Evaluation of Air Polishing With Ultrasonic Debridement in the Treatment of Initial Periodontal Pockets

Gingivitis Clinical Trial

Official title:

Clinical Outcomes of Using Erythritol Powder by Means of Air Polishing With Ultrasonic Debridement in the Treatment of Initial Periodontal Pockets in Hand of Dental Students: A Split-mouth, Randomized, Comparative, Controlled Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03863093
• Other study ID #: SPU-DN-Perio-2
• Status: Completed
• Phase: N/A
• Start date: February 9, 2019
• Est. completion date: December 30, 2019

Study information

• Verified date: November 2023
• Source: Syrian Private University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Clinical evaluation of using erythritol powder as air polishing with ultrasonic scaling and root planing in the treatment of initial periodontal pockets. This trial will be split-mouth design, in which each patient will receive traditional treatment (ultrasonic mechanical therapy and polishing) in one side, while the contralateral two quadrants of the jaws will be treated with erythritol powder by means of air polishing and ultrasonic scaling and root planing.

Description:

The aim of the study is to evaluate the usage of erythritol powder by means of air polishing in hand of undergraduate dental students as a single way to remove biofilm and the adjunctive application of ultrasonic piezo afterward for calculus removal and root planing only in the treatment of initial periodontal pockets.

The sample size will be 15 patients. Initially, oral hygiene instructions with scaling and root planing will consist of the treatment phase. Each subject will be informed comprehensively about oral hygiene instructions using disclosing solution (such as erythrosine) and hand mirror. The participant will be shown modified bass technique and the proper usage of dental floss and appropriate interdental brushes.

The control side will be treated with supra- and subgingival ultrasonic piezo scalers then supragingival polishing with rubber cup and a special fluoride containing paste as a traditional way of removal of plaque and calculus, while the test side, will be confined to erythritol powder by means of air polishing as the only way to remove ultrasonic piezo scalers.

At the end of treatment, hand instruments may be used to ensure the smoothness 0f the teeth surfaces.

Clinical measurements will be performed at baseline and at 2 weeks, 4 and 6 weeks for the plaque index and gingival indices, whereas probing will be performed only after 6 weeks.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 13
• Est. completion date: December 30, 2019
• Est. primary completion date: September 30, 2019
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 60 Years

Eligibility

Inclusion Criteria:

1. Patients are in generally good health

2. Patients are from both gender and their age is between 18 to 60 years.

3. Patients have a minimum of 20 teeth

4. The patient is a non-smoker (less than 5 cigarettes per day) and non-alcoholic.

5. Female participants must not be pregnant or breastfeeding (lactation).

6. the absence of severe oral habits

7. the presence of at least one residual pocket with pocket depth >4 mm with interdental sites with a probing depth of 3 to 5 mm without furcation involvement or subgingival restorations.

8. A sign informed consent from participation and permission to use obtained data for research purposes.

Exclusion Criteria:

1. Bruxism

2. Allergy to glycine or chlorhexidine;

3. systemic medical conditions requiring antibiotic prophylaxis (for endocarditis prophylaxis) and anti-inflammatory drugs before dental procedures;

4. active systemic infectious disease;

5. major systemic illnesses (diabetes mellitus, cancer, immunodeficiency virus, bone metabolic diseases or disorders that compromise wound healing, radiation or immunosuppressive therapy, neutropenia, agranulocytosis, or bleeding disorders.

6. chronic high dose steroid therapy

7. Patients are undergone to radiotherapy or chemotherapy before or during the study period.

8. actively smoking more than five cigarettes per day;

9. signs of generalized severe periodontitis;

10. having received periodontal maintenance within 3 months before baseline

11. patients treated with antibiotics 6 months prior to the study

12. chronic bronchitis and asthma

13. compromised immune system

14. hypersensitivity to sugar alcohols.

15. any physical limitations or restrictions that might preclude normal oral hygiene procedures.

Related Conditions & MeSH terms

• Gingivitis
• Periodontal Pocket

Intervention

Device:
• Electro Medical Systems AIRFLOW®
An erythritol powder will be used by Electro Medical Systems AIRFLOW® and then Electro Medical Systems Piezo will be used for supra- and subgingival ultrasonic instrumentation
• Electro Medical Systems Piezo
Electro Medical Systems Piezo will be used for supra- and subgingival ultrasonic instrumentation

Locations

Country	Name	City	State
Syrian Arab Republic	Syrian Private University	Damascus

Sponsors (1)

Lead Sponsor	Collaborator
Syrian Private University

Country where clinical trial is conducted

Syrian Arab Republic, 

References & Publications (6)

Flemmig TF, Arushanov D, Daubert D, Rothen M, Mueller G, Leroux BG. Randomized controlled trial assessing efficacy and safety of glycine powder air polishing in moderate-to-deep periodontal pockets. J Periodontol. 2012 Apr;83(4):444-52. doi: 10.1902/jop.2011.110367. Epub 2011 Aug 23. — View Citation

