Efeito da fase de higiene oral estrita prévia ao tratamento da periodontite : um ensaio clínico randomizado duplo cego

Abstract

Introduction: Although the practice of oral hygiene (OH) is recognized as a crucial element of periodontitis treatment and an essential part of basic and maintenance periodontal therapy, there is a significant gap in understanding the specific effect of a phase of OH prior to periodontitis treatment periodontal disease. Objective: To evaluate the effect of the oral hygiene phase prior to periodontal treatment in individuals with periodontitis. Materials and methods: This is a double-blind randomized clinical trial with 24 individuals with periodontitis randomized between the intervention groups (GI; n=12) and control group (CG; n=12). After individual and personalized OH guidance, GI underwent a rigorous OH phase for 45 days. GC did not receive any instructions or motivation about OH during this time period. Visible plaque index (IPV), bleeding on probing (SS), probing depth (PPD) and clinical attachment level (NIC) were recorded at baseline and after 45 days in both groups. Questionnaire on OH behaviors and selfperception of gum disease and halitosis was administered at t0 and t45. Data were analyzed using t-test, chi-square, repeated measures ANOVA and multilevel linear regression, considering p<0.05. Results: A significant reduction in %SS, mean NIC, number of sites with PPD≥4 mm, PPD ≥5 mm and PPD ≥6mm was observed after 45 days in the GI, despite the IPV showing no statistical difference. There was a significant increase in the use of dental floss in GI at t45; improvement in the perception of gum disease from bad (91.7%) at baseline to good (33.3%) or excellent (41.7%) at the 45-day follow-up (p>0.05), and in self-perception of halitosis in the GI (p<0.05). Multilevel linear regression revealed a significant impact of the HO phase on reducing inflammation reduction to a 20% in SS; 14 pockets of PPD≥4mm; 6.73 PS pockets≥6 mm. The CG showed a tendency to reduce parameters of %SS and sites with PPD ≥6 mm (p>0.05), possibly associated with the Hawthorne effect. Conclusion: The strict oral hygiene phase prior to treatment in patients with periodontitis was able to modify HO behaviors by reducing inflammation and improvements in the clinical parameters of SS, PPD and mean NIC.