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The removal of interproximal plaque was compared using a standard toothbrush alone, a toothbrush with unwaxed dental floss and a toothbrush with an interdental brush. 30 previously treated periodontal patients were given the cleaning aids in a three-way crossover study design. After each 1 month trial period, scores for gingivitis, buccal/lingual plaque and proximal plaque were recorded. Mean GI scores for subjects were 0.37 using the toothbrush only, 0.36 using the toothbrush with floss and 0.32 using the toothbrush with the interdental brush. Mean buccal/lingual plaque scores were 0.64 using the toothbrush only, 0.62 using the toothbrush with floss and 0.51 using the toothbrush with the interdental brush. Mean proximal plaque scores were 2.32 with the toothbrush only, 1.71 using the toothbrush with floss and 1.22 using the toothbrush with the interdental brush. Statistically significant differences were seen in proximal plaque scores between the 3 treatment groups. The results indicate that the interdental brush used in combination with a toothbrush is more effective in the removal of plaque from proximal tooth surfaces than a toothbrush used alone or in combination with dental floss. [ABSTRACT FROM AUTHOR]

The healing events of 7 patients with generalized chronic periodontitis were monitored clinically during 3 consecutive phases of treatment: 1) tooth brushing and flossing, 2) subgingival use of the Perio-Aid®, and 3) supra and subgingival instrumentation. The clinical parameters evaluated were plaque score, bleeding score, probing pocket depth, probing attachment level, and gingival recession. Each phase continued until maximum effects were achieved (5, 3, and 9 months respectively) determined by minimal or no changes in bleeding scores and probing pocket depths between 3 successive examinations. The results showed limited improvement in the bleeding scores and probing pocket depths with tooth brushing and flossing only (Phase 1). During use of the Perio-Aid (Phase 2), there was no additional improvement, but the initial limited gains made during Phase 1 were maintained. By the end of Phase 2, however, a slight loss of probing attachment level was noticeable. After instrumentation (Phase 3), there was further and more pronounced improvement in bleeding scores and probing pocket depths, as well as a reversal of the probing attachment loss. The results of this study indicate that significant improvement in periodontal pockets should not be expected following home care procedures alone, and that instrumentation may account for the bulk of improvement seen following a combined therapy of plaque control and instrumentation. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine whether changes in probing attachment levels are related to subgingival spirochete or leukocyte counts in periodontal pockets. Following initial clinical recordings and therapy consisting of oral hygiene instruction and root debridement, the probing attachment levels of proximal sites of 120 single-rooted teeth in 7 patients were measured every 3 months for 12 months. The measurements of each site were subjected to regression analysis, which determined whether the site was deteriorating, improving, or non-changing. Subgingival washings were taken of 19 deteriorating, 22 improving, and 127 non-changing sites to determine the number and % of spirochetes and the number of leukocytes at each site. Improved probing attachment levels were associated with reduced numbers of spirochetes and leukocytes. However, the ranges of individual measurements of subgingival washing variables overlapped considerably between groups. Spirochete and leukocyte counts related better to the 12-month probing depths than to changes in probing attachment levels during the preceding 12 months. These findings suggest that none of the tested subgingival washing parameters are suitable indicators of changes in attachment levels on an individual site basis. [ABSTRACT FROM AUTHOR]