Short ultrasonic debridement with adjunctive low-concentrated hypochlorite/amino acid gel during periodontal maintenance: randomized clinical trial of 12 months

• Published in: Clinical oral investigations Vol. 24; no. 1; pp. 201 - 209
• Main Authors: Megally, Andrew, Zekeridou, Alkisti, Cancela, José, Giannopoulou, Catherine, Mombelli, Andrea
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2020; Springer Nature B.V
• Subjects: Adult; Amino Acids; Clinical trials; Debridement; Dental plaque; Dental Plaque Index; Dental Scaling; Dentistry; Female; Follow-Up Studies; Humans; Hypochlorous Acid; Medicine; Original Article; Patients; Periodontal Debridement; Periodontics; Recessions; Teeth; Treatment Outcome; Ultrasonics; Clinical trial; Subgingival plaque removal; Hypochlorite/amino acid gel; Maintenance
• ISSN: 1432-6981; 1436-3771; 1436-3771
• DOI: 10.1007/s00784-019-02949-2

Objectives The objective of this study was to evaluate the benefit of repeated subgingival cleaning with a low-concentrated hypochlorite/amino acid gel in subjects in maintenance care with residual pockets ≥ 5 mm. Material and methods Examiner masked, randomized two-arm parallel design. Thirty-two adult periodontal patients in maintenance phase, > 3 months after periodontal therapy, with at least one residual periodontal pocket ≥ 5 mm, were randomly assigned to treatment by subgingival ultrasonic debridement with the gel or ultrasonic debridement only. At months 0, 4, and 8, all sites presenting with a probing depth (PD) ≥ 5 mm were treated. Six sites were monitored on each tooth. The primary end point was the presence or absence of PD ≥ 5 mm after 12 months. Secondary clinical outcomes were oral tissue safety; patient acceptance; changes in PD; bleeding on probing; recession after 4, 8, and 12 months; and the presence or absence of six target microorganisms in treated pockets at baseline, after 7 days and 4 months. Results A total of 365 sites in 32 patients with PD ≥ 5 mm were treated at baseline. At the final evaluation at month 12, 47% of these sites in the test and 49% in the control group were still in this PD category. The difference between baseline and month 12 was significant in both groups ( p  < 0.01), whereas the difference between groups was not. Repeated short ultrasonic instrumentation with adjunctive administration of the test product resulted in a clinical attachment level (CAL) gain of 1.02 mm ( p  < 0.01) and led to − 0.97 mm of pocket reduction ( p  < 0.01) without inducing further recession. However, repeated short ultrasonic debridement without the gel led to a similar clinical outcome ( p  < 0.01). No adverse events were recorded. Conclusions Short ultrasonic instrumentation of residual pockets with PD ≥ 5 mm during maintenance visits resulted in a clinically relevant CAL gain and PD reduction in the order of 1 mm in 1 year, without inducing further recession. Clinical relevance This study corroborates the benefit of regular maintenance care after periodontal therapy, including short debridement of the residual pockets.