Subgingival debridement of root surfaces with a micro-brush: macroscopic and ultrastructural assessment

Efficacy of glycine powder air polishing in comparison with sodium bicarbonate air polishing and ultrasonic scaling - a double-blind clinico-histopathologic study

BACKGROUND

Subgingival biofilm removal using glycine powder air polishing (GPAP) has antecedently been shown to be safe. The hypothesis that GPAP is efficacious during periodontal maintenance therapy and results in less gingival erosion than sodium bicarbonate air polishing (SBAP) or ultrasonic scaling was assessed.

METHODS

Initial periodontal therapy was performed in each of the 22 chronic periodontitis patients having residual 5 mm probing depth in each quadrant and were randomly assigned to one of the following interventions: GPAP (test), SBAP (positive control), ultrasonic scaling (positive control) or no treatment. Clinical parameters were assessed, and gingival biopsies were taken immediately after instrumentation and sent for histological quantification.

RESULTS

Significant improvement in plaque and gingival index scores were noted in glycine powder air-polishing and ultrasonic group. GPAP resulted in minor erosion of the gingival epithelium (score 1 & 2), whereas positive control specimens displayed moderate to severe erosions (score 3 & 4). Difference between GPAP and positive control was significant. (P < 0.05).

CONCLUSION

GPAP results in clinically significant improvement in plaque and gingival index scores and histologically causes less gingival erosion than SBAP or ultrasonic instrumentation, further supporting the safety of this debridement technique in periodontal maintenance therapy.

The effects of scaling and root planing on the marginal gap and microleakage of indirect composite crowns prepared with different finish lines: an in vitro study

The present in vitro study aimed to assess the effects of root surface mechanical instrumentation on the marginal integrity and adaptation of resin composite crowns. The following null hypotheses were tested: no differences exist between finish line and 1) marginal gap or 2) marginal microleakage before and after manual mechanical periodontal maintenance. A total of 56 intact human mandibular molars were randomly distributed into four groups and subjected to standardized tooth preparations for indirect composite crowns with different marginal finish lines (90° shoulder, beveled 90° shoulder, feather edge, chamfer). One-half of the specimens was used as a control and remained untreated, and the remaining half was subjected to root surface procedures simulating five years of semestral mechanical supportive periodontal treatment. The marginal gap and microleakage were evaluated and statistically analyzed. The specimens used as controls showed lower mean marginal gaps than those subjected to the simulated periodontal treatment, whereas the latter showed lower microleakage than the control crowns. Statistically significant differences were recorded for both the experimental variables. The root surface procedures resulted in altered surfaces of the composite crowns. The marginal gap increased after the treatment, whereas the marginal microleakage was reduced. The 90° shoulder and the chamfer preparation could be considered a viable option to fabricate composite crowns, but the beveled 90° shoulder and the feather edge should not be recommended.

Non-surgical management of periodontal disease

Non-surgical removal of plaque and calculus has been part of the initial phase of the management of patients with gingivitis and periodontitis for decades. It consists of patient motivation and oral hygiene instruction as well as mechanical removal of supra and subgingival plaque deposits. The purpose of this review was to assess recent changes. The article reports on changes in our understanding of plaque as a biofilm, developments in patient plaque control, chemical plaque control and scaling instruments. It also comments on full-mouth disinfection, the use of lasers and host modulation. Modern technology has made removal of microbial deposits by the patient and dental professionals more efficient. However, other advancements need to be used in conjunction with mechanical debridement at this time.