Periodontal tissue response, healing and monitoring
Following oral hygiene measures and root surface debridement there are two potential outcomes:
1 The tissue may respond by healing.
2 The tissue may fail to heal.
Following thorough root surface debridement and implementation of good oral hygiene, changes will occur in the bacterial flora and periodontal tissues.
There is a reduction in the total numbers of microorganisms in the periodontal pockets. The residual bacterial flora shifts from predominantly Gram-negative anaerobic to one that is largely Gram-positive aerobic and associated with periodontal health, partly because of the reduction in plaque bulk allowing in higher oxygen concentrations within the plaque.
Tissue response and healing
The response to root surface debridement is summarised in Figs 22.1 and 22.2. As the periodontal tissue heals there is a reduction in redness and swelling and the tissue becomes pink and firm. Clinically it feels more fibrous and the gingival cuff tightens. Bleeding on probing and suppuration subsides.
A reduction in pocket depths results from a combination of events: