Dinamica di guarigione dei parametri clinici dopo strumentazione sub-gengivale per il trattamento della parodontite: ci sono evidenze sui tempi della valutazione parodontale?


Lucrezia Paternò Holtzman


Aim: to investigate the healing dynamics of clinical parameters after step 2 (subgingival instrumentation) periodontal therapy and search for evidence regarding the best timing for periodontal re-evaluation.  Methods: A PICO question was defined and searches were performed of the PubMed, EMBASE, Ovid MEDLINE and Web-of-Science databases. The inclusion criteria were RCT reporting periodontal clinical parameters between at least 2 follow-up time points with a minimum initial follow-up of 1 month. Standard meta-analyses were performed using PPD and CAL changes between follow-up time points and baseline.

Results: Thirty-one papers fulfilled the inclusion criteria and were included in qualitative analysis and meta-analysis. Weighted mean PPD reductions from baseline at 1-2, 3-4 and 5-6 months were respectively 1.5mm (CI 0.83; 2.09),1.4mm (CI 0.76; 1.94) and 2mm (CI 1.4; 2.67) for initially shallow (45mm) pockets, and 2.4mm (CI 0.60;4.09), 2.4mm (CI 1.21; 3.60) and 2.8mm (CI 1.77; 3.84) for initially deep (≥6mm) pockets.

Conclusions: This analysis demonstrated that PPD reduction for shallow and deep pockets occurs mainly within 1-2 months. However, reduction increases of 0.5 mm can occur up to 6 months after therapy.