Clinical comparison of instrumentation systems for periodontal debridement: A randomized clinical trial

Abstract

Objective To compare clinical efficacy, chairside time and post‐treatment hypersensitivity of four instruments used for subgingival periodontal debridement. Materials & Methods Seventeen patients with stage II and III periodontitis were enrolled in this randomized clinical trial using a split‐mouth design. Quadrants were randomly divided into four treatment groups: Group A: Gracey curettes‐Hu‐Friedy®; Group B: piezoelectric ultrasonic (Satelec®) with No.1S insert; Group C: diamond burs 40 µm (Intensiv Perioset®); and Group D: piezosurgery ultrasonic (Mectron®) with PP1 insert. Clinical outcomes, chairside time and hypersensitivity were assessed at 1, 2, 4 and 8 weeks after treatment. The primary outcome variable was improvement in clinical attachment level. Results At 8 weeks post‐treatment, Gracey curettes, piezoelectric ultrasonic (Satelec®) and piezosurgery ultrasonic (Mectron®) were statistically more effective than diamond burs in increasing attachment level and reducing probing pocket depth. Comparison of piezoelectric ultrasonic (Satelec®) and piezosurgery ultrasonic (Mectron®) with the other instruments showed a statistical difference (p < 0.001) in chairside time. Regarding post‐treatment hypersensitivity, no statistical differences were observed in any of the groups. Conclusions Gracey curettes, piezoelectric ultrasonic (Satelec®) and piezosurgery ultrasonic (Mectron®) were clinically more effective than diamond burs 40 µm. The ultrasonic instruments showed a significant reduction in chairside time.

Factors associated with the performance of specialized periodontal procedures and achieving periodontal goals in Brazilian Dental Specialties Centers

“…The use of the latter can signi cantly reduce the needed time, with reductions of up to 50% 15 . These results are consistent with other studies and indicate that, in comparison to manual instruments, ultrasonic instruments can statistically decrease treatment time by over 30% 13 .…”

Effectiveness of Ultrasonic and Manual Instrumentation in Nonsurgical Periodontal Therapy: Are Additional Therapies More Effective? A Systematic Review

“…It is well known that the goal of typical nonsurgical periodontal treatment is to remove biofilm to create the ideal environment for efficient bacterial plaque management [5,68,69]. Historically, scaling and root planing with manual instrumentation has been the most commonly used method of root surface debridement, with both clinical and microbiological benefits [70][71][72], as demonstrated by the studies included in this review [19][20][21][22][23][24][25][26][27]. Manual instrumentation also appears to be more effective in reducing the probing depth in moderate and severe periodontal pockets, according to Zhang et al, although no particular statistically significant differences were found with ultrasonic instrumentation [64].…”

“…According to the studies included in the review [19][20][21][22][23][24][25][26][27], there was no statistically significant differences between the treatments proposed, demonstrating the achievement of clinical outcomes with the use of ultrasonic scalers and hand instruments. These results are consistent with previous research [64][65][66][67].…”

“…Table 1. RCTs included (ultrasonic and manual instruments) [19][20][21][22][23][24][25][26][27]. All treatments resulted in a significant clinical improvement, but there were no significant differences among groups.…”

“…Table 5. Risk of bias of articles (ultrasonic and manual instruments) [19][20][21][22][23][24][25][26][27]. The table shows the risk of bias of each study included in the review (a green symbol was assigned where the information was complete and accurate; a yellow symbol was allocated where information was missing).…”