1
|
Ardila CM, Vivares-Builes AM. Efficacy of Periodontal Endoscopy during Subgingival Debridement to Treat Periodontitis: A Systematic Review of Randomized Clinical Trials. Dent J (Basel) 2023; 11:dj11050112. [PMID: 37232763 DOI: 10.3390/dj11050112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/17/2023] [Accepted: 04/20/2023] [Indexed: 05/27/2023] Open
Abstract
This study aims to evaluate the clinical efficacy of periodontal endoscopy (PEND) during subgingival debridement to treat periodontitis. A systematic review of randomized clinical trials (RCTs) was performed. The search strategy included four databases: PubMed, Web of Sciences, Scopus, and Scielo. The initial online exploration generated 228 reports, and 3 RCTs met the selection criteria. These RCTs described a statistically significant decrease in probing depth (PD) in the PEND group compared to controls after 6 and 12 months of follow-up. The improvement in PD was 2.5 mm for PEND and 1.8 mm for the control groups, respectively (p < 0.05). It was also described that the PEND group presented a significantly inferior proportion of PD 7 to 9 mm at 12 months (0.5%) as compared to the control group (1.84%) (p = 0.03). All RCTs noted improvements in clinical attachment level (CAL). It was described as having significant differences in bleeding on probing (BOP) in favor of PEND, with an average reduction of 43% versus 21% in the control groups. Similarly, it was also presented that they were significant differences in plaque indices in favor of PEND. PEND during subgingival debridement to treat periodontitis demonstrated efficacy in reducing PD. Improvement was also observed in CAL and BOP.
Collapse
Affiliation(s)
- Carlos M Ardila
- Basic Studies Department, School of Dentistry, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | | |
Collapse
|
2
|
Effects of Periodontal Endoscopy-Assisted Nonsurgical Treatment of Periodontitis: Four-Month Results of a Randomized Controlled Split-Mouth Pilot Study. Int J Dent 2022; 2022:9511492. [PMID: 35082847 PMCID: PMC8786552 DOI: 10.1155/2022/9511492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/03/2022] [Indexed: 11/18/2022] Open
Abstract
Objective. Although the therapeutic effects of nonsurgical periodontal therapy (NSPT) are well established, the clinical benefits of the additional use of periodontal endoscopy (PE) remain controversial. Therefore, this randomized controlled split-mouth pilot study evaluated the effect of NSPT using PE versus NSPT without nPE on bleeding on probing (BOP) in sites with probing depth (PD)≥4 mm (primary outcome), PD, clinical attachment level (CAL), number of hard deposits (HDs), and treatment time per tooth (TrT). Methods. Two calibrated operators performed NSPT in twenty periodontitis patients, randomized into two quadrants for PE or nPE treatment. BOP, PD, and CAL were recorded at the first visit for NSPT (T0) and during reevaluation (T1: mean (SD) 119.7 (24.6) days after T0). The average TrT and the number of sites with HDs were documented at T0. Results. For BOP, no significant differences were found at the patient’s level (10/10 (male/female); aged 54.3 (10.9) years) neither within or between the groups. At tooth surface level, a lower number of surfaces with BOP
was observed in nPE. CAL and PD improved significantly during NSPT in both groups
, with higher PD reduction
and CAL gain
in nPE. There are significantly longer TrT
and more surfaces with subgingival HDs evident in PE at T0
. Conclusion. Whereas subgingival HDs can be visually detected with PE during NSPT, no additional clinical benefits regarding BOP, PD, or CAL were notable compared to conventional systematic periodontal instrumentation. Additionally, PE-assisted NSPT required a longer treatment time.
