Effects of Periodontal Endoscopy-Assisted Nonsurgical Treatment of Periodontitis: Four-Month Results of a Randomized Controlled Split-Mouth Pilot Study

Abstract

Objective. Although the therapeutic effects of nonsurgical periodontal therapy (NSPT) are well established, the clinical benefits of the additional use of periodontal endoscopy (PE) remain controversial. Therefore, this randomized controlled split-mouth pilot study evaluated the effect of NSPT using PE versus NSPT without nPE on bleeding on probing (BOP) in sites with probing depth (PD)≥4 mm (primary outcome), PD, clinical attachment level (CAL), number of hard deposits (HDs), and treatment time per tooth (TrT). Methods. Two calibrated operators performed NSPT in twenty periodontitis patients, randomized into two quadrants for PE or nPE treatment. BOP, PD, and CAL were recorded at the first visit for NSPT (T0) and during reevaluation (T1: mean (SD) 119.7 (24.6) days after T0). The average TrT and the number of sites with HDs were documented at T0. Results. For BOP, no significant differences were found at the patient’s level (10/10 (male/female); aged 54.3 (10.9) years) neither within or between the groups. At tooth surface level, a lower number of surfaces with BOP p = 0.026 was observed in nPE. CAL and PD improved significantly during NSPT in both groups p ≤ 0.001 , with higher PD reduction p < 0.001 and CAL gain p < 0.001 in nPE. There are significantly longer TrT p < 0.001 and more surfaces with subgingival HDs evident in PE at T0 p = 0.001 . Conclusion. Whereas subgingival HDs can be visually detected with PE during NSPT, no additional clinical benefits regarding BOP, PD, or CAL were notable compared to conventional systematic periodontal instrumentation. Additionally, PE-assisted NSPT required a longer treatment time.

Utilization of a periodontal endoscope in nonsurgical periodontal therapy: A randomized, split‐mouth clinical trial

“…12 Graetz et al recently reported no differences in outcomes with and without the use of the periodontal endoscope at 4 months in their split-mouth randomized controlled study. 16 We report the results of nonsurgical periodontal therapy with or without the use of a periodontal endoscope in both anterior and posterior teeth for up to 1 year, which is a longer time period than reported by the aforementioned studies. However, we were limited by the sample size in our study, especially at 12 months.…”

“…Despite this, nonsurgical treatment can still result in a state of periodontal health. Some disadvantages of periodontal endoscopy were recently reported by Graetz et al 16 . Disadvantages include the requirement for special training and equipment, an association with a learning curve, and the requirement for additional treatment time, which could result in a higher cost to the patient.…”