The Clinical Effectiveness of Subgingival Scaling and Root Planning in vivo, Direct versus Indirect Root Surface Debridement.

This study compared the effectiveness of subgingival bacterial plaque and calculus removal following periodontal scaling and root planing using an indirect closed versus direct open periodontal flap approach. Patients requiring extractions due to advanced periodontal disease were the source of the 60 single rooted teeth comprising the study group. The periodontal status of test and control teeth was evaluated initially by the Gingival Index G.I. of Loe and Silness, the Plaque Index PII of Silness and Loe and the Periodontal Index PDI of Ramfjord. The results favor the open flap procedure by a mean of 20.51 greater effectiveness. However, if one considers the root surfaces by various depths and surface areas, there is no statistically significant difference between the open and closed treatment when the periodontal pocket is greater than 3.0 mm deep. Although there was an 18 mean increase in effectiveness of plaque and calculus removal at depths greater than 3.0 mm by the open approach it did not prove to be statistically significant. This was due to the large variance within group values.