Collapse
|
3
|
Wu J, Lin L, Xiao J, Zhao J, Wang N, Zhao X, Tan B. Efficacy of scaling and root planning with periodontal endoscopy for residual pockets in the treatment of chronic periodontitis: a randomized controlled clinical trial. Clin Oral Investig 2021; 26:513-521. [PMID: 34145479 DOI: 10.1007/s00784-021-04029-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Residual pockets are a risk factor of periodontitis progression. This study evaluated the efficacy of periodontal endoscopy (PE) during scaling and root planning (SRP) of residual pockets in chronic periodontitis patients after initial periodontal treatment. MATERIALS AND METHODS A single-blinded, randomized controlled clinical trial was conducted in systemically healthy subjects presenting at least three residual pockets with a probing depth (PD) ≥ 5 mm in each quadrant. Subjects were randomly allocated to one of two trial groups using a computer-generated program: SRP + PE (test group) or SRP alone (control group). Clinical parameters (PD, clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PLI)) were then measured at baseline, 3-, and 6-month follow-up. RESULTS A total of 1629 sites in 37 patients were examined. Both treatments significantly improved all clinical outcomes (PD, CAL, BOP, and PLI) from baseline to 6 months (P < 0.05), although greater reductions in PD and PLI were observed in the test group at both 3- (PD: 3.45 ± 0.56 vs. 4.14 ± 0.59 mm; PLI: 0.55 ± 0.23 vs. 0.73 ± 0.27) and 6-month follow-up (PD: 3.12 ± 0.63 vs. 4.0 ± 0.68 mm; PLI: 0.49 ± 0.21 vs. 0.72 ± 0.28, respectively; P = 0.001 for PD and P = 0.021 for PLI). No significant differences in CAL or BOP were observed. CONCLUSIONS SRP + PE resulted in significant reductions in PD and PLI compared to SRP alone in residual pockets with a PD ≥ 5 mm. CLINICAL RELEVANCE The findings highlight the benefits of SRP + PE, supporting use as an alternative strategy in nonsurgical periodontal treatment.
Collapse
Affiliation(s)
- Juan Wu
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Xuanwu District, Nanjing, 210008, Jiangsu, China
| | - Liangyuan Lin
- Department of Stomatology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jianping Xiao
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Xuanwu District, Nanjing, 210008, Jiangsu, China
| | - Jie Zhao
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Xuanwu District, Nanjing, 210008, Jiangsu, China
| | - Ningxiang Wang
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Xuanwu District, Nanjing, 210008, Jiangsu, China
| | - Xingxing Zhao
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Jiangsu, China
| | - Baochun Tan
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Xuanwu District, Nanjing, 210008, Jiangsu, China.
| |
Collapse
|
4
|
Graetz C, Fecke P, Seidel M, Engel AS, Schorr S, Sentker J, Dörfer CE, Sälzer S. Evaluation of a systematic digitized training program on the effectivity of subgingival instrumentation with curettes and sonic scalers in vitro. Clin Oral Investig 2020; 25:219-230. [PMID: 32474807 PMCID: PMC7785550 DOI: 10.1007/s00784-020-03356-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
Objectives Whereas the key role of subgingival instrumentation in periodontal therapy is well known, the influence of operators’ experience/training with different devices on treatment results is yet uncertain. Therefore, we assessed untrained undergraduate students, working on manikins, as to how effectively they learn to use curettes (GRA) and sonic scalers (AIR); hypothesizing that AIR will result in higher relative cleaning efficacy (RCE) than GRA. Material and methods Before baseline evaluation (T0), 30 operators (9 males, 21 females) received a 2-h theoretical lesson for both instruments, followed by a 12-week period with a weekly digitized training program for 45 min. During three sessions (T1–T3), the operators had to instrument six equivalent test teeth with GRA and AIR. At T0–T3, treatment time, proportion of removed simulated biofilm (RCE-b), and hard deposits (RCE-d) were measured. Results At T0, RCE-b was in mean(SD) 64.18(25.74) % for GRA, 62.25(26.69) % for AIR; (p = 0.172) and RCE-d 85.48(12.32) %/ 65.71(15.27) % (p < 0.001). At T3, operators reached highest RCE-b in both groups (GRA/AIR 71.54(23.90) %/71.75(23.05)%; p = 0.864); RCE-d GRA/AIR: 84.68(16.84) %/77.85(13.98) %; p < 0.001). Both groups achieved shorter treatment times after training. At T3, using curettes was faster (GRA/AIR 16.67(3.31) min/19.80(4.52) min; p < 0.001). Conclusions After systematic digitized training, untrained operators were able to clean 70% of the root surfaces with curettes and sonic scalers. Clinical relevance It can be concluded that a systematic digitized and interactive training program in manikin heads is helpful in the training of root surface debridement.
Collapse
Affiliation(s)
- Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - Paula Fecke
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Miriam Seidel
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Anne Sophie Engel
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Susanne Schorr
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Johanna Sentker
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| |
Collapse
|