Hagi TT, Hofmanner P, Salvi GE, Ramseier CA, Sculean A. Clinical outcomes following subgingival application of a novel erythritol powder by means of air polishing in supportive periodontal therapy: a randomized, controlled clinical study. Quintessence Int. 2013 Nov-Dec;44(10):753-61. doi: 10.3290/j.qi.a30606. — View Citation

Moene R, Decaillet F, Andersen E, Mombelli A. Subgingival plaque removal using a new air-polishing device. J Periodontol. 2010 Jan;81(1):79-88. doi: 10.1902/jop.2009.090394. — View Citation

Muller N, Moene R, Cancela JA, Mombelli A. Subgingival air-polishing with erythritol during periodontal maintenance: randomized clinical trial of twelve months. J Clin Periodontol. 2014 Sep;41(9):883-9. doi: 10.1111/jcpe.12289. Epub 2014 Aug 7. — View Citation

Park EJ, Kwon EY, Kim HJ, Lee JY, Choi J, Joo JY. Clinical and microbiological effects of the supplementary use of an erythritol powder air-polishing device in non-surgical periodontal therapy: a randomized clinical trial. J Periodontal Implant Sci. 2018 Oct 24;48(5):295-304. doi: 10.5051/jpis.2018.48.5.295. eCollection 2018 Oct. — View Citation

Wennstrom JL, Dahlen G, Ramberg P. Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonic instrumentation during maintenance therapy. J Clin Periodontol. 2011 Sep;38(9):820-7. doi: 10.1111/j.1600-051X.2011.01751.x. Epub 2011 Jul 7. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	change in the papillary bleeding index	Probing is performed in all four quadrants. A quadrant 1 is probed only from the oral aspect, quadrant 2 from the facial, 3 again from oral, and from the facial in quadrant 4; Grade 1-Point: 20-30 seconds after probing the mesial and distal sulci with a periodontal probe, a single bleeding point is observed.; Grade 2-Line/Points: A fine line of blood or several bleeding points become visible at the gingival margin.; Grade 3-Triangle: The interdental triangle becomes more or less filled with blood.; Grade 4-Drops: Profuse bleeding. Immediately after probing, blood flows into the interdental area to cover portions of the tooth and/or gingiva.; Calculation: Papillary bleeding index= Bleeding Number/ Number of sites measured	baseline, 2-weeks, 4-weeks, 6-weeks after the treatment
Primary	change in the percentage of study sites positive for bleeding on probing	All four surfaces of all teeth are assessed with regard to whether probing elicits bleeding (+) or not (-). The severity of gingivitis is expressed as a percentage.; - no bleeding upon probing (not recorded); + bleeding upon probing; Calculation: Bleeding on probing= Number of bleeding sites x100 / Number of sites evaluated	baseline, 6-weeks after the treatment
Secondary	change in the full mouth Plaque Index	a score of 0 to 5 is assigned to each facial and lingual unrestored surface of all the teeth except third molars, as follows: The Plaque Index System; Scores Criteria; 0 No plaque; 1 Separate flecks of plaque at the cervical margin of the tooth; 2 A thin continuous band of plaque (up to one mm) at the cervical margin of the tooth; 3 A band of plaque wider than one mm but covering less than one-third of the crown of the tooth; 4 Plaque covering at least one-third but less than two-thirds of the crown of the tooth; 5 Plaque covering two-thirds or more of the crown of the tooth	baseline, 2-weeks, 4-weeks, 6-weeks after the treatment
Secondary	change in the Calculus index	0, no calculus; 1, mild supragingival calculus extending to marginal gingiva is present; 2, moderate supra and subgingival calculus or only subgingival calculus is present; and; 3, excessive supra and subgingival calculus is present.; it will be estimated visually	baseline, 2-weeks, 4-weeks, 6-weeks after the treatment
Secondary	change in the Modified Gingival Index	0 = Normal gingiva; 1 = Mild inflammation - slight change in color and slight edema; 2 = Moderate inflammation - redness, edema and glazing; 3 = Severe inflammation - marked redness and edema, ulceration with tendency to spontaneous bleeding.; it will be estimated visually	baseline, 2-weeks, 4-weeks, 6-weeks after the treatment
Secondary	change in the Probing pocket depth	measure as the change in distance from the gingival margin to the bottom of the gingival sulcus by using a periodontal probe (UNC 15 "University of North Carolina")	baseline, 6- weeks after the treatment
Secondary	The change of the root sensitivity	will be evaluated using a visual analogue scale (VAS). The VAS root sensitivity scores ranges between 0 to 10. (0: no root sensitivity, 5: moderate root sensitivity, 10: severe root sensitivity).	baseline, 24- hours, 48- hours, 72-hours, 1- week, 2-weeks, 4-weeks, 6-weeks after the treatment