The use of a disclosing agent during resective periodontal surgery for improved removal of biofilm

Marco Montevecchi, Vittorio Checchi, Maria Rosaria Gatto, Sascha Klein, Luigi Checchi, Marco Montevecchi, Vittorio Checchi, Maria Rosaria Gatto, Sascha Klein, Luigi Checchi

Abstract

A total removal of the bacterial deposits is one of the main challenges of periodontal therapy. A surgical approach is sometimes required in order to allow a correct access to the areas not thoroughly reached during the initial therapy. The present study focuses on the surgical scaling effectiveness in root deposits removal; the potential support of a disclosing agent during this procedure is also evaluated. Forty surgical periodontal patients were randomly divided between surgeries where the operator was informed about a final examination of the residual root deposits and surgeries where the operator was not informed. Straight after scaling procedures a supervisor recorded the O'Leary Plaque Index of the exposed roots by mean of a disclosing agent and the percentage of teeth with residual biofilm. After the stained deposits removal, a second chromatic examination was performed and new data were collected. Mann-Whitney U-test and Wilcoxon test for paired samples were used for comparisons respectively between the two surgery groups and the first and the second chromatic examination; one-sided p-value was set at 0.05. At first examination no significant differences between the two groups were observed regarding Plaque Index (p=0.24) and percentages of teeth with residual biofilm (p=0.07). The 100% removal of roots deposits was never achieved during the study but a significant reduction of 80% of root deposits was observed between first and second examination (p=0.0001). Since root deposits removal during periodontal surgery resulted always suboptimal, the use of a disclosing agent during this procedure could be a useful and practical aid.

Keywords: Disclosing agent; biofilm; periodontal surgery; scaling and root planing..

Figures

Fig. (1)
Fig. (1)
Palatal view of the target area just before surgery.
Fig. (2)
Fig. (2)
Palatal view after flap rising: submarginal surfaces are now exposed and calculus is detectable.
Fig. (3)
Fig. (3)
Palatal view during disclosing agent application.
Fig. (4)
Fig. (4)
Palatal view after disclosing agent washing: stained biofilm and calculus are now clearly detectable.
Fig. (5)
Fig. (5)
Palatal view after root deposits removal.
Fig. (6)
Fig. (6)
Third molar, devoid of periodontal problems, extracted and stained according to the protocol of this study. Note the pigmented periodontal ligament and the area free of stain after a curette stroke.

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