Evaluation of residual calculi after scaling and root planing in patients with moderate-to-severe periodontitis

Non-surgical treatment modalities, including scaling and root planing, have always been considered effective periodontal treatments. The purpose of subgingival instrumentation is complete elimination of calculi and other calcified deposits and creation of a smooth surface on the root. This study evaluated the effectiveness of conventional scaling methods on removal of subgingival deposits.

In this clinical trial on 23 patients with moderate-to-severe periodontitis, 276 different sites with probing depths of >4 mm were selected. Initially, perfect SRP was performed for patients and its accuracy was approved by one experienced periodontist. In the surgical phase those sites were exposed and evaluated for presence and quantity of residual calculi and their relationship with pocket depth. Data was analyzed with Mann-Whitney, Kruskal-Wallis and correlation coefficient tests using SPSS software (α = 0.05).

Of 276 different sites, 60.9% had residual calculi. The mean residual calculi in interproximal areas (63.1%) was more than that on radicular surfaces (50%) (p value = 0.029). The mean of calculus index was higher in females than males (p value = 0.039) and more on right sides than left sides (p value = 0.001). There was a direct correlation between probing depth and calculus index: an increase in probing depth resulted in more residual calculi.

Closed SRP method in deep pockets is not a reliable method for elimination of subgingival deposits, with 50% of calculi remaining, necessitating open scaling procedures in periodontal pockets with deep pockets.