The subgingival irrigation tip should be gently inserted into pockets or furcation areas, 3mm if possible, and each pocket shoud be. Among individuals who do not perform excellent oral hy giene, supragingival irrigation with and without medicaments is capable of reducing gingival inflammation beyond that normally achieved by toothbrushing alone. A comparative study n ravindrareddy 1, ds madhubabu 2, c mahendraraju 3, c himasilpa 1, k kiran 4 1 department of periodontics, cks teja institute of dental sciences, tirupati, india 2 department of periodontics, govt. To remove bias in any of the irrigation groups, 480 ml of supragingival oral irrigation is kept constant in group 3, group 4, and group 5. The ultrasonic scaler not the curette is your most potent weapon against periodontal disease. Effectiveness of subgingival irrigation as an adjunct to. Pocket irrigation aims to cleanse plaque from the interdental between teeth and subgingival under the gumline regions of the mouth in order to prevent the colonization of harmful oral bacteria.
Dentists have always liked the viajet for its convenient features, reliable construction and use of the same water pump found in. A wide array of subgingival irrigation devices have been used in patient applied home irrigation. Irrigation as an adjunct to oral hygiene seems to be of limited value. Perio flow ultrasonic adapter vista transforms piezo ultrasonic handpiece into a versatile subgingival pocket irrigator. Management of chronic periodontitis using subgingival.
In this chapter, surgical procedures will be presented that can be used effectively to retain teeth with a variety of complications in addition to pulpal disease. Professional subgingival oral irrigation is the inoffice flushing of pockets performed by the dental hygienist or dentist using one of three systems. Pdf the role of supra and subgingival irrigation in the treatment. Daily supragingival irrigation with a dilute antiseptic, chlorhexidine, lor o months resulted in significant reductions in bleeding and. Vf in % present in subgingival dental plaque following one single subgingival irrigation with saline s, chlorhexidine chx or povidone iodine i 2, but without any subgingival instrumentation. In the present study, the clinical parameters in individuals using toothbrushing alone significantly reduced from baseline to 14 and 28 days. Supragingival definition of supragingival by medical. Clinical effect of subgingival chlorhexidine i gation on gingivitis in adolescent orthodontic patients dan morrow, dmd, phd, david p. Selection of antimicrobial agents in periodontal therapy. Professional subgingival irrigation with antimicrobial agents is generally used as an adjunct to scaling and root planing srp. Subgingival irrigation showed overall reduction but not. Clinical trials on subgingival irrigation using chlorhexidine, providone iodine, tetracycline, boric acid etc have reported significant improvements in clinical and microbiological parameters of periodontal disease. This procedure is also used to deliver antibacterials to the subgingival areas. I he irrigators nozzle should be positioned at some distance from the gingival margin and ihe jet stream lined perpendicular to the long axis of the teeth to achieve optimal subgingival penetration of an irrigant dig.
The aim of this study was to evaluate clinical efficacy of different chlorhexidine gluconate chx preparations applied. The most common problems encountered are clinical crowns with subgingival carious or fractured margins. Wood, dds, mcid,b and mark speechley, phdc london, ontario, canada twentythree adolescent orthodontic patients with gingivitis affecting all. The object of this study was to monitor the proportion of vital bacteria microbial vitality. During the past decade numerous studies addressed the impact of subgingival irrigation on clinical and microbiologic parameters. Supragingival irrigation periodontal disease click to.
A minimally invasive interdisciplinary approach rambabu tanikonda 1, sasidhar nalluru 2, suneetha koneru 3, satheesh mannem 3 1 department of conservative dentistry and endodontics, vishnu dental college and hospital, bhimavaram, andhra pradesh, india 2 department of conservative dentistry and endodontics, dr. Povidoneiodine for subgingival irrigation and systemic antibiotics to reach microorganisms within periodontal tissues and in hardtoreach subgingival sites. Adjunctive subgingival application of chlorhexidine gel in. Subgingival irrigation of the periodontal pockets in the right two quadrants splitmouth study were performed with 10% povidoneiodine solutions 3 irrigations with 1ml solution with interval 1minute per periodontal pocket. It was prepared by the committee on research, science and therapy of the american academy of periodontology.
