Impact of Debridement Invasiveness on Attachment Gain After Antiinfective Periodontal Therapy

Study Overview
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Brief Summary
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This study compared the gain of periodontal attachment after concomitant one-stage removal of bacterial biofilms and subgingival calculus with a two-stage procedure removing subgingival calculus 6 weeks after the initial removal of soft subgingival bacterial biofilms.

Detailed Description
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The concomitant removal of subgingival calculus and soft bacterial biofilms in a one-stage procedure might impair periodontal healing in deep infrabony pockets due to the mechanical disruption of demineralized bone sections at the bottom of periodontal lesions. This randomized controlled clinical trial therefore aims at comparing the resulting attachment gain 6 months after one-stage antiinfective periodontal therapy comprising the concomitant subgingival removal of soft bacterial biofilms and calculus with a two-stage approach removing subgingival calculus only 6 weeks after the initial removal of soft subgingival bacterial biofilms.

Official Title
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Impact of Debridement Invasiveness on Attachment Gain After Antiinfective Periodontal Therapy

Conditions
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Periodontitis, Periodontal Attachment Loss, Periodontal; Lesion

Intervention / Treatment
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* Procedure: Subgingival Debridement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: presence of periodontal disease minimum of 1 tooth with an infrabony periodontal lesion and pocket depth ≥ 6mm minimum of 15 natural teeth Exclusion Criteria: systemic disease interfering with periodontal healing (e.g. diabetes) antibiotic therapy ≤ 12 month prior to study participation necessity for preventive antibiotic therapy during dental interventions inability to comply with the study protocol

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: controlled prospective parallel group intervention trial
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Two-Stage Subgingival Debridement<br>Initially soft subgingival bacterial biofilms are removed from periodontal lesions by an airpolishing device and erythritol cleaning powder. 6 weeks later subgingival calculus is mechanically removed in a second step by mechanical scaling and root planing | Procedure: Subgingival Debridement<br>* Removal of subgingival bacterial biofilms and subgingival calculus from periodontal lesions<br>* Other names: Scaling and Root Planing;|
| Active Comparator: One-Stage Subgingival Debridement<br>Soft subgingival bacterial biofilms, as well as subgingival calculus are concomitantly removed from periodontal lesions by mechanical scaling and root planing | Procedure: Subgingival Debridement<br>* Removal of subgingival bacterial biofilms and subgingival calculus from periodontal lesions<br>* Other names: Scaling and Root Planing;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reduction of Clinical Attachment Loss | Measuring the distance between the cemento-enamel-junction and the probeable bottom of the periodontal pocket | 168 days (24 weeks) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Bleeding on Probing | Recording the possible appearance of a bleeding spot immediately after the probing of periodontal lesions for the measurement of clinical attachment loss | 168 days (24 weeks) | 
| Probing Pocket Depth | Measuring the distance between the gingival sulcus and the bottom of the periodontal lesion | 168 days (24 weeks) | 
| Gingival Index | Visual Assessment of the inflammatory status of the gingiva according to the criteria set by Lobene et al. | 168 days (24 weeks) | 
| Plaque Index | Measuring the extent of supragingival plaque coverage according to the criteria set by Silness and Loe | 168 days (24 weeks) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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periodontitis, scaling, attachment gain, air polishing, periodontal lesion