Periodontitis Clinical Trial
Official title:
Comparison of Ultrasonic Versus Hand Instrumentation Plus Ultrasonic for Effective Sanative Therapy
Periodontitis is a chronic oral infection that results in the breakdown of connective tissue and alveolar bone that support the teeth. Non-surgical sanative therapy using a combination treatment of hand and ultrasonic instrumentation is the primary treatment option for patients with periodontitis. However, the hand-held instrumentation requires continuous sharpening for optimal outcomes, which introduces tremendous variability as well as a large increase in time spent by the treating dental hygienists. Therefore, this study aimed to determine if ultrasonic instrumentation alone can provide similar improvements to periodontal outcomes compared to ultrasonic plus hand instrumentation.
Periodontitis is a chronic oral infection that results in the breakdown of connective tissue
and alveolar bone that support the teeth. Bacteria and the body's own immune system mediate
the severity of periodontitis, where teeth may become loose, fall out or have to be removed.
Non-surgical sanative therapy (also referred to as "deep cleaning") is the primary treatment
option for patients with generalized chronic periodontitis. This includes debridement with
both ultrasonic and hand instrumentation. Using this approach, surgery is avoided for 93% of
patients who undergo sanative therapy at our private periodontal specialty practice
(unpublished data). However, the hand-held instrumentation requires continuous sharpening for
optimal performance, which introduces tremendous variability as well as a large increase in
time spent by the hygienists. Ultrasonic instrumentation does not require sharpening, as a
new instrument head is used for every new patient.
Therefore, given the interest in "contemporary instrumentation", meaning ultrasonic therapy
alone, the primary objective of this study is to determine if similar improvements in
periodontal indices can be achieved using ultrasonic instrumentation alone versus ultrasonic
instrumentation in conjunction with hand instrumentation.
Secondary objectives included the following: i) to determine if the time required to complete
sanative therapy is reduced using ultrasonic therapy alone, given the ultrasonic instruments
do not require sharpening and less instrument changes by the hygienist are required during
treatment. If the time is less for ultrasonic therapy alone, there is a potential
cost-savings for the patient, as well as less time spent receiving therapy in the dental
chair; ii) to determine if the treatment with ultrasonic therapy versus ultrasonic therapy
and hand instrumentation is more comfortable for the patient; and iii) to determine if there
is less sensitivity to the teeth with ultrasonic therapy alone compared to the combination of
ultrasonic therapy and hand instrumentation.
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