Two-year follow-up of the outcomes of endoscope-assisted minimally invasive nonsurgical periodontal therapy for deep intrabony defects / 口腔疾病防治

Objective@#To explore the clinical efficacy and imaging changes of minimally invasive nonsurgical periodontal therapy (MINST) assisted by endoscopy for deep intrabony defects and to compare its effectiveness with that of traditional scaling and root planning (SRP) to therefore provide a reference for clinical periodontal treatment.@*Methods@#Patients with deep intrabony defects ≥ 4 mm in size were selected and divided into two groups: the MINST (MINST, 20 cases, 81 sites) group and the classic scaling and root planing (SRP, 20 cases, 80 sites) group. Before treatment and 12 and 24 months after treatment, probing depth (PD) and clinical attachment loss (CAL) were examined. Moreover, changes in the depth and angle of the intrabony defects were analyzed. Follow-up examination and maintenance treatment should be conducted every 3 months for 12 months after the initial treatment and every 6 months thereafter until 24 months.@*Results@#The PD and CAL of patients in both groups continued to decrease (P<0.001), and imaging examinations revealed a decrease in defect depth and an increase in intrabony defect angle (P<0.001). The changes in the first 12 months were significantly greater than those in the last 12 months in both groups (P<0.001). The decreases in PD, CAL, and depth of intrabony defects and increase in angle in the MINST group were significantly greater than those in the SRP group (P<0.001). At 12 and 24 months after treatment, the PD and CAL in the MINST group were lower than those in the SRP group (P<0.001). The defect height of the MINST group decreased more than that of the SRP group (P<0.001), and the defect angle of the MINST group increased more than that of the SRP group (P<0.001).@*Conclusion@#Minimally invasive nonsurgical periodontal therapy can significantly promote the healing of deep intrabony defects and the regeneration of alveolar bone. Imaging reflects that alveolar bone healing is rapid at first and then slows. Compared with traditional SRP, endoscopically assisted MINST can yield better clinical indicators and imaging changes in intrabony defects.

Clinical study of periodontal endoscope-assisted subgingival scaling in the treatment of residual pocket / 华西口腔医学杂志

OBJECTIVES@#To compare the treatment effects of periodontal endoscope-assisted and traditional subgingival scaling on residual pockets.@*METHODS@#A total of 13 patients with periodontitis from Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University were recruited. After 4-6 weeks of initial treatment, the residual pockets with a probing depth (PD) of ≥4 mm and attachment loss (AL) of ≥4 mm and bleeding on probing were examined with traditional (control group) and periodontal endoscope-assisted subgingival scaling (endoscopy group) in a randomly controlled split-mouth design. At baseline and 6 weeks and 3 months after treatment, plaque index (PLI), PD, AL, and bleeding index (BI) were measured. Differences in these clinical parameters within and between groups and patient-reported outcomes were compared.@*RESULTS@#A total of the 694 sites of 251 teeth were included in this trial. Both groups showed significant improvement in each periodontal parameters 6 weeks and 3 months after treatment (@*CONCLUSIONS@#Periodontal endoscope-assisted subgingival scaling resulted in better effects than traditional subgingival scaling when the residual pockets were in a single-rooted tooth, with a PD of ≥5 mm but without vertical alveolar bone resorption and furcation involvement.

Effects of ultrasonic subgingival scaling and root planing with a periodontal endoscope on the root surface / 口腔疾病防治

