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When plaque is supragingival, the bacterial content contains a great proportion of aerobic bacteria and yeast, [20] or those bacteria which utilize and can survive in an environment containing oxygen. Subgingival plaque contains a higher proportion of anaerobic bacteria, or those
Heavy plaque. Subgingival biofilm is plaque that is located under the gums. It occurs after the formation of the supragingival biofilm by a downward growth of the bacteria from above the gums to below. This plaque is mostly made up of anaerobic bacteria, meaning that these bacteria will only survive if there is no oxygen.
"In patients with chronic periodontitis, subgingival debridement (in conjunction with supragingival plaque control) is an effective treatment in reducing probing pocket depth and improving the clinical attachment level. In fact it is more effective than supragingival plaque control alone". [8]
In addition, Gracey curettes is the ideal instrument to use for subgingival scaling and root planing due to the design of the instrument that allows for best adaptation to root anatomy. [ 3 ] [ 7 ] While periodontal curettes are primarily for subgingival calculus removal and root planing, sickle scalers are primarily used for supragingival ...
For the periodontal pocket to form, several elements need to be present. It all starts with the dental plaque [tone]. The invasion of the bacteria from the plaque eventually triggers inflammatory response. This in turn results in the gradual destruction of the tissues surrounding the teeth, known as the periodontium. [6]
Subgingival microorganisms (those that exist under the gum line) colonize the periodontal pockets and cause further inflammation in the gum tissues and progressive bone loss. Examples of secondary causes are those things that, by definition, cause microbic plaque accumulation, such as restoration overhangs and root proximity.
After supra-gingival oral hygiene cleaning, plaque biofilm will quickly develop at the gingival margin and will enter the gingival sulcus after some time. The junctional epithelium, which is at the base of the gingival sulcus, permits plaque bacteria and its toxin to enter the underlying gingival connective tissue via the large spaces between ...
It requires a few appointments, depending on time and clinician skills, for effective removal of supragingival and subgingival calculus, when periodontal pockets are involved. It can assist in periodontal healing and reduce periodontal pocketing by changing the subgingival ecological environment. [44]