Hand instrumentation versus ultrasonic debridement in the treatment of chronic periodontitis: a randomized clinical and microbiological trial

Ioannou I, Dimitriadis N, Papadimitriou K, Sakellari D, Vouros I, Konstantinidis A. Hand instrumentation versus ultrasonic debridement in the treatment of chronic periodontitis. a randomized clinical and microbiological trial. J Clin Periodontol 2008; doi: 10.1111/j.1600-051X.2008.01347.x. To compare the effectiveness of scaling and root planing (SRP) with the use of hand instruments to that of non-surgical treatment with the use of an ultrasonic device, using clinical and microbiological criteria. Thirty-three patients with chronic periodontitis participated in this randomized-controlled clinical trial divided into two groups. Patients in the control group received SRP with hand instruments, whereas patients in the test group received ultrasonic debridement (UD). Clinical recordings concerning probing pocket depth, clinical attachment level, plaque index and gingival bleeding index were performed at baseline, 3 and 6 months after baseline. Subgingival samples were analysed using the "checkerboard" DNA-DNA hybridization technique for Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia and Treponema denticola. Both treatments resulted in a significant improvement in all clinical recordings. Three months after treatment, a numerical decrease was observed for P. gingivalis, T. forsythia and T. denticola in both groups, which was statistically significant only for P. gingivalis (p < 0.05). Inter-group differences were observed at 6 months for T. forsythia and T. denticola (p < 0.05), favouring SRP. Both treatment modalities provided comparable clinical results in the treatment of chronic periodontitis.