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Effectiveness of Using the Perioscope as an Adjunct to Nonsurgical Periodontal Therapy
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
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.
METHODS
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.
RESULTS
Both groups had significant improvements in clinical outcomes. The test (T) group had a significantly lower percentage of PPDs 7 to 9 mm 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 + 0.2 mm; C: 2.98 ± 0.4 mm), 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 ± 0.2 mm; C: -0.50 ± 0.6 mm) (P < 0.05). More radiographic bone gain was observed in the test group (0.69 ± 0.3 mm) as compared with the control group (0.49 ± 0.2 mm). This was also observed around multi-rooted teeth (T: 0.83 ± 0.45 mm; C: 0.46 ± 0.36 mm).
CONCLUSION
The adjunctive use of the perioscope provided a slight benefit to the outcomes of non-surgical therapy particularly at deeper probing depths.
Additional Info
Disclosure statements are available on the authors' profiles:
The effectiveness of using the perioscope as an adjunct to non-surgical periodontal therapy: Clinical and radiographic results
J. Periodontol. 2022 Jan 01;93(1)20-30, M Naicker, LH Ngo, AJ Rosenberg, IB DarbyFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Although scaling and root planing is the gold standard in non-surgical periodontal therapy (NSPT), lack of direct visualization of the root, anatomical challenges, pocket depth, and subjectivity in tactile detection often result in residual subgingival calculus deposits, which can result in the need for periodontal surgery. Periodontal endoscopy was developed in an attempt to overcome these challenges. Periodontal endoscopy is based on fiber-optic technology that enables real-time visualization of the root surface with 40–100× magnification without requiring surgery. Several studies have reported improvements in inflammatory and clinical outcomes using endoscope-guided NSPT. However, the majority of studies have not included radiographic assessment as a clinical endpoint. In this randomized clinical trial, NSPT was performed for 90 minutes in each group. The control group received traditional NSPT, whereas the test group received endoscope-guided NSPT. This study reflects the previous literature where endoscope-guided NSPT resulted in more long-term and sustained improvements in probing pocket depths, bleeding on probing, and plaque index. Additionally, this study found that endoscope-guided NSPT resulted in higher levels of bone regeneration overall and in multi-rooted teeth. Endoscope-guided NSPT appears to remove some of the inherent challenges observed in traditional NSPT, resulting in improved non-surgical outcomes.