Initial Healing of Periodontal Pockets After a Single Episode of Root Planing Monitored by Controlled Probing Forces

THE PURPOSE OF the present study was to evaluate, using controlled probing forces, the response of periodontal pockets to a single episode of root planing. The clinical characteristics of 128 pockets (3-7 mm depth) distributed in ten subjects, were monitored immediately before and 1, 2, 3, and 4 weeks after a single episode of subgingival root planing. The clinical parameters measured were: pocket depth and bleeding after probing with 15 gm, 25 gm, 50 gm of controlled probing force and manual probing, gingival margin location, loss of attachment, gingival and plaque indices. Oral hygiene instruction and supragingival prophylaxis were given at each time point. An average aggregated score for each subject for each parameter was calculated at each time point. A repeated measure all-within analysis of variance was done, and the Tukey multiple range test was used to assess the significance of differences among and between the means. Plaque and gingival indices decreased significantly after 1 week. Significant pocket depth reduction (initial) occurred 1 week after root planing, and reduced further (secondary) at 3 weeks. Initial pocket reduction was associated with significant gingival recession, whereas secondary pocket reduction was associated with significant gain of clinical attachment. Bleeding upon probing was virtually absent after 3 weeks. All probing changes were detected more consistently using controlled insertion pressures. It was concluded that substantial reduction in pocket depth occurs within 3 weeks after a single episode of root planing owing to initial gingival recession and secondary gain in clinical attachment.