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http://dx.doi.org/10.5051/jpis.2007080354

Chemical cleansing as an adjunct to subgingival instrumentation with ultrasonic and hand devices in deep periodontal pockets: a randomized controlled study  

Zafar, Fahad (Department of Surgical Sciences, University of Turin C.I.R. Dental School)
Romano, Federica (Department of Surgical Sciences, University of Turin C.I.R. Dental School)
Citterio, Filippo (Department of Surgical Sciences, University of Turin C.I.R. Dental School)
Ferrarotti, Francesco (Department of Surgical Sciences, University of Turin C.I.R. Dental School)
Dellavia, Claudia (Department of Biomedical, Surgical and Dental Sciences, University of Milan)
Chang, Moontaek (Department of Surgical Sciences, University of Turin C.I.R. Dental School)
Aimetti, Mario (Department of Surgical Sciences, University of Turin C.I.R. Dental School)
Publication Information
Journal of Periodontal and Implant Science / v.51, no.4, 2021 , pp. 276-284 More about this Journal
Abstract
Purpose: The aim of this randomized clinical trial was to assess whether chemical cleansing using a sulfonic/sulfuric acid gel solution (HBX) as an adjunct to scaling and root planing (SRP) resulted in a decrease in residual plaque and calculus in deep periodontal pockets compared to SRP alone. Methods: Fifty-six patients with 56 hopeless posterior teeth, scheduled for extraction due to severe periodontitis, were enrolled in this study. Each tooth was randomly assigned to 1 of the 2 experimental procedures. The test teeth were subjected to the irrigation of the subgingival area with HBX for 2 minutes, followed by SRP with hand and ultrasonic instruments for 14 minutes, and then extracted. The control teeth received only mechanical instrumentation before extraction. Residual biofilm was evaluated on photographs and measured as total area and percentage of root surface covered by remaining plaque (RP) or calculus (RC) after treatment. Results: The initial pocket depth (PD) and total subgingival root surface area were similar between the 2 treatment groups. After treatment, the total subgingival root area covered by RP and RC was statistically significantly larger (P<0.001) in the control group than in the test group. The test teeth showed a lower percentage of RP, but a higher percentage of RC than the control teeth (both P<0.001). Complete calculus removal was achieved in 42% of the control teeth surfaces and in 25% of the test teeth surfaces for a PD of 4 mm. Conclusions: The additional chemical cleansing with HBX resulted in a statistically significant improvement in bacterial plaque removal during SRP of deep pockets, but it was not effective in reducing calculus deposits.
Keywords
Decontamination; Dental calculus; Periodontitis; Root planing; Sulfates;
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1 Buchanan SA, Robertson PB. Calculus removal by scaling/root planing with and without surgical access. J Periodontol 1987;58:159-63.   DOI
2 Allen DL, Kerr DA. Tissue response in the guinea pig to sterile and non-sterile calculus. J Periodontol 1965;36:121-6.   DOI
3 Listgarten MA, Ellegaard B. Electron microscopic evidence of a cellular attachment between junctional epithelium and dental calculus. J Periodontal Res 1973;8:143-50.   DOI
4 Friskopp J, Hammarstrom L. A comparative, scanning electron microscopic study of supragingival and subgingival calculus. J Periodontol 1980;51:553-62.   DOI
5 Anerud A, Loe H, Boysen H. The natural history and clinical course of calculus formation in man. J Clin Periodontol 1991;18:160-70.   DOI
6 Aimetti M. Nonsurgical periodontal treatment. Int J Esthet Dent 2014;9:251-67.
7 Rabbani GM, Ash MM Jr, Caffesse RG. The effectiveness of subgingival scaling and root planing in calculus removal. J Periodontol 1981;52:119-23.   DOI
8 Waerhaug J. Healing of the dento-epithelial junction following subgingival plaque control. II: As observed on extracted teeth. J Periodontol 1978;49:119-34.   DOI
9 Lopez MA, Andreasi Bassi M, Confalone L, Silvestre F, Arcuri C. The treatment of peri-implant diseases: a new approach using hybenx® as a decontaminant for implant surface and oral tissues. Oral Implantol (Rome) 2016;9:106-14.
