Absence of Histologic Signs of Chronic Inflammation Following Closed Subgingival Scaling and Root Planing Using the Dental Endoscope: Human Biopsies - A Pilot Study

Background: The primary goal of periodontal therapy is the reduction or elimination of inflammation. Traditionally, this is accomplished through removal of subgingival tooth-borne accretions using non-surgical and/or surgical treatment modalities. Numerous studies indicated the difficulty in removing these accretions to the point that histologic manifestations of chronic inflammation are eliminated. A companion to the current study demonstrated that subgingival inflammation was associated most often with calculus covered with biofilm, not biofilm alone. This pilot study evaluated the histologic response in humans to removal of calculus and biofilm with the aid of the dental endoscope. Methods: Twelve teeth in six patients were identified as test teeth, and all subgingival deposits visible with the endoscope were removed in a single treatment by an operator experienced in root planing and the use of the dental endoscope. The 12 teeth and the coronal portion of their periodontal attachment apparatus were removed 6 months after a single episode of closed subgingival scaling and root planing. Biopsies were processed for histologic evaluation. Results: There were no histologic signs of chronic inflammation. Deposits of calculus and biofilm were seen on one section of one tooth but apparently were deposited after initial therapy. Bone repair and the growth of a long junctional epithelium were observed on previously diseased root surfaces. Conclusion: Histologic signs of chronic inflammation were absent 6 months after a single course of closed subgingival scaling and root planing using the dental endoscope. J Periodontol 2008; 79:2036-2041.