To evaluate the effectiveness of subgingival irrigation with 10% povidoneiodine as an adjunct to scaling and root planing srp and to assess the effectiveness of 10% povidoneiodine in reducing periodontal pathogens mainly porphyromonas gingivalis pg and aggregatibacter actinomycetemcomitans aa. Their use in regular clinical practice, however, is less, perhaps due to concerns about clinical success or probably due to a lack of knowledge of their effectiveness or cost. The 12step cleaning procedure is the foundation from which proper diagnosis and treatment flow. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Subgingival applications of various chemotherapeutic agents have been used as an adjunct to nonsurgical periodontal treatment and preventive periodontal therapy. The viajet is specifically designed for both supragingival and subgingival irrigation and is one of our most popular products. Effectiveness of subgingival irrigation as an adjunct to scaling and. Management of chronic periodontitis using subgingival irrigation of. The objective of this metaanalysis was to evaluate the efficacy of adjunctive subgingival. Supragingival and subgingival irrigation slideshare. Upon completion, students should be able to demonstrate knowledge of methods of treatment and management of periodontally compromised and special needs patients. Publishers pdf, also known as version of record includes final page. Supragingival and subgingival irrigation dental hygiene.
A graduate of the medical college of virginia school of dentistry, dr. Its effect on the main composition of the microflora was also assessed. This position paper addresses the role of supra and subgingival irrigation in the treatment of periodontal diseases. Patients seem to comply with recommendations to use home jet irrigators, and find them relatively easy to use. In subgingival irrigation currently, two types of irrigator tips are useful for subgingival irrigation. The application method of ttchcl in the present study was transoperatory subgingival irrigation after srp, which was idealized because it allows the irrigating solution to reach subgingival microflora of the periodontal pocket apical portion, regardless of the probing depth 11. In the regions treated with subgingival irrigation with 10% povidoneiodine solution superior reduction of the probing depth, more attachment gain and better reduction of the gingival inflammation. If you are diligent in applying these steps, your patients will benefit, your clients will notice the difference, and you will be rewarded. The efficacy of a single pocket irrigation on subgingival. Adjunctive role of supra and subgingival irrigation in. Adjunctive use of professional subgingival irrigation with scaling and root. Efficacy of subgingival irrigation with 10% povidone.
The aim of this randomized clinical trial was to evaluate the effect of subgingival irrigation of periodontal pockets with a hy droalcoholic solution of propolis extract 20% wv as an adjunct. Clinical effect of subgingival chlorhexidine irrigation on. Subgingival irrigationinterferes with complex ecosystem and prevents initiation or further. Does professional preventive care benefit from additional. This position paper addresses the role of supraand subgingival irrigation in the treatment of periodontal diseases. The document is divided into two portions, consisting of supragingival irrigation and subgingival irrigation. It is important to note that the majority of the studies concluded that water. The rftnthcfm treatment of plaqueinduced gingivitis. Lccc hygiene students demonstrate sub gingival irrigation.
Socransky, relationship of bacteria to the etiology of periodontal disease j dent res 49. Pocket irrigation periodontal disease is a progressive condition which leads to gum inflammation, the recession of bone and gum tissue, and tooth loss if left untreated. Assessment of the halflife of cationic periodontal pocket irrigation. Lory laughter, rdh, notes that the topic of antibiotic premedication for joint replacements during dental care seems to get buried under opinion and fear. Reviewing subgingival irrigations and future considerations charles h. There are a variety of effective treatments and procedures available, including pocket irrigation, which can assist in treating the progression of the disease. This position paper addresses the role of supra and subgingival irrigation in the treatment of periodontal. Studies of the incidence of measurable bacteremia, after a regiment of scaling and root planing or periodontal maintenance which can include site specific periodontal scaling and root planing show limited benefit from using a subgingival irrigation. Pocket irrigation kitchener, on lackner woods family. Effect of supragingival oral irrigation as an adjunct to.
