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Treatment of Juvenile Periodontitis With Microbiologically Modulated Periodontal Therapy (Keyes Technique)
by Thomas E. Rams, Paul H. Keyes, William E. Wright

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Antimicrobial therapeutic strategies widely referred to as the Keyes Technique were directed at suppression of the periodontopathic microflora of 7 juvenile periodontitis patients who were treated and followed for at least 22 months.

Following collection of baseline clinical and microbiological parameters, the patients received meticulous scaling and root planing of all teeth with concomitant irrigation to probing depth of saturated inorganic salt solutions and 1% chloramine-T. The patients were recalled at approximately 2- to 3-month intervals for maintenance care which was modulated by clinical parameters and phase-contrast microscopic findings. Six patients received at least 2 courses of systemic tetracycline (1 gm/day for 14 days) during the study. Patient home treatments included daily application of a sodium bicarbonate/3% hydrogen peroxide paste, and inorganic salt irrigations.

Clinical reevaluations made an average of 29.6 months posttreatment showed statistically significant (P<.01) decreases in bleeding on probing in all patients. Significant decreases in probing depth, and gains in clinical attachment levels also were found in all patients, particularly in advanced sites initially 4 to 6 mm and >7 mm in probing depth. Among sites with initial attachment loss >5 mm, 25.8% experienced a >3 mm gain in clinical attachment level from baseline with therapy. Significant decreases in motile organisms and crevicular polymorphonuclear leukocytes present in the subgingival plaque of the patients also occurred with the antimicrobial therapy employed.

These findings demonstrate that juvenile periodontitis patients can be treated successfully and maintained on a long-term basis without periodontal surgery when appropriate antimicrobial therapy is directed at the subgingival periodontopathic microbiota. (Pediatr Dent. 1985;7:259-270)

Source: http://www.aapd.org/searcharticles/article.asp?ARTICLE_ID=1452


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