Comparative clinical responses related to the use of various periodontal instrumentation.

AIM: The aim of this study was to evaluate in vivo the effectiveness of scaling and root planing of a power-driven mechanism compared with hand instruments and ultrasonic insert alone with a split-mouth design after 3 and 6 months. METHODS: Healing events after initial periodontal therapy were investigated in 20 patients with moderate-to-severe adult periodontitis. Plaque index (PlI), bleeding on probing (PBI), probing pocket depth (PPD), probing attachment level (PAL) and number of moderate and deep pockets (NMP, NDP) were recorded at baseline and 3 and 6 months after treatment. Oral hygiene instruction was provided for each patient. Randomly assigned quadrants per patient were scaled and root planed with hand instrumentation (curettes, hoes and files), with reciprocating power-driven instruments, with ultrasonic scaler alone and with the combined use of ultrasonic scaler and power-driven inserts. The Friedman test was applied to test the significance of difference between the various methods of root instrumentation. Repeated measures of analysis of variance (manova) were used to analyse the time effect on the different treatments. RESULTS: At the 6-month evaluation, all groups in the scaling and root planing treatment presented with an improvement in the measured clinical parameters, as compared with baseline. No statistical differences (p>0.05) were observed in the assessed periodontal indices among the study sites between the four groups for either treatment. CONCLUSIONS: Under our experimental conditions, this clinical study demonstrates that mechanized root planing with power-driven instruments, as effective as the usual procedures (hand and sonic instruments), represents a satisfactory and alternative means of nonsurgical root therapy