Abstract

BackgroundThis pilot study was part of a larger study which compared the effect of subgingival air-polishing using trehalose powder with sonic scaling on clinical parameters during supportive periodontal therapy. Within this microbiological part of the investigation subgingival samples were taken from 10 participants to analyze the survival of different bacterial species after the two different treatments as a proof of principle.MethodsIn 10 participants two non-adjacent, single-root teeth requiring treatment (PD =5 mm with bleeding on probing (BOP) or > 5 mm) were selected following a split-mouth design and were treated either with a sonic scaler or air-polishing device and trehalose powder. For persistent pockets (PD =4 mm and BOP or > 4 mm), treatment was repeated after 3 months. Subgingival biofilm samples were taken at baseline (BL), subsequently and three and six months after treatment. After determination of the bacterial counts (TBL), isolated bacteria were identified by MALDI-TOF-MS. If unsuccessful, PCR and 16S rDNA sequencing were performed.ResultsIn both treatment groups, TBL decreased immediately after treatment remaining at a lower level. This confirms the findings of the larger study regarding clinical parameters showing a comparable effect on PD, BOP and CAL. Immediately after treatment, the diversity of detected species decreased significantly more than in the sonic group (p = 0.03). After 3 months, the proportion of Gram-positive anaerobic rods was lower in the air-polishing group (powder/ sonic 7%/ 25.9%, p = 0.025). Also, there was a greater reduction of Gram-negative aerobic rods for this group at this time (air-polishing/ sonic − 0.91 / -0.23 Log10 cfu/ ml, p = 0.020).ConclusionWithin the limitations of this study air-polishing and sonic treatment seem to have a comparable effect on the subgingival oral biofilm during supportive periodontal treatment.Trial registrationThe study was registered in an international trial register (German Clinical Trial Register number DRKS 00006296) on 10th of June 2015. HTML&TRIAL_ID = DRKS00006296.

Highlights

  • This pilot study was part of a larger study which compared the effect of subgingival air-polishing using trehalose powder with sonic scaling on clinical parameters during supportive periodontal therapy

  • Concerning reduction of bacterial counts immediately after subgingival instrumentation, a superiority of air-polishing over hand instrumentation could be proven in a clinical trial [7]

  • Another investigation after twelve months could find no differences of the total bacterial count between airpolishing and sonic scaling compared to baseline [5]

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Summary

Introduction

This pilot study was part of a larger study which compared the effect of subgingival air-polishing using trehalose powder with sonic scaling on clinical parameters during supportive periodontal therapy. Since deeper periodontal pockets might not fully be eradicated during active periodontal therapy, repeated subgingival biofilm removal in those sites is essential during supportive periodontal treatment to disturb dysbiotic biofilms and to overcome inflammation [3, 4] In this context the use of hand instruments as well as sonic scalers or air-polishing devices could be proven effective for subgingival instrumentation [5,6,7]. Concerning reduction of bacterial counts immediately after subgingival instrumentation, a superiority of air-polishing over hand instrumentation could be proven in a clinical trial [7] Another investigation after twelve months could find no differences of the total bacterial count between airpolishing and sonic scaling compared to baseline [5]. In a consensus conference in 2017 it was summarized, that subgingival air-polishing in periodontal pocket depths up to 9 mm is more effective in the removal of biofilm than hand instrumentation or (ultra-) sonic scalers [13]

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