A short-term clinical and microbial evaluation of periodontal therapy associated with amalgam overhang removal

Background: This study evaluated the effect of periodontal therapy plus amalgam overhang removal (PT+AOR) on periodontal status and the presence of Actinobacillus actinomycetemcomitans and Streptococcus mutans and compared two microbiological sampling techniques. Methods: Molar teeth with Class II overhang restorations were selected as the test group, and homologous sound teeth were selected as the control group. Periodontal probing depth (PD), clincal attachment level (CAL), and plaque and gingival indices were measured, and restorations were evaluated using radiographs and clinical exploration at baseline (T1) and 90 days after PT+AOR (T2). Microbial samples were taken with dental floss and paper points at T1 and T2. S. mutans and A. actinomycetemcomitans were detected using culture and commercial kits. Results: Mean values of plaque and gingival indices did not show statistically significant differences between test and control teeth between T1 and T2. At T2, the mean CAL decreased among test teeth, and the number of test teeth positive for A. actinomycetemcomitans showed a decrease, whereas positive samples for S. mutans increased. At T1, an association between the two sampling techniques for both bacteria was found. At T2, dental floss presented low sensitivity values for A. actinomycetemcomitans, whereas paper points showed low sensitivity for S. mutans. Conclusions: PT+AOR showed a beneficial effect on clinical parameters and a decrease of A. actinomycetemcomitans. At T1, both sampling techniques showed appropriate results. At T2, the use of paper points was a more sensitive sampling technique for isolate A. actinomycetemcomitans, whereas dental floss was found to be an alternative sampling method for isolate S. mutans.