Effect of periodontal initial therapy on teeth with chronic periodontitis and secondary occlusal trauma

Objective To evaluate the effect of subgingival scaling/root planning (SRP) and occlusal adjustment on clinical and occIusal parameters in teeth with chronic periodontitis and secondary occlusal trauma.Methods Eighteen patients with chronic periodontitis and occlusal trauma were included and randomly divided into group A and group B.On day 0,group A was treated by full-mouth subgingival scaling and root planning,and group B was treated by occlusal adjustment in occlusal trauma site.On day 28,group A was treated by occlusal adjustment in occlusal trauma site,and group B was treated by full-mouth subgingival scaling and root planning.Probing depth(PD),attachment loss (AL),bleeding index (BI) were evaluated on 0,28 and 56 d,and the occlusal time (OT) and the percentage of occlusal force were evaluated on 0,28 and 56 d in occlusal trauma site.The data was statistically analyzed.Results In baseline,thePD[(4.42 ± 1.41) mm vs (4.36 ± 1.38) mm],AL[(2.75 ± 1.32) mm vs (2.63 ± 1.37) mm] and BI [(2.20 ± 0.81) vs (2.24 ± 0.89)] of the full-mouth showed no significant difference between the two groups (P ＞ 0.05).There was no significant difference in PD [(5.21 ± 1.21) mm vs (5.08±1.12) mm],AL[(4.94±1.47) mm vs (4.89± 1.32) mm],BI[(2.61 ±0.92) vs 2.50±0.79)],OT[(1.29 ±0.39) s vs (1.34 ±0.35) s] and the percentage of occlusal force[(6.8 ±2.1)％ vs (7.4 ± 1.7) ％] in occlusal trauma site between the two groups (P ＞ 0.05).After SRP therapy,the PD,AL,BI and OT were significantly decreased (P ＜ 0.05).The clinical parameters exhibited no significant difference after only occlusal adjustment(P ＞ 0.05).On 56 d,the reduction in clinical parameters was not significantly different between the two groups(P ＞ 0.05),however the reduction of OT and the change of the percentage of occlusal force in group A [(0.85 ± 0.41) s,(2.2 ± 2.2) ％] were more significant than those in group B[(0.70 ± 0.38) s ; (1.5 ± 1.6) ％] (P ＜ 0.05).After occlusal adjustment,the increase of OT in group A[(0.21 ±0.11) s] was lower than that in group B[(0.67±0.37) s]through the28-day observation period (P ＜ 0.05) Conclusions Occlusal adjustment alone is inadequate for control and management of periodontitis.SRP therapy can eliminate the inflammation and decrease the OT of tooth with occlusal trauma.The combination of SRP and occlusal adjustment rnay achieve more stable results. Key words: Periodontitis;  Sulgingival curettage;  Occlusal trauma;  Occlusal adjustment