The effectiveness of using the perioscope as an adjunct to non-surgical periodontal therapy: Clinical and radiographic results.

Abstract

It is well known that following root surface debridement (RSD) residual deposits remain. Periodontal endoscopy has provided a method of directly visualizing root surfaces during periodontal debridement in an intact pocket without the need for surgical incision. The aim of this study was to determine if periodontal debridement using endoscopic visualization was more effective in improving clinical and radiographic parameters as compared to RSD. Thirty-eight subjects were randomized into RSD with perioscope (n=19) or RSD only (n=19) groups. A full-mouth evaluation included probing pocket depths (PPDs), clinical attachment levels (CAL), bleeding on probing (BOP) and plaque scores (PI) recorded at baseline, 3 and 12 months and compared among groups. Radiographs were taken at sites with deepest pockets at baseline and 12-month and the change in radiographic bone levels (RBL) compared. An independent samples T-test was used to assess statistical significance. Both groups had significant improvements in clinical outcomes. The test (T) group had a significantly lower percentage of PPDs 7 to 9mm at three (0.72±1.2%) and 12 months (0.5±1.0%) as compared with the control (C) group (2.25±2.9%; 1.84±2.3%). At 12 months, the test group recorded a significantly lower mean PPD (T: 2.70 + 0.2mm; C: 2.98±0.4mm), BOP% (T: 4.3±3.2%; C: 11.95±7.1%), PI% (T: 25.61±3.9%; C: 30.11±6.3%) and less change in gingival recession (T: -0.13±0.2mm; C: -0.50±0.6mm) (P<0.05). More radiographic bone gain was observed in the test group (0.69±0.3mm) as compared with the control group (0.49±0.2mm). This was also observed around multi-rooted teeth (T: 0.83±0.45mm; C: 0.46±0.36mm). The adjunctive use of the perioscope provided a slight benefit to the outcomes of non-surgical therapy particularly at deeper probing depths.