Comparing the efficacy of scaling with root planing and modified widman flap in patients with chronic periodontitis

The present study was aimed to compare non-surgical treatment (scaling and root planing) with surgical (Modified Widman Flap procedure) treatment for chronic periodontitis. Modified Widman Flap procedure was chosen in our study because it results in removal of pocket epithelium to allow direct approximation of connective tissue with the tooth surface, less mechanical trauma than closed curettage, minimal bone removal, maximal conservation of periodontal tissue, facilitation of oral hygiene, and less root exposure with less sensitivity. The study was performed for a six month period .At initial examination, oral prophylaxis was performed and meticulous oral hygiene instructions were given. The patients were recalled after 21 days. At baseline, 15 subjects were selected with 5-7 mm periodontal pocket in at least 2 quadrants of the mouth. It was a split mouth design, with one quadrant of mouth as Control Group and another quadrant as Test Group. In the Control group, Scaling and root planning was carried out and in test group modified widman flap procedure was carried out. Sutures were removed after 1 week. Oral hygiene instructions and professional tooth cleaning were repeated once every 2 weeks during study period for both selected quadrants. The clinical assessment was carried out from baseline to 3 months and 6 months to evaluate the respective treatments and to compare between Non surgical mechanical treatment (control group) and surgical treatment (test group).This study demonstrated that both surgical and nonsurgical methods of treatment are effective in eliminating gingivitis and reducing probing depths provided the subgingival plaque is eliminated and reinfection prevented following active therapy. The investigation demonstrated that active therapy including meticulous subgingival debridement resulted in low frequency of gingival sites which showed bleeding on probing, a high frequency of sites with shallow pockets 4 mm and disappearance of pockets with probing depth of > 6 mm.