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Journal of Peking University (Health Sciences) ›› 2023, Vol. 55 ›› Issue (4): 716-720. doi: 10.19723/j.issn.1671-167X.2023.04.024

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Comparison of clinical effects between periodontal endoscopy aiding subgingival debridement and flap surgery

Xi-yan PEI1,Wen YANG1,Xiang-ying OUYANG2,*(),Feng SUN1   

  1. 1. First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100034, China
    2. Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
  • Received:2020-08-15 Online:2023-08-18 Published:2023-08-03
  • Contact: Xiang-ying OUYANG E-mail:kqouyangxy@bjmu.edu.cn
  • Supported by:
    the New Technology and New Treatment Foundation of Peking University School and Hospital of Stomatology(PKUSSNCT-18B14)

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Abstract:

Objective: To compare the clinical effects of periodontal endoscopy aiding subgingival debridement with periodontal flap surgery on residual deep pockets of chronic periodontitis. Methods: In the single-blind randomized control clinical study, residual deep pockets of periodontitis patients were still existing when re-evaluation after receiving initial periodontal treatment.The pockets which were necessary for bone surgery or guided tissue regeneration surgery were excluded.The sites were divided into test group and control group randomly.Test group sites underwent periodontal endoscopy aiding debridement and control group sites had periodontal flap surgery.At the baseline and 3 months later, parameters, such as plaque index (PLI), bleeding index (BI), probing depth (PD), attachment loss (AL) were examined.Bone height was measured by parallelly digital X-ray dental film.Meanwhile, treatment time and comfort scale (visual analogue scale, VAS) were also recorded. Results: At baseline, 41 proximal sites with residual deep pockets were enrolled (test sites=21, control sites=20).All the parameters were not significantly different between the two groups.PD decreased by (1.67±0.91) mm from (5.62±0.86) mm to (3.95±0.74) mm in test group and by (2.25±1.12) mm from (5.95±1.19) mm to (3.70±0.73) mm in control group significantly (P < 0.05).The difference between the two groups was not significant.The PD of all the sites decreased lower than 5 mm, meanwhile, 76% was lower than 4 mm in test group and 85% was lower than 4 mm in control group.The BI decreased by 0.81±0.93 in test group and 0.65±0.99 in control group significantly (P < 0.05).The difference between the two groups was not significant.The PLI showed a tendency of decrease more in test group and bone height showed a trend of decrease more in control group, however, the difference was not significant.The treatment time was almost the same.The patients felt more comfortable in the test group (VAS was 0.60±0.89) than the control group (VAS was 1.20±1.64), however, the difference was not significant. Conclusion: Periodontal endoscopy aiding subgingival debridement could improve periodontal status by reducing the PD and BI significantly in short term.The effect was almost the same with periodontal surgery and endoscopy treatment may decrease the necessity of surgery.Meanwhile, periodontal endoscopy has more comfortable treatment experience than flap surgery and does not need extra treatment time.

Key words: Periodontal endoscopy, Flap surgery, Chronic periodontitis

CLC Number: 

  • R781.4

Table 1

Comparison of probing depth results between two groups at baseline and 3 months later"

Group n Baseline/mm, $\bar x \pm s$ 3 months later/mm, $\bar x \pm s$ Change/mm, $\bar x \pm s$ P value
Test group 21 5.62±0.86 3.95±0.74 1.67±0.91 < 0.001
Control group 20 5.95±1.19 3.70±0.73 2.25±1.12 < 0.001
P value 0.31 0.28 0.07

Figure 1

Comparison of probing depth before and after treatment"

Table 2

Comparison of attachment loss results between two groups at baseline and 3 months"

Group n Baseline/mm, $\bar x \pm s$ 3 months later/mm, $\bar x \pm s$ Change/mm, $\bar x \pm s$ P value
Test group 21 4.40±1.44 4.04±1.16 0.36±1.20 0.38
Control group 20 4.95±1.76 4.45±1.39 0.50±1.43 0.32
P value 0.28 0.32 0.73

Table 3

Comparison of bleeding index results between two groups at baseline and 3 months"

Group n Baseline, $\bar x \pm s$ 3 months later, $\bar x \pm s$ Change, $\bar x \pm s$ P value
Test group 21 2.95±0.67 2.14±0.97 0.81±0.93 < 0.001
Control group 20 2.75±0.79 2.10±0.72 0.65±0.99 < 0.009
P value 0.38 0.85 0.60

Table 4

Comparison of plaque index results between two groups at baseline and 3 months"

Group n Baseline, $\bar x \pm s$ 3 months later, $\bar x \pm s$ Change, $\bar x \pm s$ P value
Test group 21 0.62±0.66 0.43±0.60 0.19±0.92 0.34
Control group 20 0.85±0.81 0.95±0.76 0.1±0.64 0.69
P value 0.32 0.02 0.25

Table 5

Comparison of alveolar bone height results between two groups at baseline and 3 months"

Group n Baseline/mm, $\bar x \pm s$ 3 months later/mm, $\bar x \pm s$ Change/mm, $\bar x \pm s$ P value
Test group 21 3.90±0.95 3.91±1.10 0.02±0.43 0.96
Control group 20 4.03±1.43 3.95±1.23 0.08±0.54 0.84
P value 0.72 0.92 0.52
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