What procedure effectively removes subgingival plaque, calculus, and cementum to maintain smooth subgingival root surfaces?

The procedure that effectively removes subgingival plaque, calculus, and cementum is root planing. This treatment involves the meticulous instrumentation of the root surfaces to ensure that any diseased cementum or rough surface is smoothed out, which helps facilitate healing and reduces pathogenic bacteria.

Root planing is specifically designed to achieve a smooth root surface, which is essential for the reattachment of periodontal tissues. A smooth surface is less conducive to further plaque accumulation, thus aiding in periodontal health and supporting tissue regeneration.

Other procedures, while they may contribute to periodontal therapy, do not focus on the precise removal of cementum or the complete smoothing of root surfaces like root planing does. For instance, scaling primarily addresses the removal of supragingival and subgingival plaque and calculus but does not typically involve the thorough smoothing of the root surface to the same extent as root planing. Flap surgery is a surgical procedure that provides access to the roots for more extensive cleaning but does not perform root planing as its primary aim. Prophylaxis generally refers to preventive care for maintaining dental health and does not specifically target the treatment of periodontal tissues in the same way as root planing.

Therefore, root planing stands out as the key procedure for achieving