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Journal of Peking University(Health Sciences) ›› 2020, Vol. 52 ›› Issue (1): 64-70. doi: 10.19723/j.issn.1671-167X.2020.01.010

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Clinical outcomes of ultrasonic subgingival debridement combined with manual root planing in severe periodontitis

Yue YAN1,Xian-e WANG1,Ya-lin ZHAN2,Li-li MIAO1,Ye HAN1,Chu-ren ZHANG1,Zhao-guo YUE1,Wen-jie HU1,△(),Jian-xia HOU1,△()   

  1. 1. Department of Periodontology,Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. Department of General Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Beijing 100034, China
  • Received:2019-10-14 Online:2020-02-18 Published:2020-02-20
  • Contact: Wen-jie HU,Jian-xia HOU E-mail:huwenjie@pkuss.bjmu.edu.cn;jxhou@163.com
  • Supported by:
    Supported by the National Natural Science Foundation of China(81470738);Supported by the National Natural Science Foundation of China(81800976)

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Abstract:

Objective:To compare the clinical effects of ultrasonic subgingival debridement and ultrasonic subgingival debridement combined with manual root planing on severe periodontitis and then to investigate the necessity and significance of manual root planing. Methods: Twenty-three patients with severe periodontitis participated in this split-mouth randomized-controlled clinical trial. Baseline examination and randomization were performed after supragingival scaling: each of the upper and lower jaws had a quadrant as the test group treated with ultrasonic subgingival debridement combined with manual root planing, whereas the other two quadrants were the control group treated with ultrasonic subgingival debridement. Treatment of each patient was at intervals of one week and completed in two visits. Clinical indicators concerning probing depth (PD), clinical attachment loss (CAL) and bleeding index (BI) were recorded at baseline and 1 month, 3 months, 6 months after treatment. Results: There was no significant difference of periodontal indicators between the test group and the control group at baseline. Both the test group and control group resulted in significant improvement of PD, CAL and BI. One and three months after treatment, reduction of PD in the test group was higher than that in the control group [1 month: (2.13±1.31) mm vs. (1.79±1.33) mm, P<0.01; 3 months: (2.46±1.33) mm vs. (2.17±1.38) mm, P<0.01] and reduction of CAL in the test group was higher than that in the control group [1 month: (1.89±2.03) mm vs. (1.65±1.93) mm, P<0.01; 3 months: (2.03±2.05) mm vs. (1.83±1.97) mm, P<0.05]. Six months after treatment, PD in the test group and the control group decreased by (2.52±1.40) mm and (2.35±1.37) mm respectively, and the improvement in the test group was significantly better than that in the control group (P<0.01). CAL in the test group and the control group decreased by (1.89±2.14) mm and (1.77±2.00) mm respectively, and there was no statistical difference between the groups. There was no significant difference in the changes of BI between the two groups 1, 3 and 6 months after treatment. Conclusion: Ultrasonic subgingival debridement combined with manual root planing has more reduction in PD and CAL compared with ultrasonic subgingival debridement. Therefore, it is still necessary to use manual instruments for root planing following ultrasonic subgingival debridement.

Key words: Severe periodontitis, Ultrasonic subgingival debridement combined with manual root planing (SRP), Ultrasonic subgingival debridement (SD), Split-mouth design

CLC Number: 

  • R781.4

Table 1

On individual level, mean PD and CAL scores before and after treatment (x?±s)"

Group Baseline/mm 1M/mm 3M/mm 6M/mm
Mean PD SD 5.45±0.61 3.69±0.62#* 3.31±0.61#* 3.14±0.58#
SRP 5.56±0.60 3.47±0.57#* 3.11±0.51#* 3.08±0.60#
Mean CAL SD 4.58±1.34 3.03±1.57# 2.76±1.65# 2.81±1.70#
SRP 4.74±1.27 2.89±1.79# 2.65±1.77# 2.84±1.87#

Table 2

On individual level, reduction of PD and CAL scores after treatment(x?±s)"

Group 1M/mm 3M/mm 6M/mm
Reduction of PD SD 1.76±0.55☆ 2.13±0.46☆ 2.29±0.55*
SRP 2.09±0.46☆ 2.44±0.50☆ 2.48±0.62*
Reduction of CAL SD 1.64±1.16 1.85±1.18* 1.79±1.30
SRP 1.92±1.32 2.09±1.37* 1.92±1.53

