Analysis of patient factors impacting duration of periodontal maintenance appointments: an exploratory study.

PURPOSE: The periodontal maintenance (PM) appointment requires varying amounts of time and is absolutely essential for long-term successful periodontal therapy. This study assessed time requirements for PM and relative contribution of patient-level factors such as oral health status, complex medical history, maintenance compliance and demographics. METHODS: One hundred patients receiving PM in a graduate periodontal program at a dental school participated in this cross sectional, observational study and components of their PM were timed in minutes/seconds. Descriptive data were obtained for average total-time required for PM and relative time for each treatment component. Hierarchical multiple linear regression determined what patient-level factors demonstrated the greatest impact on total-time to complete PM. RESULTS: The average PM appointment interval, with radiographs, was 1 hour, 16 minutes, 23 seconds (SD 19:25 minutes). When cubicle preparation and disinfection was included, the total-time was 1 hour, 24 minutes, 31 seconds (±19:32 minutes). Multiple regression showed that BOP, dentist examinations, number of carious lesions and/or restorative defects, number of teeth/implants, taking radiographs, female gender and deposit aggregate (supragingival and subgingival calculus and stain) were significant predictors of total PM duration and explained 57% variance (p<0.05, R2=0.569). CONCLUSION: Based on the average comprehensive PM appointment time of 1:16 minutes, the typical appointment of 60 minutes is insufficient to achieve the goals of a comprehensive PM in this academic clinic setting. These findings suggest the need to utilize more customized models for scheduling PM in order to achieve time allocations that are individualized to address specific patients' needs.

Comparison of probes for microbial contamination following use in periodontal pockets of various depths.

BACKGROUND: It has been speculated that periodontal probes can transmit periodontal pathogens from site to site. The purpose of this study was to evaluate the potential for bacterial transmission as a function of periodontal probe design. METHODS: Four different periodontal probes were used to measure probing depths ranging from 0 to 3 mm and > or = 4 mm. Following measurement of each pocket, probes were transported to a laboratory and cultured on blood agar, and colony forming units (CFUs) were determined for total aerobic, anaerobic, and dark-pigmented colonies (DPCs). Eight randomly selected probe tips, representing each probe type and probing depth category, were selected for examination by scanning electron microscopy (SEM) to determine distribution and morphotypes of adhering microbes. RESULTS: Results showed no statistically significant main effect for probes with respect to CFUs. However, there was a statistically significant increase in CFUs for deeper pockets when compared to pockets 0 to 3 mm. SEM observations were consistent among groups, regardless of probe design or probing depth. All probes exhibited a rough surface texture. Microbes were observed as single organisms or in aggregates and were adherent along the entire length of the probe up to the maximum probing depth. CONCLUSIONS: There was no difference in CFUs obtained as a function of periodontal probes. The rough surfaces of the probes used in this study likely promoted bacterial adherence through two different mechanisms: through scraping of the pocket walls by the roughened surfaces of the probe and by the high surface-free energy of the metal probes, facilitating bacterial adherence.