10 Ye WH, Fan B, Purcell W, Meghil MM, Cutler CW, Bergeron BE, et al. Anti-biofilm efficacy of root canal irrigants against in-situ Enterococcus faecalis biofilms in root canals, isthmuses and dentinal tubules. J Dent 2018;79:68-76.   DOI
11 Porter SR, Al-Johani K, Fedele S, Moles DR. Randomised controlled trial of the efficacy of HybenX in the symptomatic treatment of recurrent aphthous stomatitis. Oral Dis 2009;15:155-61.   DOI
12 Pini-Prato G, Magnani C, Rotundo R. Treatment of acute periodontal abscesses using biofilm decontamination approach: a case report study. Int J Periodontics Restorative Dent 2016;36:55-63.   DOI
13 Isola G, Matarese G, Williams RC, Siciliano VI, Alibrandi A, Cordasco G, et al. The effects of a desiccant agent in the treatment of chronic periodontitis: a randomized, controlled clinical trial. Clin Oral Investig 2018;22:791-800.   DOI
14 Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Clin Periodontol 2018;45 Suppl 20:S149-61.   DOI
15 Bracke J, Basara M, Savord E, Dunaway A, Watkins M. Pilot evaluation of a simple adjunctive method for improved removal of oral biofilm during conventional scaling and root planing therapy. J Biol Regul Homeost Agents 2015;29 Suppl 1:6-9.
16 Nishimine D, O'Leary TJ. Hand instrumentation versus ultrasonics in the removal of endotoxins from root surfaces. J Periodontol 1979;50:345-9.   DOI
17 Caffesse RG, Sweeney PL, Smith BA. Scaling and root planing with and without periodontal flap surgery. J Clin Periodontol 1986;13:205-10.   DOI
18 Jones WA, O'Leary TJ. The effectiveness of in vivo root planing in removing bacterial endotoxin from the roots of periodontally involved teeth. J Periodontol 1978;49:337-42.   DOI
19 Matia JI, Bissada NF, Maybury JE, Ricchetti P. Efficiency of scaling of the molar furcation area with and without surgical access. Int J Periodontics Restorative Dent 1986;6:24-35.
20 Eschler B, Moskowicz DG, Alvares O. Measurements of residual stained material on treated periodontally involved roots. J Dent Res 1987;66:149.
21 Breininger DR, O'Leary TJ, Blumenshine RV. Comparative effectiveness of ultrasonic and hand scaling for the removal of subgingival plaque and calculus. J Periodontol 1987;58:9-18.   DOI
22 Mombelli A, Nyman S, Bragger U, Wennstrom J, Lang NP. Clinical and microbiological changes associated with an altered subgingival environment induced by periodontal pocket reduction. J Clin Periodontol 1995;22:780-7.   DOI
23 Offenbacher S. Periodontal diseases: pathogenesis. Ann Periodontol 1996;1:821-78.   DOI
24 Cobb CM. Clinical significance of non-surgical periodontal therapy: an evidence-based perspective of scaling and root planing. J Clin Periodontol 2002;29 Suppl 2:6-16.
25 Fleischer HC, Mellonig JT, Brayer WK, Gray JL, Barnett JD. Scaling and root planing efficacy in multirooted teeth. J Periodontol 1989;60:402-9.   DOI
26 Lombardo G, Signoretto C, Corrocher G, Pardo A, Pighi J, Rovera A, et al. A topical desiccant agent in association with ultrasonic debridement in the initial treatment of chronic periodontitis: a clinical and microbiological study. New Microbiol 2015;38:393-407.
27 Wilson TG Jr, Harrel SK, Nunn ME, Francis B, Webb K. The relationship between the presence of tooth-borne subgingival deposits and inflammation found with a dental endoscope. J Periodontol 2008;79:2029-35.   DOI
28 Badersten A, Nilveus R, Egelberg J. Effect of nonsurgical periodontal therapy. II. Severely advanced periodontitis. J Clin Periodontol 1984;11:63-76.   DOI
29 John MT, Michalowicz BS, Kotsakis GA, Chu H. Network meta-analysis of studies included in the Clinical Practice Guideline on the nonsurgical treatment of chronic periodontitis. J Clin Periodontol 2017;44:603-11.   DOI
30 Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, et al. Systematic review and metaanalysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc 2015;146:508-24.e5.
31 Kaldahl WB, Kalkwarf KL, Patil KD, Molvar MP, Dyer JK. Long-term evaluation of periodontal therapy: I. Response to 4 therapeutic modalities. J Periodontol 1996;67:93-102.   DOI
32 Tomasi C, Leyland AH, Wennstrom JL. Factors influencing the outcome of non-surgical periodontal treatment: a multilevel approach. J Clin Periodontol 2007;34:682-90.   DOI
33 Sherman PR, Hutchens LH Jr, Jewson LGClinical Responses Related to Residual Calculus. The effectiveness of subgingival scaling and root planing. II. Clinical responses related to residual calculus. J Periodontol 1990;61:9-15.   DOI
34 Antonelli A, Giovannini L, Baccani I, Giuliani V, Pace R, Rossolini GM. In vitro antimicrobial activity of the decontaminant HybenX® compared to chlorhexidine and sodium hypochlorite against common bacterial and yeast pathogens. Antibiotics (Basel) 2019;8:188.   DOI