Miremadi, S.R., De Bruyn, H., Steyaert, H., Princen, K., Sabzevar, M.M., Cosyn, J.
Aim
To compare immediate surgery to scaling and root planing (SRP) in the treatment of advanced periodontal disease focusing on the prevalence of residual sites and cost-effectiveness (1); to evaluate the adjunctive effects of azithromycin in a second treatment phase (2).
Materials and methods
A total of 39 patients (18 males, 21 females; mean age: 54.6) received oral hygiene instructions and were randomly allocated to surgery (n = 19) or SRP (n = 20). Patients with residual pockets (≥6mm) at six months received re-debridement of these sites and systemic azithromycin. Treatment groups were followed for up to 12 months and evaluated in terms of clinical response parameters and cost-effectiveness. Chair time was used to assess the financial impact of treatment.
Results
Both treatment arms were equally effective in terms of clinical outcome demonstrating less than 1% residual pockets at 12 months. Surgery imposed an extra €746 on the patient up to six months when compared to SRP. At 12 months, €46 of this amount could be offset as a result of a reduced need for supportive care. Only six patients in the surgery group needed systemic antibiotics, whereas 14 patients in the SRP needed such additional treatment.
Conclusions
Although €700 could be saved on average by performing SRP instead of surgery, the latter significantly reduced the need for supportive care and systemic antibiotics.
Journal of Clinical Periodontology 2014; 41 (2): 164-171.