Mechanical Debridement of Subgingival Biofilm in Subjects with Asymptomatic Third Molars Does not Reduce Deeper Probing Depths in the Molar Regions of the Mouth

Thursday, October 10, 2013: 7:50 AM
Eric S. Burgon DDS, MD, Oral and Maxillofacial Surgery, University of North Carolina, Chapel Hill, NC
Ray White DDS, PhD, Oral and Maxillofacial Surgery, University of North Carolina School of Dentistry, Chapel Hill, NC
Elda Fisher DMD, MD, Department of Oral and Maxillofacial Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
George Blakey III DDS, Oral & Maxillofacial Surgery, UNC-Chapel Hill, Chapel Hill, NC
Steven Offenbacher DDS, PhD, MMSc, NC Oral Health Institute, UNC School of Dentistry, Durham, NC
Ceib Phillips MPH, PhD, Orthodontics, UNC-Chapel Hill, Chapel Hill, NC
Purpose: Assess the impact of mechanical debridement of sub-gingival biofilm on periodontal outcomes in young adults with asymptomatic 3rdmolars

Subjects and Methods: Healthy subjects with four asymptomatic 3rd molars were enrolled in an IRB-approved longitudinal study. Clinical data were collected at enrollment and at follow-up visits. Full mouth periodontal probing, 6 sites per tooth were assessed as measures of clinical periodontal status. At enrollment all subjects had a dental prophylaxis after data collection which included removal of sub-gingival biofilm; this was repeated annually. The primary outcome measures were the comparison from baseline to follow-up two years after enrollment of subjects’ periodontal probing depths for 3rd molars and 1st/2ndmolars. In addition, a comparison of extent scores baseline to follow-up two years after enrollment for periodontal probing sites at least 4mm (PD4+) were calculated for the same molar regions of the mouth. Changes over time in clinical periodontal status from enrollment to the follow-up at least two years later were analyzed with Mantel-Haenszel row mean score statistics. Level of significance set at P<0.05.  

Results: Median follow-up from entry to the study was 2.2 years (IQR 2.0-2.8 years) for 262 subjects who averaged 27.7 years of age (SD 1.2 years); 53% were female, and 81% Caucasian. Most subjects, 90%, were educated beyond high school. Based on periodontal probing depths, subjects’ clinical periodontal status did not differ from enrollment to follow-up.  

Conclusions: Dental prophylaxis at yearly intervals in subjects with asymptomatic 3rd molars which included mechanical removal of sub-gingival biofilm, had minimal or no impact on reducing deeper probing depths, clinical indicators of periodontal pathology in young adults.

References: 

Blakey GH, Jacks MT, Offenbacher S, Nance PE, Phillips C, Haug RH, White RP Jr. Progression of periodontal disease in the second/third molar region in patients with asymptomatic third molars.

 J Oral Maxillofac Surg 64:189, 2006

Nordland P, Garrett s, Kiger R, Vanooteghem R, Hutchens LH, Egelberg J: The effect of plaque 

     control and root debridement in molar teeth. J Clin Periodontol 14:231, 1987.

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