Application of full mouth disinfection combined with enamel matrix proteins in the treatment of chronic periodontitis

Application of full mouth disinfection combined with enamel matrix proteins in the treatment of chronic periodontitis: Microbiological and clinical evaluationPeriodontal disease is caused by the pathological events of periodontium. The majority of the inflammatory periodontal diseases are caused by bacterial infections and have multifactorial nature. The microorganisms that accumulate on the teeth (plaque and its products) seem to play the dominant role in the etiology of the periodontal disease. In the absence of bacterial plaque, none of the systemic disease has initiator effect on periodontitis. Therefore, the treatment of the disease is based on the mechanical removal of subgingival and supragingival biofilms from colonized teeth and root surfaces in order to arrest and control inflammatory processes. 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 12 weeks period, the clinical benefits of an one stage full-mouth disinfection with mine matixs proteins usage in the control of severe periodontitis. Fifty patients with severe adult periodontitis were randomly assigned to test and two control groups. The first control group with 15 patient was scaled and root planed, per quadrant, at 2-week intervals and given standard oral hygiene instructions. The oher control group with 15 patient had one stage full-mouth disinfection alone. In the test group the full mouth disinfection and the regenerative material, enamel matrix proteins that new treatment approaches are used together in the treament of the chronic periodontitis for the assessment of their efficiency. A one stage full-mouth disinfection was sought by scaling and root planing the 4 quadrants within 24 hours in combination with the application of saline to all intra-oral niches for periodontopathogens. The plaque index, gingival index were recorded at baseline and at 3, 6, 9, and 12 weeks afterwards. Probing depth, bleeding on probing, gingival recession, and clinical attachment level were recorded at baseline and at 12 week afterwards. All of the treatment modalities had a significant probing depth reduction and gain in attachment up to 12 weeks, and had significant improvments in other clinical parameters.The results of this study showed that all treatment groups provided statistically significant improvement on periodontal health while there were no differences between groups.