Abstract
To evaluate in patients with untreated adult periodontitis, the effect of treatment with a novel pocket irrigator/evacuator device (IED) compared to conventional subgingival debridement (CPT), both provided during the initial phase of active periodontal therapy. This study was an examiner-blind, randomized controlled clinical trial using a split-mouth design. Systemically healthy patients with adult periodontitis were selected. Full-mouth probing pocket depth (PPD), gingival bleeding on pocket probing scores (BOPP), gingival recession (REC) and dental plaque (PI) were assessed at baseline. All participants received oral hygiene instructions and supragingival prophylaxis including polishing. In 2 randomly assigned contra-lateral quadrants, approximal sites were irrigated with the IED, whereas in the other quadrants, CPT was provided. The CPT consisted of subgingival debridement using ultrasonic devices followed by the use of hand instruments. At 3months post-treatment, the clinical parameters were re-assessed. Twenty-five patients met the inclusion criteria and were willing to participate. At 3months post-treatment, the PPD and BOPP had significantly improved for both treatment modalities. Pockets of ≥5mm reduced by 0.64mm in the IED group (P<.001), compared to a reduction of 0.82mm for the CPT group (P<.001). With respect to the primary outcome parameter (PPD) and BI, the results with the IED were less pronounced. Between the test and control groups, no significant differences were observed for REC and PI. Oral hygiene instructions, supragingival prophylaxis and subgingival lavage with the IED resulted in a significant reduction in PPD and BOPP. However, the effect does not reach the results of CPT which included the subgingival use of ultrasonic and hand instruments.
Highlights
Periodontitis is one of the most common chronic inflammatory diseases in humans, characterized by gingival inflammation and periodontal tissue breakdown
Objectives: To evaluate in patients with untreated adult periodontitis, the effect of treatment with a novel pocket irrigator/evacuator device (IED) compared to conventional subgingival debridement (CPT), both provided during the initial phase of active periodontal therapy
Oral hygiene instructions, supragingival prophylaxis and subgingival lavage with the IED resulted in a significant reduction in probing pocket depth (PPD) and bleeding on pocket probing scores (BOPP)
Summary
Periodontitis is one of the most common chronic inflammatory diseases in humans, characterized by gingival inflammation and periodontal tissue breakdown. Loss of alveolar bone support results in loss of teeth.[1] The most important risk factor for periodontitis is the accumulation of a plaque biofilm at and below the gingival margin within which dysbiosis develops and which is associated with an inappropriate and destructive host inflammatory immune response.[2] Periodontitis is a ubiquitous disease affecting over 50% of the world’s adult population, the occurrence of which increases with age.[3] Severe periodontitis is the sixth most prevalent human disease, with a standardized prevalence of 11.2%4 according to the 2010 global burden of diseases study, and a major cause of tooth loss It has a negative impact on oral health, quality of life, speech, nutrition, confidence and overall well-being and is independently associated with several systemic chronic inflammatory diseases. Periodontitis, represents a significant public health concern.[2]
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