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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
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