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S/RPScaling and Root Planing
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Tabanella presents a case study of a tooth fracture associated with excessive and multiple sessions of scaling and root planing during maintenance therapy following treatment for periodontitis.
Comment: In this study, vitamin E supplementation, when used as an adjunct to scaling and root planing, improved chronic periodontitis.
The sites in the control group were treated by only scaling and root planing without use of laser.
After this procedure, the areas between the grooves were treated using scaling and root planing with manual instruments (Gracey curettes no.
Periodontitis is usually treated with scaling and root planing (SRP) as an initial therapy to remove subgingival plaque and calculus.
(2) Another systematic review showed, for periodontal pockets initially measuring 4 to 6 mm, the mean reduction in probing depth was 1.29 mm with a net gain in clinical attachment levels of 0.55 mm following scaling and root planing. (3) A 2012 systematic review, to be discussed next, showed a pronounced chance of pocket closure at 3 and 6 months following scaling and root planing (NSPT) with or without adjunctive antibiotics, although the addition of antibiotics showed additional benefits.
The goals of periodontal treatment and therapies are intended to arrest and control infection, remove plaque and calculus, reduce the amount of bioburden within the pocket, and provide an environment in which the tissue can return to health and be maintained primarily with scaling and root planing. (8) Some microorganisms remain on the root surface even after root planing and scaling procedures.
Nonsurgical scaling and root planing may remove or decrease the bacterial loads, but is frequently ineffective against Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Bacteroides forsythus, staphylococci and enteric rods.
As a companion article to clinical effectiveness of using the periodontal endoscope, Geisinger et al examined root surface area of residual calculus with and without the aid of this technology during scaling and root planing. (6) Fifty tooth pairs of single-rooted teeth with a hopeless prognosis were used in this study.
Recent investigations has examined the use of periodontal endoscopy in an effort to improve the outcome of scaling and root planing. The bulk of this research has been conducted on sites that have been non-responsive to traditional therapy.
Ultrasonic instrumentation in this era was a preliminary measure prior to definitive hand scaling and root planing. Clinicians had previously relied on chisels and hoes to break up heavy ledges of calculus; files and sickles eliminated the bulk of deposit before following with assorted curets and Gracey curets to root plane.