Modern understanding of endoscopy technology at a periodontal appointment: a systematic review

Abstract

Relevance. Periodontitis is a common chronic infectious and inflammatory disease. Multiple microorganisms, including periodontal pathogens in the dental biofilm, are the principal reason for inflammatory periodontal diseases. The initial stage of periodontitis treatment involves the mechanical removal of dental deposits from the tooth surface. Subgingival scaling is technically complex due to the limited visualization. An experienced clinician does not always have a chance to thoroughly treat all roo ts’ surfaces and remove all plaque and tartar.Modern technology, e.g., Perioscopy, enables illumination and visualization of periodontal pockets and their content. Thus, dental endoscopy technology practicability determination requires the study of the systematization of a large initial data array.Materials and methods. Publications were searched and studied in seven electronic databases PubMed, Google Search, Embase, Web of Science, ScienceDirect, and SciELO II eLibrary. The study reviewed the articles published from 2000 to 2022, available in full text, and assessed for relevance. The search resulted in 119 selected publications. Based on the inclusion criteria, we selected 44 articles, which included 42 clinical trials and two reviews. The study methodology meets the requirements for systematic reviews (PRISMA).Results. High-quality visualization allows for the operating field control enabling access to hard-to-reach areas and improves periodontal treatment outcomes. Closed periodontal scaling, the most commonly used non-surgical inflammatory periodontal disease treatment technique, is based on the dentist’s tactile sensations and experience. Due to the lack of visual control, even an experienced practitioner may not always effectively treat all surfaces or remove all plaque and tartar. The examination with the endoscope (Perioscopy) after the instrumentation reveals areas of tartar and biofilm remains, which may lead to further periodontal destruction and future surgical treatment. The article presents the studies proving the sufficient effectiveness of a dental endoscope for periodontal disease treatment. It is of note that the endoscope significantly increases the treatment quality in cases with deep pockets and severe periodontitis.Conclusion. Endoscopic imaging of dental deposits and pocket content indirectly reduces the risk of recurrence and complications of inflammatory periodontal diseases. The treatment of patients with moderate and severe periodontitis requires the development of algorithms for the management of such patients with the mandatory use of an endoscope.