Graduation Date

Summer 8-14-2015

Document Type

Thesis

Degree Name

Master of Science (MS)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Wayne Kaldahl

Abstract

Purpose: Scaling and root planing with adjunctive chemical pocket disinfection (SRP+C) utilizing sodium hypochlorite solution has been used to treat inflamed pockets of periodontal maintenance patients for many years, without evidence of its benefits. The primary objective was to determine if SRP+C is more effective than scaling and root planing alone (SRP) in improving clinical outcomes. The secondary objective was to compare the effect of SRP+C and SRP on pro-inflammatory IL-1β, anti-inflammatory IL-1ra, and anti-inflammatory index (IL-1ra/IL-1β ratio) found in gingival crevicular fluid (GCF).

Materials and Methods: Pockets (≥ 5 mm and BOP) of 31 maintenance patients were included. Test (SRP+C; 41 sites) and control (SRP; 43 sites) therapies were randomly administered. Clinical measurements and GCF samples were collected at baseline and 3-months post-therapy. Cytokine levels were determined and all data analyzed.

Results: Both SRP+C and SRP resulted in significant improvements of all clinical outcomes with no differences between therapies. There were no differences between therapies in IL-1β and anti-inflammatory index. IL-1ra was greater in SRP+C than SRP post-therapy (P = 0.007). When the results of both therapies were combined, the anti-inflammatory index was greater (P = 0.02) with a trend in greater PD reduction (P = 0.0552) in sites where bleeding on probing (BOP) resolved compared to unresolved sites.

Conclusions: The addition of sodium hypochlorite to scaling and root planing did not improve clinical parameters in inflamed pockets of periodontal maintenance patients, but increased anti-inflammatory IL-1ra.

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