific species. At 12 months post-ther-
apy, A. naeslundii genospecies 2 was de-
tected on average at about 80% of
sampled sites and comprised almost 40%
of the total DNA probe count. These
findings suggest that one of the more im-
portant effects of SRP was to increase
suspected beneficial species that might
diminish potential harmful effects of
other, more pathogenic species coloniz-
ing the same periodontal site.
While SRP is the most commonly
employed form of periodontal therapy
in both the initial and maintenance
phases of treatment, it is unlikely to be
sufficient to control periodontal disease
progression in all periodontitis subjects.
The procedure is designed to remove
hard and soft deposits from tooth sur-
faces above and below the gingival mar-
gin. SRP, however, does have limi-
tations including the inability to ad-
equately instrument deep periodontal
pockets and bifurcations as well as re-
move organisms within the tissues lin-
ing the periodontal pocket. Removal of
deposits and organisms from these loca-
tions may require surgical intervention
and/or the use of antimicrobial agents.
Nonetheless, the results of the present
investigation confirm the notion that
SRP can control periodontal diseases in
a major proportion of adult peri-
odontitis subjects since almost 60% (32/
57) of subjects were successfully treated
and maintained by this therapy.
The results of the present investiga-
Maintenance therapy 35
tion reinforced the notion that most
clinical improvement and the greatest
reduction in specific subgingival species
occurred within the first 6 months post
SRP and clinical and microbial par-
ameters remained stable or improved
modestly thereafter. The initial clinical
improvements and long-term stability
were associated with limited changes in
the subgingival microbiota. There were
decreases in periodontal pathogens
such as B. forsythus and P. gingivalis,
as well as an increase in potentially
beneficial Actinomyces species. The
data suggest that the maintenance
phase of therapy may be essential in
consolidating clinical and microbiologi-
cal improvements achieved as a result of
initial therapy.
Acknowledgments
This work was supported in part by re-
search grant DE-04881 from the Na-
tional Institute of Dental and Cranio-
facial Research.
Zusammenfassung
Auswirkungen von Scaling und Wurzelglät-
tung auf die klinischen und mikrobiologischen
Parameter parodontaler Erkrankungen: Er-
gebnisse nach 12 Monaten
Bei 32 Patienten (mittleres Alter 48∫11) mit
Erwachsenenparodontitis wurden die klini-
schen und mikrobiologischen Auswirkungen
von Scaling und Wurzelglättung (SRP) über
einen Zeitraum von 12 Monaten untersucht.
Plaque, Rötung der Gingiva, Eiterung und
Blutung auf Sondieren, Sondierungstiefe
(ST) und Attachmentlevel (PAL) wurden vor
sowie 3, 6, 9 und 12 Monate nach SRP ge-
messen. Subgingivale Plaqueproben wurden
zu jedem Untersuchungstermin entnommen
und mittels ‘‘Checkerboard’’ DNS-DNS-Hy-
bridisierungstechnik nach Vorkommen und
Menge von 40 subgingivalen Spezies ausge-
wertet. Bei jedem Patienten wurde während
jedes Untersuchungstermins ein Scaling im
Sinne einer unterstützenden Nachsorge
durchgeführt. Unterschiede der klinischen
Parameter bzw. des Vorkommens sowie der
Menge der untersuchten Bakterien vor bzw.
nach Therapie wurden mit Hilfe des Wilco-
xon-Tests analysiert. Der Quade-Test für ver-
bundene Stichproben wurde benutzt, um
multiple Untersuchungen zu analysieren. Die
mittlere ST (∫Standardfehler) reduzierte sich
von 3.2∫0.3 mm vor SRP auf 2.9∫0.3 12
Monate danach (p∞0.01). 6 Monate nach
SRP ergab sich ein signifikanter Attachment-
gewinn, der dann bis zu 12 Monate nach
SRP stabil blieb. Bluten auf Sondieren
(p∞0.001) und Rötung der Gingiva (p∞0.05)
waren signifikant reduziert 12 Monate nach
SRP. Prävalenz und Menge von Porphyromo-
36 Cugini et al.

nas gingivalis, Bacteroides forsythus und Tre-
ponema denticola nahmen zur Untersuchung
nach 6 Monaten ab und blieben auch nach 9
und 12 Monaten niedrig. Signifikante Zu-
nahmen in der Prävalenz und Menge wurden
für Actinomyces naeslundii Genospezies 2,
Actinomyces odontolyticus, Fusobakterium
nucleatum Subspezies polymorphum, Strepto-
coccus mitis, Capnocytophaga-Spezies und
Veillonella parvula beobachtet.
Résumé
L’effet du détartrage et du surfaçage sur les
paramètres cliniques et microbiologiques de la
maladie parodontale: résultats à 12 mois
Les effets cliniques et microbiologiques du
détartrage et du surfaçage radiculaire (SRP)
chez 32 sujets d’âge moyen de 48∫11 ans
avec parodontite de l’adulte ont été évalués
pendant 12 mois. Des mesures cliniques de la
plaque dentaire, de la rougeur gingivale, de
la suppuration, du saignement au sondage,
de la profondeur de poche et du niveau d’at-
tache ont été effectués avant le SRP et 3, 6,
9 et 12 mois après. Des échantillons de pla-
que sous-gingivale ont été prélevés à chaque
visite et analysés en utilisant la technique
d’hybridisation par ADN-Damier ADN
pour la présence et les taux de 40 espèces
sous-gingivales. Chaque sujet a également
reçu un détartrage de maintenance à chacune
des ces visites de suivi. Des différences dans
les paramètres cliniques et la fréquence glo-
bale et les niveaux d’espèces bactériennes ont
été analysés avant et après le traitement en
utilisant le test de Wilcoxon de signed ranks.
Le test Quade pour les échantillons en rela-
tion a été utilisé pour l’analyse des visites
multiples. La profondeur de poche moyenne
diminuait de 3.2∫0.3 mm lors de l’examen
initial à 2.9∫0.3 mm douze mois après
(p∞0.01). Le niveau d’attache moyen accu-
sait une réduction significative après 6 mois
mais ne diminuait plus ensuite. Le saigne-
ment au sondage et la plaque dentaire étaient
significativement réduits après douze mois
(respectivement p∞0.001, p∞0.05). Le Por-
phyromonas gingivalis, le Bacteroides forsy-
thus et le Treponema denticola diminuaient
puis se nivelaient à la visite de 6 mois et de-
meuraient à ces niveaux bas lors des examens
à neuf et 12 mois. Les augmentations signi-
ficatives dans les niveaux et fréquences globa-
les étaient notées à douze mois pour l’Actino-
myces naeslundii géno-espèces 2, l’Actinomy-
ces odontolyticus, le Fusobacterium nucleatum
ss polymorphum, le Streptococcus mitis, le
Capnocytophaga sp et le Veillonella parvula.
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Address:
A. D. Haffajee
Department of Periodontology
The Forsyth Institute
Boston, MA
USA