Effectiveness of ultrasonic instruments in the therapy of severe periodontitis: a comparative clinical-microbiological assessment with curettes

Patients with deep periodontal pockets were treated with either Vector (R) System (TG) or manual instruments (CG). Clinical assessments by supragingival plaque (PL+), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL) and subgingival plaque collection for microbiological analysis were made prior to and after treatment. Multiplex Polymerase Chain Reaction was used to determine the presence of Actinobacillus actinomycetemcomitans, Campylobacter rectus, Eikenella corrodens, Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythensis and Treponema denticola. GI, PD, CAL and the number of BOP+ sites underwent a significant reduction over time in both groups. When compared to baseline, the pair-wise analyses showed significantly lower PD and CAL at 6 months in the CG and significant reductions in the GI, PD, CAL and a number of BOP+ sites at 3 and 6 months in the TG. For microbiological results, significant reductions were seen for C. rectus and P. gingivalis in the CG and for T forsythensis, E. corrodens and T denticola in the TG. The total bacterial count underwent a reduction in both groups. Both ultrasonic and manual debridement are equally effective in non-surgical periodontal therapy of severe periodontitis in terms of clinical and microbiological effects.