Table 3

On sites’ level, mean PD scores before and after treatment for various PD categories according to initial PD (x?±s)"

Group Baseline/mm 1M/mm 3M/mm 6M/mm
4-6 mm
SD 4.78±0.63 3.31±1.03#☆ 3.03±0.96#☆ 2.89±0.90#*
SRP 4.83±0.65 3.09±0.94#☆ 2.83±0.83#☆ 2.80±0.89#*
≥7 mm
SD 7.58±0.93 4.93±1.54#☆ 4.33±1.56#* 4.02±1.46#
SRP 7.57±0.81 4.51±1.59#☆ 4.01±1.53#* 3.87±1.63#
Overall
SD 5.54±1.44 3.76±1.39#☆ 3.39±1.30#☆ 3.20±1.19#
SRP 5.63±1.43 3.51±1.33#☆ 3.18±1.21#☆ 3.11±1.26#

Table 4

On site’s level, reduction of PD scores after treatment for various PD categories according to initial PD(x?±s)"

Group 1M/mm 3M/mm 6M/mm
4-6 mm
SD 1.47±1.04☆ 1.76±1.02☆ 1.89±0.97☆
SRP 1.74±0.98☆ 1.99±0.94☆ 2.03±0.97☆
≥7 mm
SD 2.65±1.59☆ 3.26±1.60* 3.56±1.53
SRP 3.07±1.50☆ 3.57±1.46* 3.70±1.56
Overall
SD 1.79±1.33☆ 2.17±1.38☆ 2.35±1.37☆
SRP 2.13±1.31☆ 2.46±1.33☆ 2.52±1.40☆

Table 5

On site’s level, mean CAL scores before and after treatment for various PD categories according to initial PD(x?±s)"

Group Baseline/mm 1M/mm 3M/mm 6M/mm
4-6 mm
SD 3.84±1.76 2.52±1.89# 2.33±1.94# 2.38±1.90#
SRP 3.97±1.82 2.39±2.14# 2.26±2.10# 2.44±2.13#
≥7 mm
SD 6.50±1.79 4.41±2.44# 4.10±2.35# 4.16±2.41#
SRP 6.64±1.71 4.23±2.62# 3.92±2.55# 3.99±2.67#
Overall
SD 4.58±2.13 3.07±2.24# 2.82±2.21# 2.87±2.20#
SRP 4.76±2.16 2.95±2.45# 2.75±2.37# 2.90±2.41#

Table 6

On site’s level, reduction of CAL scoresafter treatment for various PD categories according to initial PD(x?±s)"

