Clinical evaluation of a novel protocol for supportive periodontal care: A randomized controlled clinical trial

Abstract

Background: The aim of this study was to compare the clinical efficacy and the patient perception of subgingival debridement with either guided biofilm management (GBM) or conventional scaling and root planing (SRP) during supportive periodontal care (SPC).

Methods: Forty-one patients in SPC were randomly assigned to either treatment with GBM or SRP every 6 months. The primary outcome was the percentage of bleeding on probing (BoP) at 1 year. Moreover, pocket probing depths (PPD), recession, and furcation involvements were also measured. Full-mouth and specific site analyzes were performed at baseline, 6 and 12 months of SPC. Patient comfort was evaluated using a visual analogue scale (VAS) at 12 months.

Results: At 1 year, mean BoP percentage decreased from 12.2% to 9.0% (p = 0.191) and from 14.7% to 7.9% (p = 0.004) for the GBM and SRP groups, respectively. Furcation involved multirooted teeth but no through-and-through lesions were significantly fewer in the GBM than in the SRP group after 12 months (p = 0.015). The remaining parameters showed slight improvement in both groups without any statistically significant differences between the two groups after 1 year. Pain evaluation as patient reported outcome measures (pain evaluation) was in favor (p = 0.347) of the SRP group, while overall satisfaction was similar for both groups. Treatment time was not statistically significantly different between the two groups (p = 0.188).

Conclusion: In well-maintained SPC patients, SRP protocols resulted in significant clinical improvements in terms of BoP; however, for the other clinical improvements, similar efficacy for both GBM and SRP was observed.

Keywords: dental hygiene; periodontal disease; prevention; scaling, subgingival; scaling, supragingival.

FIGURE 1

Consort flow chart.

FIGURE 2

(A) Median BoP percentage for GBM and SRP at baseline and after 1 year. (B) Median PPD in mm for GBM and SRP at baseline and after 1 year. BoP, bleeding on probing; GBM, guided biofilm management; PPD, pocket probing depth; SRP, scaling and root planing

FIGURE 3

Median number of sites with PPD 4 and 5 mm and concomitant BoP positivity for GBM and SRP at baseline and after 1 year. BoP, bleeding on probing; GBM, guided biofilm management; PPD, pocket probing depth; SRP, scaling and root planing

FIGURE 4

(A) Median number of recession for GBM and SRP at baseline and after 1 year. (B) Median recession depths in mm. (C) Median number of furcation involvements (Class I) for GBM and SRP at baseline and after 1 year. GBM, guided biofilm management; SRP, scaling and root planing

FIGURE 5

Mean and SD of pain and overall satisfaction VAS for GBM and SRP after the SPC procedures. GBM, guided biofilm management; SD, standard deviation; SPC, supportive periodontal care; SRP, scaling and root planing; VAS, visual analogue scale