J Periodontal Implant Sci.  2021 Aug;51(4):276-284. 10.5051/jpis.2007080354.

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

Affiliations
  • 1Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy
  • 2Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
  • 3Department of Periodontology, Institute of Oral Bioscience, Jeonbuk National University School of Dentistry, Jeonju, Korea
  • 4Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea

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.

Keyword

DecontaminationDecontamination; Dental calculus; Periodontitis; Root planing; Sulfates
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