The evaluation of root surface modifications after different subgingival mechanical instrumentation techniques – an in vitro study

Objectives. The aim of this in vitro study was to observe through scanning electron microscopy (SEM) the surface morphology of root samples treated with different mechanical instrumentation methods and the additional application of a nanocolloidal silver-based antiseptic solution. Material and methods. Root samples were prepared from extracted molars and divided in four groups: group 1 of samples was instrumented with Gracey curette (7/8), group 2 of samples was instrumented with ultrasonic tip 1S, group 3 of samples was instrumented with ultrasonic tips 1S plus H4R/L, group 4 of samples was treated with ultrasonic tips 1S plus H4R/L and application of the silver-based antiseptic solution. All samples were then subjected to SEM examination. Outcomes. Group 1 of samples presented a smoother surface compared to the samples in the other groups. Group 2, 3 and 4 displayed superficial grooves parallel to the direction of action of the ultrasonic tip. In group 3 and 4, root planning with tip H4R/L did not ameliorate the smoothness of the surface. The smear layer was present, regardless the instrumentation method. In group 4, the additional application of the antiseptic solution did not influence the surface morphology or the amount of smear layer. Conclusions. Gracey curettes created a smoother radicular surface compared to ultrasonic tips. Smear layer was obvious on the radicular surfaces, no matter the instrumentation method. The application of the silver-based antiseptic solution had no additional impact on surface morphology

Adjunctive use of a nanocolloidal silver-based local antiseptic solution in the nonsurgical treatment of periodontitis: A split-mouth clinical study

Objectives. The aim of the present study was to evaluate the potential additional clinical benefit of a commercial nanocolloidal silver-based local antiseptic used as irrigation solution after subgingival mechanical instrumentation. Material and methods. Periodontitis patients were treated following the current guidelines. Two randomly assigned hemiarches of each patient received subgingival mechanical instrumentation plus irrigations with the commercial product (experimental group); the other two hemiarches received mechanical instrumentation plus saline irrigations (control group). A clinical periodontal examination at baseline moment and after 3 months was performed. The parameters considered for analysis were oral hygiene index (IHI), bleeding on probing score (BoP), periodontal pocket probing depth (PD), gingival recession (GR) and clinical attachment level (CAL). 72 sites were included in the analysis, the site with the highest PD/quadrant for each patient. Data were analyzed using GraphPad Prism version 8.0.1 (GraphPad Software Inc., La Jolla, CA, USA). p<0.05 was set as statistical significance level. Outcomes. Eighteen periodontitis patients were treated. All clinical parameters improved at re-evaluation, compared to baseline, both in experimental and control group. The differences were statistically significant in terms of IHI, BoP and PD reduction. At re-evaluation, there were no statistically significant differences between periodontal parameters registered in the experimental and control sites. Conclusions. The present study failed to prove an adjunctive clinical benefit of the antiseptic product in the nonsurgical treatment of periodontitis. These results support the gold standard role of subgingival mechanical instrumentation in the periodontitis’ therapeutic protocol