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Clinicians have noted for a long
time that Certain patients cause problems for this model since they maintain
healthy gingival tissues despite failure to clean plaque off their teeth. These
people are considered fortunate to be "genetically predisposed" to
health. Today for example I saw two new patients – cohabiting spouses both
whom had not had dental treatment of any kind for eight years and they do not
floss. Neither had perfect plaque control and both had subgingival tartar
deposits. Neither had any signs of periodontal disease. Their bacteriologic
testing revealed absence of anaerobic bacteria in subgingival plaque.
This first citation revealed some important contradictions in the current model which the researchers pointed out.
The next few slides document some important clinical studies comparing the effects of nonsurgical vs. surgical treatment of gum disease.
The first controlled clinical study comparing surgical and nonsurgical treatment was carried out at University of Michigan by Ramfjord and Nissle in 1968. No comparative treatment study could be found in the literature prior to that date. Treatments up to that date were conceived simply from clinical impressions about what worked.
This study utilized subgingival curettage for its nonsurgical method and gingivectomy (pocket reduction surgery) for its surgical method.
The study was of split mouth design and the results were as follows: