Clinical comparison of instrumentation systems for periodontal debridement: A randomized clinical trial

Objective To compare clinical efficacy, chairside time and post-treatment hypersensitivity of four instruments used for subgingival periodontal debridement. Materials & Methods Seventeen patients with stage II and III periodontitis were enrolled in this randomized clinical trial using a split-mouth design. Quadrants were randomly divided into four treatment groups: Group A: Gracey curettes-Hu-Friedy(R); Group B: piezoelectric ultrasonic (Satelec(R)) with No.1S insert; Group C: diamond burs 40 mu m (Intensiv Perioset(R)); and Group D: piezosurgery ultrasonic (Mectron(R)) with PP1 insert. Clinical outcomes, chairside time and hypersensitivity were assessed at 1, 2, 4 and 8 weeks after treatment. The primary outcome variable was improvement in clinical attachment level. Results At 8 weeks post-treatment, Gracey curettes, piezoelectric ultrasonic (Satelec(R)) and piezosurgery ultrasonic (Mectron(R)) were statistically more effective than diamond burs in increasing attachment level and reducing probing pocket depth. Comparison of piezoelectric ultrasonic (Satelec(R)) and piezosurgery ultrasonic (Mectron(R)) with the other instruments showed a statistical difference (p < 0.001) in chairside time. Regarding post-treatment hypersensitivity, no statistical differences were observed in any of the groups. Conclusions Gracey curettes, piezoelectric ultrasonic (Satelec(R)) and piezosurgery ultrasonic (Mectron(R)) were clinically more effective than diamond burs 40 mu m. The ultrasonic instruments showed a significant reduction in chairside time.