Air Polishing and CHX Effects in Addition to Subgingival Ultrasonic Instrumentation on Clinical Periodontal Parameters: A Randomised Clinical Trial
Keywords:dental plaque, root planning, chlorhexidine, glycine, periodontal index
Objectives: This study was performed to investigate the efficacy of using glycine powder air-polishing (GPAP) or antiseptics (CHX) adjunctively to scaling and root planing (SRP) in the treatment of periodontitis.
Methods: In this trial, ninety patients (between 28-80 years old) who had at least three teeth with 3 to 7- mm periodontal pockets, were Ä±ncluded from the Department of Periodontology. The patients were divided into three groups randomly. In the control group ultrasonic instrumentation was performed with distilled water and hand instrumentation, in the CHX group ultrasonic instrumentation was performed with CHX and hand instrumentation, in the GPAP group in addition to SRP with ultrasonic performed with distilled water and hand instrumentation, GPAP was performed for 10â€‰seconds per periodontal pocket using a Perio-Flow device. All treatments were performed in one session.
Resuls: The scores of plaque index(PI),gingival index (GI), probing depth (PD), bleeding on probing (BOP) and clinical attachement level (CAL) were decreased in all groups after 1 month and the results were statistically significant in intergoup comparisions. PI and CAL scores were statistically significant in intragroup comparisions in GPAP group. Altough GI, PD and BOP scores were lower in the GPAP group than CHX and control group, the differences after 1 month were not statistically significant.
Conclusion: Within the limits of this study, it was seen that SRP was effective alone in the treatment of periodontitis. However, using a CHX with ultrasonic devices has little beneficial effects on periodontal parameters when compared with control and GPAP groups. GPAP groups was found more effectively in PI and CAL scores.
2. NagarakantÄ± S, GunupatÄ± S, Chava V. K, Reddy B. V. R. Effectivess of Subgingival Irrigation as an Adjunt to Scaling and Root Planing in the Treatment of Chronic Periodontitis:A systematic review.JCDR. 2015; 9(7):6-8.
3. Ioannou I, Dimitriadis N, Papadimitrious K,et al. Hand instrumentation versus ultrasonic debridement in the treatment of chronic periodontitis:a randomized clinical and microbiological trial. J Clin Periodontol. 2009;36:132-141.
4. Cobb C.M. Clinical significance of non-surgical periodontal therapy:an evidence-based perspective of scaling and root planing. J Clin Periodontol. 2002;2: 6-16.
5. Quirynen M, Teughels W, De Soete M, et al. Topical antiseptics aspects.Periodontol 2000.2002;28:72-92.
6. Cosyn, J, Sabzevar M.M. A systematic review on the effects of subgingival chlorhexidine gel administration in the treatment of chronic periodontitis. J Periodontol. 2005;76:1805-13.
7. Gunsolley J.C.Clinical efficacy of antimicrobial mouthrinses. J Dent.2010;38:6-10.
8. Tumer H, Berberoglu A, Caygur A, et al. Clinican evaluation of chlorhexidine and essential oils adjunctive effects in subgingival ultrasonÄ±c Ä±nstrumentation on periodontal parameters and halitosis. Journal of essential oils bearing plants. 2019;22(1):169-175.
9. Walker C. B, Karpani K, Baehn, P. Chemotherapeutics:antibiotics and other antimicrobials. Periodontol 2000.2004; 36:146-165.
10. Dogan S, Gunay H, Leyhausen G, et al. Effect of low-concentrated chlorhexidine on growth of Streptococcus sobrinus and primary human gingival fibroblasts. Clin Oral Investig. 2003; 7(4):212-216.
11. Boisnic S, Ben Slama L, Branchet-Gumila M,C, et al Woulnd healing effect of Eludril in a model of human gingival mucosa(Serbian). Rev Stomatol Chir Maxillofac. 2006; 107:431-35.
12. Ribeiro D.A, Bazo A.P, da Silva Franchis C.A, et al. Chlorhexidine induces DNA damage in rat peripheral leukocytes and oral mucosel cells. J Periodontal Res. 2004;39(5):358-361.
13. Petersilka G, Faggon C.M, Stratmann U, et al. Effect of glycine powder air-polishing on the gingiva. J Clin Periodontol. 2008; 35:324-332.
14. Zhong Z, Wheeler M.D, Li X, rt al L-Glycine:a novel antiinflammatory,immunomodulatory, and cytoprotective agent. Curr Opin Clin Nutr Metab Care. 2003; 6:229-240.
15. PetersÄ±lka G.J. Subgingival air-polishing in the treatment of periodontal biofilm infections. Periodontol 2000. 2011;55:124-142.
16. Silness J, Loe h. Periodontal disease in pregnancy II.Correlation between oral hygiene and periodontal condition.Acta Odontol Scand. 1964;22:121-135.
17. Loe H, Silness J. Periodontal disease in pregnancy I. Prevalance and severity. Acta Odontol Scand.1963;21:533-551.
18. Khosravi M, Baharami Z. S, Atabaki M.S.J. et al. Comparative effectiveness of hand and ultrasonic instrumentations in root surface planing in vitro. J Clin Periodontol. 2004;31:160-165.
19.Chaves E.S, Jeffcoat M.K, Ryerson C.C. et al. Persistent bacterial colonization of Porphymonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans in periodontitis and its association with alveolar bone loss after 6 months of therapy. J Clin Periodontol. 200;27:897-903.
20. Caygur A, Albaba M.R,Berberoglu A, et al. Efficacy of glycine powder air-polishing combined with scaling and root planing in the treatment of periodontitis and halitosis: A randomised clinical study. 2017;45(3):1168-1174.
21. Petersilka G.J, Ehmke B, Flemming T.F. Antimicrobial effects of mechanical debriment. Periodontol 200. 2002; 28: 56-71.
22. Yilmaz H.G, BayÄ±ndÄ±r H. Clinical evaluation of chlorhexidine and essential oils for adjuctive effects in ultrasonic instrumentation of furcation involvements: a randomized control trial. J Clin Periodontol. 2011;38:637-643
23. Guarnelli M.E, Franceschetti G, Manfrini R. Et al. Adjuctive effect of chlorhexidine in ultrasonic instrumentation of aggresive periodontitis patients: a pilot study. J Clin Periodontol. 2008; 35:333-341.
24.Preus H.R, Koldsland O C, Aass A.N, et al. The plaque-and-gingivitis-inhibiting capacity of a commercially available essential oil product. A parallel, split-mouth, single blind,randomized, placebo-controlled clinical study. Acta Odontol Scand. 2013;71:1613-19.
25. Flemming T.F, Hetzel M, Topoll H, et al. Subgingival debridement efficacy of glycine powder air polishing. J Periodontol. 2007;78:1002-1010.
26. Petersilka G.J, Tunkel J, Barakos K, et al. Subgingival plaque removal at interdental sites using a low abrasive air polishing. J Periodontol. 2003;74:307-311.
27. Moene R, Decaillet F, Andresan E, et al. Subgingival plaque removal using new air-polishing device. J Periodontol. 2010; 81:79-88.
28. MÃ¼ller N, Moene R, Cancela J.A, et al. Subgingival air polishing with eryhriol during periodontal maitenanace. J Clin Periodontol. 2014;41:883-889.