Long‐term effect of surgical and non‐surgical periodontal treatment. A 5‐year clinical study

The aim of the present study was to evaluate the long‐term (5 yr.) effect of surgical and non‐surgical periodontal treatment. 16 patients with advanced periodontal disease participated in the study‐ All patients were subjected to initial treatment comprising supra‐ and subgingival scaling and instruction in performing proper oral hygiene. Modified Widman flap surgery was always employed in a quadrant in both the maxilla and mandible. Reverse bevel flap surgery or root planing under local anesthesia were used in the contralteral quadrants. During the 1st 2 wk after surgery or root planing the patients rinsed twice daily with 0.2% chlorhexidine digluconate They were then recalled for professional tooth cleaning once every 2nd wk for the 1st yr. every 3rd month during the 2nd yr, and every 6th month during the last 3 yr. Subgingival scaling was performed at each recall appointment during the last 4 yr. Surgical as well as non‐surgical treatment resulted in a considerable reduction in probing pocket depth which was maintained during the 5‐yr observation period. A small gain of probing attachment (0.0‐0.4 mm) was assessed 3 months after treatment for all procedures, but after 5 yr a small loss of attachment (0.0‐0.2 mm) bad occurred in surgically treated areas, whereas a gain of 0.3 mm was maintained in the areas treated with root planing. The changes in bone level were minute following both surgical and non‐surgical treatment. Less than 5% of the tooth surfaces exhibited a loss of probing attachment of more than 2 mm or a loss of alveolar bone of 15% or more of the “normal” bone height alter 5 yr. The number of deteriorating sites in each individual did not correlate with the level of self‐performed oral hygiene.