Clinical and biological effects of the topical application of antimicrobial agents accompanied by scaling and surfacing

Authors: Stamate Eduard, Silvia Martu


Gingivitis and periodontitis are dental plaque-induced infections triggered by the accumulation and maturation of pathogenic film on the tooth surface and the oral cavity soft tissues. Subgingival plaque control plays an essential role in periodontal disease treatment. In addition to subgingival scaling, the topical application of antimicrobial preparations was supported and used
since beneficial effects were noticed when it was employed as adjuvant therapy to conventional treatment, both from the clinical and microbiological viewpoints. Aim: This trial was designed to compare the effects of the topical application of certain antimicrobial agents (such as chlorhexidine and an antibiotic gel) accompanied by root scaling and surfacing, and to reveal the possible treatment response differences between medium deep and very deep periodontal pockets. Material and method: The trial was performed on a group of 216 patients of the Periodontology Clinic aged between 24 and 47 years, of whom 148 were suffering from generalized marginal chronic periodontitis and 68 from aggressive marginal periodontitis. The patient inclusion criteria were: no antibiotic treatment on the 3 months preceding the trial and no periodontal treatment on the 6 months preceding the trial; only patients suffering from a generalized or aggressive periodontal condition were included, and not those whose condition did not require the topical application of chemotherapeutical substances. Results: After 4 weeks, the pockets that were smaller than 4.4 mm decreased by 9 % further to scaling, by 16.5% after chlorhexidine treatment, and by 19.3% in patients that underwent antibiotic gel treatment. Combined chlorhexidine treatment resulted into a 24.7% drop, antibiotic treatment triggered a 25.6% decrease, and root scaling and surfacing brought about a 19.5% drop.
Conclusions: We may say that root scaling and surfacing is an extremely efficient method in treating moderate and/or severe periodontitis. Although most of the sites respond positively to this treatment, when there are however sites that require a more complex treatment, topically released antimicrobial products are recommended.

  • curettage
  • scaling
  • topical medical treatment.