Short-Term Clinical Outcomes of Initial Scaling and Root Planing with or Without Surgical Periodontal Therapy in Patients with Advanced Periodontitis: A Retrospective Comparative Study

Background/Objectives: Surgical periodontal therapy is frequently performed when residual periodontal pockets persist after scaling and root planing (SRP). This study compared the clinical outcomes of SRP alone and SRP followed by surgical periodontal therapy in patients with stage III/IV periodontitis. Methods: A retrospective comparative study was conducted in 180 adults with stage III/IV periodontitis. Ninety patients received SRP alone, while ninety underwent SRP followed by surgical periodontal therapy when clinically indicated. Probing depth (PD), clinical attachment level/loss (CAL), and bleeding on probing (BOP) were recorded at baseline and at a 12-week reevaluation. Results: PD reduction was significantly greater in the SRP followed by surgical therapy group than in the SRP-alone group (p < 0.001). BOP also showed a significantly greater reduction following surgical therapy (p < 0.001). CAL improved in both groups; however, the between-group difference was not statistically significant (p = 0.104). Conclusions: Both treatment approaches improved periodontal clinical parameters. However, SRP followed by surgical periodontal therapy resulted in greater reductions in probing depth and bleeding on probing, while CAL improvement was similar between groups.