Oral irrigation lias been shown to disrupt and detoxify subgingival plaque and can be useful in delivering antimicrobial agents into periodontal pockets. This was followed by an additional subgingival irrigation three times, repeated within 10 minutes of all pockets with a 1% chlorhexidine gel figure 5 in order to suppress the remaining bacteria. A literature search of electronic database was performed for articles published through december 31, 2014, followed by manual search of dental. Subgingival applications of chlorhexidine chx gel are commonly used as an adjunct in nonsurgical periodontal treatment nspt for chronic periodontitis cp. Localized irrigation of specific sites such as deep pocket, furcation, implant, crown and bridge. Overview in response to increasing concerns on the part of health care providers, thirdparty payers, and consumers about the quality, cost, and access to dental. The status of professional subgingival irrigation periodontitis treatment remains controversial 27,28. Professional subgingival irrigation foundations of. Why, to hide the ugly metal ring of the restoration. Subgingival irrigation irrigation with soft site specific tip.
I drank celery juice for 7 days and this is what happened no juicer required. Subgingival irrigation of the periodontal pockets in the right two quadrants splitmouth study were performed with 10% povidoneiodine solutions. During the past decade numerous studies addressed the impact of subgingival irrigation on. Sixty patients with chronic periodontitis of mild to.
Reddy irrigation involves the artificial application of water to soil, usually for assisting the growth of crops in dry areas or where there is a shortage of rainfall. Clinical effects of professional antimicrobial subgingival. Comparison of the efficacy of subgingival irrigation with. Attaches any style of luerlock irrigation tip to your piezo ultrasonic scaler. Subgingival irrigation performed with an oral irrigator using chlorhexidine diluted to onethird. How to do a subgingival irrigation procedure for periodontal patients or patients with severe gingivitis. As the process of agriculture becomes increasingly mechanised, the application of scientific methods and technology to the procedure of irrigation comes as no surprise. An introduction to subgingival ultrasonic scaling forget what you learned in school.
The aim of this study was to evaluate the efficacy of supragingival oral irrigation either with water or different concentrations of chlorhexidine chx digluconate as an adjunct to toothbrushing on plaque accumulation in chronic generalized gingivitis patients. Experimental periodontal disease treatment by subgingival. The following duties of a dentist shall not be delegated. This effect is likely due to the flushing out of subgingival bacteria.
Comparison of the efficacy of subgingival irrigation with 2% povidoneiodine and tetracycline hcl in subjects with chronic moderate periodontitis. Furthermore, tongue was brushed with 1% chlorhexidine gel chlorhexamed, glaxosmithkline figure 4 for 1 minute. Pdf different methods for subgingival application of chlorhexidine. Therefore, various subgingival irrigation devices syringe, jet irrigator with a cannula and ultrasonic instrument have been studied 9,10,11. Supragingival irrigation is usually performed once or twice daily by the patient as an adjunct to toothbrushing and flossing. Further studies utilizing larger sample sizes and longer followup periods are recommended for supporting the finding of this study. The current evidence of the use of subgingival irrigation alone or as an adjunct to scaling and root planing in the treatment of periodontitis remains controversial 43,44. Full mouth scaling and root planning within 24 hrs to reduce number of subgingival pathogenic organisms subgingival irrigation of all pockets with 1% chlorhexidine gel to kill remaining bacteria tongue brushing with an antiseptic to suppress the bacteria in the niche mouth rinsing with. Supragingival irrigation with water, water and antimicrobial, and placebo alone and in conjunction with tooth brushing showed no significant evidence in improved outcomes in treating and managing periodontal disease or gingivitis.
84 1063 240 53 793 1197 1512 469 789 814 1025 711 644 546 556 848 514 277 15 674 922 1338 940 172 1313 454 17 25 29 1416 1381 1487 969 26 345 1006 1196 636