CPG

CPG
TITLE :
CLINICAL PRACTICE GUIDELINES
Non-Surgical Periodontal Treatment
EFFECTIVE DATE : June 25, 2021
CPG NO. : 2021-078
1. STATEMENT OF PURPOSE
1.1 NA
2. REVISION HISTORY
Date Rev. No. Change
1 Shaa.I 1442 AH (March 13, 2021) V.1
3. DEFINITIONS
3.1 Scaling: procedure for removing plaque and calculus from tooth surface by either
subgingival or supragingival instrumentation.
3.2 Root Planning: a procedure where the diseased and softened cementum is removed
and the root surface is recovered to be hard and smooth.
3.3 ASA (American Society of Anesthesiologists) classification scores:
3.3.1 ASA I – Normal healthy patient.
3.3.2 ASA II – A patient with a mild systemic disease.
3.3.3 ASA III – A patient with severe systemic disease limiting activity but not
incapacitating.
3.3.4 ASA IV – A patient with incapacitating disease that is a constant threat to life.
3.4 Periodontology: The science and art of diagnosis, management and treatment of the
gingiva and the supporting tissues of the teeth.
4. POLICIES
4.1 Root planning is performed by a dentist with specialist periodontal training, periodontist
or the dental hygienist under the direct supervision of the afore-mentioned dentist or
periodontist.
4.2 Modifications based on patient's ASA score:
4.2.1 ASA I: no modification
4.2.2 ASA II: no modification making attention to any changes in the systemic
condition of the patient and reducing the duration of the treatment visit the
best he/she can and he may establish a continuous communication with the
patient’s treating physician for his systemic problem.
4.2.3 ASA III: should not receive this procedure until the systemic condition is
converted to stability/ control level judged by a report from the treating
physician. Patients undergoing immunosuppressive therapy may be treated
with this CPG before the start of the therapy.
4.2.4 ASA IV: is contraindicated for this procedure.
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CPG Scaling and Root Planning
5. PROCEDURES
5.1 Perform scaling and root planning on indicated teeth as per treatment plan
e.g. periodontally involved teeth with >4mm probing pocket depth.
5.2 Perform under local anesthesia suitable to the patient's medical condition.
5.3 Proceed with mechanical scaling and root planning with sonic or
ultrasonic instrumentation.
5.4 Perform full mouth debridement within 48 hours, whenever possible.
5.5 Use hand instruments carefully on the root surface with a suitable curette until all tooth
surfaces indicated are hard, clean and smooth.
5.6 Use 0.12-0.2% Chlorhexidine rinse or saline during instrumentation.
5.7 Prescribe 0.12-0% Chlorhexidine rinse for patient use twice a day for up to 10 days
after the last treatment.
5.8 Prescribe adjunctive systemic antibiotic therapy as necessary.
5.9 Re-evaluation of scaling and root planning performed after 4-6 weeks to re-assess the
effectiveness of scaling and root planning and to review the proficiency of home care.
Steps include checking for ; bleeding on probing, probing depths, clinical attachment
levels, pathologic tooth mobility, furcation involvement, assessment of local factors,
plaque index, and review of oral hygiene. If needed, re- instrumentation is
performed.
6. RESPONSIBILITIES
6.1 Dentist or Periodontist 6.1 through 6.11
7. APPENDIX
7.1 Instruments for scaling and root planning
8. REFERENCES
8.1 Lindhe. J Clinical Periodontology and Implant Dentistry Text book, 5 th Ed. Blackwell
Munkssgaard, 2008. Oxford.
8.2 Herbert F.Wolf, Edith M& Klaus H.Rateitschak. Periodontology, color Atlas of Dental
Medicine, 3rd Ed. 2004.
8.3 Mombelli A, Cionca N, Almaghlouth A (2011). Does Adjunctive Antimicrobial Therapy
Reduce the Perceived Need for Periodontal Surgery? Periodontol 2000. 55(1):205-16.
8.4 Rankin KV, Jones D, Redding S,3rd edition, Oral Health in Cancer Therapy.
8.5 Segelnick SL, Weinberg MA. Reevaluation of initial therapy: when is the appropriate
time? J Periodontol. 2006 Sep;77(9):1598-601. doi: 10.1902/jop.2006.050358. PMID:
16945039.
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PREPARED BY:
DR. REHAM AL JASSER

Consultant in Periodontics & Implant Dentistry Associate Professor,
Department of Periodontics and Community Dentistry, College of Dentistry,
King Saud University
REVIEW OF REGULATORY DOCUMENTS DEPT.:
REVIEWED BY:
PROF. FATIN ARAB AWARTANI

Position
Department
Date of Signature
APPROVED BY:
DR. ADNAN AL MAGHLOUTH

Consultant
Head of the Publication Committee
Date of Signature
3 of 5
Page 3 of 5
Appendix 8.1 Instruments for scaling and root planning
1 Curette Gracey SG 5/6 Hu-Friedy

1 Pierre à aiguisage SS4 Hu-Friedy
1 Détartreur SM 23 Hu-Friedy
1 Sonde paro + courbe XP 23/12 Hu-Friedy
1 Sonde Nabers PQ 2N Hu-Friedy
1 Sonde Pigtail EXD 2A Hu-Friedy
1 Précelle Merian (diamentée) DP 18 Hu-Friedy
1 Curette SM 23A Hu-Friedy
1 Miroir 4 ss plan 4 plan ss Kaladent
1 Miroir 5 ss plan 5 plan ss Kaladent
2 Manche miroir 81626 Kaladent
1 Détartreur implants 1350 KerrHawe Neos
1 Fraisier IMS-1372 TH Hu-Friedy
1 Fraise périoset court rouge RA 740 Kaladent
1 Fraise périoset long rouge RA 640 Kaladent
1 Fraise périoset court bleu RA 775 Kaladent
1 Fraise périoset long bleu RA 675 Kaladent
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DR. REHAM AL JASSER

REVIEW OF REGULATORY DOCUMENTS DEPT.:

PROF. FATIN ARAB AWARTANI

DR. ADNAN AL MAGHLOUTH

Appendix 8.1 Instruments for scaling and root planning

1 Curette Gracey SG 5/6 Hu-Friedy

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