Subgingival scaling and root planing during minimally invasive periodontal surgery: A randomized controlled split‐mouth trial

• Published in: Journal of periodontology (1970) 2024-01, Vol.95 (1), p.9-16
• Main Authors: Dunegan, Kara A., Deas, David E., Powell, Charles A., Ruparel, Nikita B., Kotsakis, Georgios A., Mealey, Brian L.
• Format: Article
• Language: English
• Subjects: calculus; dental scaling; endoscopy; periodontal diseases; root planing
• ISSN: 0022-3492; 1943-3670
• DOI: 10.1002/JPER.23-0198

Background The purpose of this randomized, controlled split‐mouth study was to evaluate a videoscope as a visual adjunct to scaling and root planing when utilized in combination with minimally invasive surgery. Methods Twenty‐five pairs (89 interproximal surfaces) of periodontally hopeless teeth planned for extraction were scaled and root planed with minimal surgical access using surgical loupes (control) or adjunctive use of a videoscope (test). Teeth were extracted with minimal trauma, stained with methylene blue, and photographed with a digital microscope for analysis. The primary outcome of residual calculus was calculated as a percentage of the total interproximal area of interest. Secondary outcomes included treatment time, as well as residual calculus according to probing depth, tooth location, and treatment date. Data were analyzed using Student's paired t‐tests, two‐way analyses of variance, and Spearman's correlation tests. Results Residual calculus area was 2.61% on control and 2.71% on test surfaces with no significant difference between groups. Subgroup analysis showed no difference in residual calculus between groups at moderate or deep sites. Treatment time per surface was significantly longer in the test group compared to the control group. Treatment order, tooth location, and operator experience did not significantly affect the primary outcome. Conclusions Though the videoscope provided excellent visual access, it did not improve the efficacy of root planing for flat interproximal surfaces during minimally invasive periodontal surgery. Small amounts of calculus remain after instrumentation even with minimal surgical access and when root surfaces appear visually clean and tactilely smooth.