Objective @# To evaluate the effects of root calculus residue and root cement preservation by ultrasonic subgingival scaling and root planing (SRP) with or without perioscopy.@*Methods @# Twelve teeth extracted due to severe periodontitis were randomly divided into three groups with four teeth in each group: ① Endoscope-assisted SRP group. The root surfaces of the affected teeth were cleaned with an EMS ultrasonic treatment instrument. ② Traditional SRP group. The affected teeth were treated by ultrasonic subgingival scaling and hand root planing with a Gracey curette. ③ Untreat group. The above operations were performed by the same senior physician. Under local anesthesia, each tooth was scraped for 10 minutes and then extracted. The residual amount of calculus on the root surface after plaque staining was observed and recorded. The thickness of the retained cementum at 1/3 of the root neck was measured.@*Results@# The residual rate of calculus on the root surface was the lowest in the endoscope-assisted SRP group, which was significantly different from the traditional SRP group and the untreated group (P < 0.001). Histological observation showed that the mean residual cementum thickness at 1/3 of the root neck increased gradually from the cemento-enamel junction (CEJ), 2.5 mm below the CEJ and 5 mm below the CEJ. Ultrasound SRP assisted by endoscopy caused less damage to the cementum and preserved the cementum better than traditional subgingival scaling (P < 0.001). @*Conclusion@# Compared with traditional SRP therapy, endoscope-assisted SRP treatment can remove subgingival plaque and calculus more effectively and can better preserve the cementum of the root surface.

Clinical efficacy evaluation of minimally invasive periodontal therapy assisted by endoscopy / 口腔疾病防治

Objective @# To investigate the clinical effect of periodontal endoscope-assisted scaling and root planing (SRP) in treating advanced periodontitis. @*Methods@# Nineteen cases of grade Ⅲ and Ⅳ periodontitis selected from June 2017 to January 2019 in the Nanjing Stomatological Hospital, Medical School of Nanjing University were divided into the periodontal endoscope and control groups. In the periodontal endoscope group, SRP was performed under a periodontal microscope in one treatment after initial supragingival scaling; in the control group, SRP was performed under regular conditions, and additional SRP was conducted in positive bleeding on probing sites twice every other week as needed. Periodontal status, including probing depth (PD), bleeding on probing (BOP) and attachment loss (AL), was recorded by a Florida probe.@*Results@# For sites of 4<PD ≤ 6 mm, there was no significant difference in PD- and BOP-positive rates or AL between the two groups at baseline. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. PD in the endoscope group was smaller than that in the control group at 3 months (P < 0.05). There was no significant difference between the two groups at 6 months (P >0.05). There was no significant difference in the BOP positive rate or AL change between the two groups at 3 months and 6 months (P > 0.05). For sites with PD > 6 mm, at baseline, the positive rates of PD, BOP and AL in the endoscope group were more serious than those in the control group, and the differences were statistically significant. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. However, PD in the endoscope group became shallower than that in the control group (P < 0.05) after 3 and 6 months. There was no significant difference in the BOP positive rate or AL between the two groups (P>0.05). @*Conclusion @#When compared to regular SRP, periodontal microscope-assisted SRP achieves better improvement in PD and is more beneficial for reducing the BOP and AL of deeper sites.

Efficacy of periodontal endoscope-assisted non-surgical treatment for severe and generalized periodontitis / 华西口腔医学杂志

OBJECTIVE@#To evaluate the effectiveness of periodontal endoscope as an adjuvant therapy for the non-surgical periodontal treatment of patients with severe and generalized periodontitis.@*METHODS@#Patients (n=13) were divided into three groups: patients treated with conventional subgingival scaling and root planing (SRP) (n=7, 408 sites) (group A), SRP using periodontal endoscope (n=4, 188 sites) (group B) or SRP with periodontal endoscope 3 months after initial SRP (n=2, 142 sites) (group C). Two subgroups were divided into 2 subgroups according to PD at the baseline: 46 mm as subgroup 2. Probing depth (PD), attachment loss (AL), gingival recession (GR) and bleeding on probing (BOP) were recorded.@*RESULTS@#The results of 3 months after treatment showed all PD, AL, and GR values in group A1 were less than those in group B1 (P6 mm, the application of periodontal endoscopy can increase the effect, reducing PD and GR, which may be an effective supplement to the current non-surgical periodontal treatment.