Non-surgical treatment of periodontitis patients with different mechanical instruments: A parallel design clinical study

Non-surgical periodontal treatment can be performed with many different tools such as hand instruments, sonic/ultrasonic devices, air abrasives and lasers. There are no clinical studies in the literature comparing the effects of four different instruments as titanium nitride (TiN) -coated curette, ultrasonic device (UD) with a specifically designed tip, Er:YAG laser and stainless steel (SS) curette in one study with respect to the clinical outcome measures on residual pockets in periodontitis patients under supportive periodontal care (SPC) program. We aimed to evaluate the clinical effectiveness of four different instruments for subgingival debridement in a randomized, controlled, parallel design clinical trial during 6-month period. A total of 40 SPC patients diagnosed as Stage II or III, Grade B periodontitis with probing pocket depths (PPD) of ≥5mm on minimum 3, maximum 8 teeth were included in the study. Patients were randomly divided into 4 groups. Full-mouth supragingival debridement was performed followed by subgingival instrumentation with TiN-coated curette (TiN curette group) (n=10) or UD (UD group) (n=10) or Er:YAG laser (Er:YAG group) (n=10) or SS curette (SS curette Group) (n=10). Plaque Index (PI), gingival Index (GI), probing pocket depth (PPD) and bleeding on probing (BoP) were evaluated at baseline and after 6 months. No statistically significant differences were found between the groups at baseline and at 6 months in terms of clinical measurements (p>0.05). All groups responded treatment with statistically significant changes (p<0.05). Within the limits of this study, it can be concluded that residual pockets between 5-7mm responded to all tested non-surgical periodontal treatment modalities and reduced the need of further surgical interventions with the minimization of the surgical area.