Full-mouth versus quadrant-wise scaling--clinical outcome, efficiency and treatment discomfort

Abstract

The aim of this randomized clinical study was to compare full-mouth scaling and root planing (FM-SRP) in two sessions within 24 hours with quadrant-wise scaling and root planing (Q-SRP) in four sessions within 4-6 weeks and evaluate (I) clinical outcome, (II) treatment efficiency, and (III) treatment discomfort of patients and therapists. Twenty individuals, aged 28-65 years, with severe chronic periodontitis were randomly assigned to treatment with FM-SRP or Q-SRP. At baseline and after 6 months, there were no between-group differences in clinical findings, treatment discomfort, or post-treatment body temperature. The therapists, however, felt that FM-SRP was more physically and psychologically demanding than Q-SRP. Mean effective scaling and root planing (SRP) time was 165.5 min during the two FM-SRP sessions and 202.1 min during the four Q-SRP sessions. FM-SRP's initial time savings of 36.6 min compared with Q-SRP diminished to 30.8 min at the 6-month follow-up due to rescaling needs. Total mean treatment time (comprising SRP and patient reinformation and reinstruction in oral hygiene) during the first 6 months post-treatment was 321.2 min for FM-SRP and 353.0 min for Q-SRP. Thus, mean savings in total treatment time with FM-SRP was 31.8 min compared with Q-SRP. In conclusion, this study found that both treatment modalities may be recommended for chronic periodontitis patients. Although time saving is possible with FM-SRP,the modality may compromise the therapist's well-being if practiced frequently due to the risk of musculoskeletal problems.