Appointment planning

A review of current evidence confirms that, in terms of clinical outcomes, there is no difference between providing PMPR over one or two long appointments within a 24 hour period (full mouth approach) or, alternatively, spreading PMPR over several shorter appointments (quadrant approach).⁴² The evidence is considered to be of moderate certainty due to the consistency of findings across the included studies, which were judged to be at low or unclear risk of bias. Some clinicians have reported that providing treatment at fewer, longer appointments is more physically demanding.⁴³ Operator and patient fatigue, as well as the patient’s preferences, need to be considered when planning appointments. 

Accordingly, the BSP implementation of European S3 – level evidence-based treatment guidelines for stage I-III periodontitis in UK clinical practice (BSP-S3) guideline⁶ suggests that subgingival periodontal instrumentation can be performed either using a traditional quadrant approach or a full mouth approach using a 1 or 2 stage technique within a 24-hour period.

Further details on the development of the recommendations in this guidance can be found in Methodology.