Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (10): 684-688.doi: 10.12016/j.issn.2096-1456.2021.10.006

• Clinical Study • Previous Articles     Next Articles

Effects of ultrasonic subgingival scaling and root planing with a periodontal endoscope on the root surface

ZHAO Junjie1(),TAN Baochun1(),LI Lili1,ZHANG Yangheng1,CHEN Sheng2   

  1. 1. Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
    2. Department of Oral Pathology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
  • Received:2021-01-20 Revised:2021-04-08 Online:2021-10-20 Published:2021-06-23
  • Contact: Baochun TAN E-mail:junjie1983@126.com;tanbaochun2002@sina.com
  • Supported by:
    National Natural Science Foundation of China(81801041);Jiangsu Provincial Natural Science Foundation(BK20190133);Nanjing Medical Science and Technology Development Program(YKK17139)

Abstract:

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.

Key words: periodontitis, subgingival plaque, dental calculus, periodontal endoscope, ultrasonic subgingival scaling, Gracey curette, subgingival scaling, root planing, root surface, cemento-enamel junction, cementum, minimally invasive treatment

CLC Number: 

  • R78

Figure 1

Staining results of residual calculus in each group a: endoscope-assisted SRP group; b: traditional SRP group; c: untreated group; there were a lot of dental calculus on the root surface in the untreated group, the removal effects of dental calculus in the apical area and the concave surface in the endoscope-assisted SRP group and the traditional SRP group were better than that in the untreated group; SRP: subgingival scaling and root planing"

Figure 2

Residual cementum tissue sections at different positions in each group (× 20) In the endoscopic-assisted SRP group, the dentin on the root surface was relatively complete, with occasional local shedding; in the traditional SRP group, there was almost no residual cementum on the root surface. Although the root surface was flat, the dentin was completely exposed, and there was a small amount of smear layer on the dentin surface. In the untreated group, because the calculus covered by the root surface fell off after decalcification treatment, the cementum remained intact and thick; CEJ: cementoenamel junction; SRP: subgingival scaling and root planing"

Table 1

Comparison of cementum thickness at different positions in each group x ± s, n = 4"

Site Endoscope-assisted SRP group(μm) Traditional SRP group(μm) Untreated group(μm) F P
CEJ 12.58 ± 1.00 4.72 ± 3.82 13.20 ± 1.98 17.194 < 0.001
2.5 mm below CEJ 27.64 ± 7.97 19.58 ± 5.40 63.74 ± 11.88 35.460 < 0.001
5 mm below CEJ 65.52 ± 11.72 31.20 ± 4.64 101.66 ± 14.01 52.404 < 0.001
F 55.281 40.463 86.489
P < 0.001 < 0.001 < 0.001
[1] Groenen MJ, Kuipers EJ, Van Berge Henegouwen GP, et al. Computerisation of endoscopy reports using standard reports and text blocks[J]. Neth J Med, 2006,64(3):78-83.
pmid: 16547359
[2] Jepsen S, Deschner J, Braun A, et al. Calculus removal and the prevention of its formation[J]. Periodontol 2000, 2011,55(1):167-188. doi: 10.1111/j.1600-0757.2010.00382.x.
doi: 10.1111/j.1600-0757.2010.00382.x
[3] Martinez-Canut P, Llobell A, Romero A. Predictors of long-term outcomes in patients undergoing periodontal maintenance[J]. J Clin Periodontol, 2017,44(6):620-631. doi: 10.1111/jcpe.12730.
doi: 10.1111/jcpe.12730
[4] Jy K. Enhanced periodontal debridement with the use of micro ultrasonic, periodontal endoscopy[J]. J Calif Dent Assoc, 2005,33(3):241-248.
[5] Michaud RM, Schoolfield J, Mellonig JT, et al. The efficacy of subgingival calculus removal with endoscopy-aided scaling and root planing: a study on multirooted teeth[J]. J Periodontol, 2007,78(12):2238-2245. doi: 10.1902/jop.2007.070251.
doi: 10.1902/jop.2007.070251 pmid: 18052694
[6] Geisinger ML, Mealey BL, Schoolfield J, et al. The effectiveness of subgingival scaling and root planing: an evaluation of therapy with and without the use of the periodontal endoscope[J]. J Periodontol, 2007,78(1):22-28. doi: 10.1902/jop.2007.060186.
doi: 10.1902/jop.2007.060186 pmid: 17199535
[7] 孟焕新. 牙周病学[M].5版. 北京: 人民卫生出版社, 2020: 212-213.
Meng HX. Periodontology[M]. 5th edition. Beijing: People’s Medical Publishing House, 2020: 212-213.
[8] Wilson TG, Harrel SK, Nunn ME, et al. The relationship between the presence of tooth-borne subgingival deposits and inflammation found with a dental endoscope[J]. J Periodontol, 2008,79(11):2029-2035. doi: 10.1902/jop.2008.080189.
doi: 10.1902/jop.2008.080189
[9] Osborn JB, Lenton PA, Lunos SA, et al. Endoscopic vs. tactile evaluation of subgingival calculus[J]. J Dent Hyg, 2014,88(4):229-236.
pmid: 25295843
[10] Kuang YC, Hu B, Chen J, et al. Effects of periodontal endoscopy on the treatment of periodontitis: a systematic review and meta-analysis[J]. J Am Dent Assoc, 2017,148(10):750-759. doi: 10.1016/j.adaj.2017.05.011.
doi: 10.1016/j.adaj.2017.05.011
[11] Bozbay E, Dominici F, Gokbuget AY, et al. Preservation of root cementum: a comparative evaluation of power-driven versus hand instruments[J]. Int J Dent Hyg, 2018,16(2):202-209. doi: 10.1111/idh.12249.
doi: 10.1111/idh.12249 pmid: 27860247
[12] Foster BL. On the discovery of cementum[J]. J Periodontal Res, 2017,52(4):666-685. doi: 10.1111/jre.12444.
doi: 10.1111/jre.12444
[13] 徐岩, 蔡军. 保留根面牙骨质对人牙周韧带细胞分化的影响[J]. 山东医药, 2017,57(26):41-43. doi: 10.3969/j.issn.1002-266X.2017.26.012.
doi: 10.3969/j.issn.1002-266X.2017.26.012
Xu Y, Cai J. Effect of root cementum preservation on differentiation of human periodontal ligament cells[J]. Shandong Medical Journal, 2017,57(26):41-43. doi: 10.3969/j.issn.1002-266X.2017. 26.012.
doi: 10.3969/j.issn.1002-266X.2017.26.012
[14] 夏娇娇, 李厚轩. 内窥镜辅助下微创牙周基础治疗的临床疗效评价[J]. 口腔疾病防治, 2021,29(3):171-177. doi: 10.12016/j.issn.2096-1456.2021.03.005.
doi: 10.12016/j.issn.2096-1456.2021.03.005
Xia JJ, Li HX. Clinical efficacy evaluation of minimally invasive periodontal therapy assisted by endoscopy[J]. J Prev Treat Stomatol Dis, 2021,29(3):171-177. doi: 10.12016/j.issn.2096-1456.2021. 03.005.
doi: 10.12016/j.issn.2096-1456.2021.03.005
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