Group 1M/mm 3M/mm 6M/mm
4-6 mm
SD 1.46±1.63* 1.60±1.72 1.56±1.71
SRP 1.67±1.71* 1.75±1.74 1.56±1.83
≥7 mm
SD 2.10±2.48 2.41±2.41 2.34±2.54
SRP 2.42±2.53 2.72±2.51 2.66±2.60
Overall
SD 1.65±1.93☆ 1.83±1.97* 1.77±2.00
SRP 1.89±2.03☆ 2.03±2.05* 1.89±2.14
[1] Aleo JJ, Renzis FA, De Farber PA . In vitro attachment of human gingival fibroblasts to root surfaces[J]. J Periodontol, 1975,46(11):639-645.
[2] 孟焕新 . 临床牙周病学 [M]. 2版. 北京: 北京大学医学出版社, 2014: 275-283.
[3] Daly CG, Seymour GJ, Kieser JB . Bacterial endotoxin: a role in chronic inflammatory periodontal disease[J]. J Oral Pathol, 1980,9(1):1-15.
[4] Nakib NM, Bissada NF, Simmelink JW , et al. Endotoxin penetration into root cementum of periodontally healthy and diseased human teeth[J]. J Periodontol, 1982,53(6):368-378.
[5] Laleman I, Cortellini S, De Winter S , et al. Subgingival debridement: end point, methods and how often[J]. Periodontol 2000, 2017,75(1):189-204.
[6] Badersten A, Nilveus R, Egelberg J . Effect of nonsurgical periodontal therapy[J]. J Clin Periodontol, 1984,11(1):63-76.
[7] Obeid PR, William DH, Pierre B . Comparative clinical responses related to the use of various periodontal instrumentation[J]. J Clin Periodontol, 2004,31(3):193-199.
[8] Ioannou I, Dimitriadis N, Papadimitriou K , et al. Hand instrumentation versus ultrasonic debridement in the treatment of chronic periodontitis: a randomized clinical and microbiological trial[J]. J Clin Periodontol, 2009,36(2):132-141.
[9] Armitage GC . Development of a classification system for periodontal diseases and conditions[J]. Ann Periodontol, 1999,4(1):1-6.
[10] Papapanou PN, Sanz M, Buduneli N , et al. Periodontitis: consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions[J]. J Periodontol, 2018,89(Suppl 1):S173-S182.
[11] Jiao J, Shi D, Cao ZQ , et al. Effectiveness of non-surgical periodontal therapy in a large Chinese population with chronic periodontitis[J]. J Clin Periodontol, 2017,44(1):42-50.
[12] Jiao J, Zhang L, Meng HX , et al. Clinical performance of non-surgical periodontal therapy in a large Chinese population with generalized aggressive periodontitis[J]. J Clin Periodontol, 2018,45(10):1184-1197.
[13] Zhan YL, Lu RF, Meng HX , et al. The role of platelets in inflammatory immune responses in generalized aggressive periodontitis[J]. J Clin Periodontol, 2017,44(2):150-157.
[14] 孟圆, 刘雪楠, 郑树国 , 等. 国内外口腔疾病负担的现况和分析[J]. 中华口腔医学杂志, 2017,52(6):386-389.
[15] Apatzidou DA . Modern approaches to non-surgical biofilm management[J]. Front Oral Biol, 2012,15:99-116.
[16] Marda P, Prakash S, Devaraj CG , et al. A comparison of root surface instrumentation using manual, ultrasonic and rotary instruments: an in vitro study using scanning electron microscopy[J]. Indian J Dent Res, 2012,23(2):164-170.
[17] 冯希平 . 中国居民口腔健康状况:第四次中国口腔健康流行病学调查报告 [R]. 西安: 2018 年中华口腔医学会第十八次口腔预防医学学术年会, 2018.
[18] 高小芳, 梁妍 . 单独龈下超声刮治与结合人工刮治两种方法的临床效果比较[J]. 口腔材料器械杂志, 2012,21(3):137-139.
[19] Tunkel J, Heinecke A, Flemmig TF . A systematic review of efficacy of machine-driven and manual subgingival debridement in the treatment of chronic periodontitis[J]. J Clin Periodontol, 2002,29(S3):72-81.
[20] Christgau M, Männer T, Beuer S , et al. Periodontal healing after non-surgical therapy with a new ultrasonic device: a randomized controlled clinical trial[J]. J Clin Periodontol, 2007,34(2):137-147.
[21] 龚逸明, 丁小军, 任颖 . 龈下刮治和根面平整术后牙本质过敏的临床评价[J]. 国际口腔医学杂志, 2009,36(3):256-259.
[22] 中华口腔医学会口腔预防医学专业委员会牙本质敏感专家组. 牙本质敏感的诊断和防治指南(2019修订版)[J]. 中华口腔医学杂志, 2019,54(4):223-227.
[23] Aspriello SD, Piemontese M, Levrini L , et al. Ultramorphology of the root surface subsequent to hand-ultrasonic simultaneous instrumentation during non-surgical periodontal treatments: an in vitro study[J]. J Appl Oral Sci, 2011,19(1):74-81.
[24] Van der Weijden GA, Timmerman MF . A systematic review on the clinical efficacy of subgingival debridement in the treatment of chronic periodontitis[J]. J Clin Periodontol, 2002,29(Suppl 3):55-71.
[25] Rohanizadeh R, Legeros RZ . Ultrastructural study of calculus-enamel and calculus-root interfaces[J]. Arch Oral Biol, 2005,50(1):89-96.
[26] Pattison AM, Pattison GL . Carranza’s clinical periodontology[M]. 12th ed. Saunders Canada: Saunders an Imprint of Elsevier Inc, 2015: 1015.
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