# Scaling and root planing:
A. Prevent further loss of attachment in deep pockets
B. Most effective in reducing pocket depth than surgical means
C. More successful in posterior than anterior tooth
D. Same as curettage
The correct answer is A. Prevent further loss of attachment in deep pockets.
Of all clinical dental procedures, subgingival scaling and root planing in deep pockets are the most difficult and exacting skills to master. It has been argued that such proficiency in instrumentation cannot be attained, and therefore periodontal surgery is necessary to gain access to root surfaces. Others have argued that although proficiency is possible, it need not be developed because access to the roots can be gained more easily with surgery. However, without mastering subgingival scaling and root-planing skills, the clinician will be severely hampered and unable to treat adequately those patients for whom surgery is contraindicated.
Scaling and root planing alone are effective for reducing pocket depths, gaining increases in periodontal attachment levels, and decreasing inflammation levels (i.e., bleeding with probing). When scaling and root planing are combined with the subgingival placement of sustained-release vehicles, however, additional clinical benefits are possible, including the further reduction of pocket depths, additional gains in clinical attachment levels (e.g., 0.39 mm with minocycline gel), and further decreases in inflammation. Improvements in clinical attachment levels also occur with the chlorhexidine chip (0.16 mm) and doxycycline gel (0.34 mm). When systemic antibiotics are used as adjuncts to scaling and root
planing, the evidence indicates that some systemic antibiotics (e.g., metronidazole, tetracycline) provide additional improvements in attachment levels (0.35 mm for metronidazole; 0.40 mm for tetracycline)
when used as adjuncts to scaling and root planing. The use of anti-infective chemotherapeutic treatment adjuncts does not result in significant patient-centered adverse effects.
Reference: Carranza's Clinical Periodontology, 12th Edition, Page no: 524
