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Article: A systematic review of efficacy of machine-driven and manual subgingival debridement in the treatment of chronic periodontitis

TitleA systematic review of efficacy of machine-driven and manual subgingival debridement in the treatment of chronic periodontitis
Authors
KeywordsPeriodontitis-therapy
Sonication
Subgingival curettage
Systematic review
Ultrasonics
Dental-scaling
Meta-analysis
Issue Date2002
Citation
Journal of Clinical Periodontology, 2002, v. 29, n. SUPPL. 3, p. 72-81 How to Cite?
AbstractObjectives: The purpose of this systematic review was to determine the efficacy of machine-driven compared with manual subgingival debridement in the treatment of periodontitis. Background: Mechanical debridement of the periodontal pocket plays a pivotal role in the treatment of periodontitis. Methods: A literature search for controlled clinical trials with at least 6 months' follow-up comparing machine-driven instruments with hand instruments for the treatment of chronic periodontitis was performed up to April 2001. Screening of titles and abstracts as well as data extraction was conducted independently by two reviewers (J.T. & T.F.F.). As primary outcome variable, the prevention of tooth loss was used; secondary outcome variables were the prevention of disease progression, the resolution of anatomical defects and the resolution of gingival inflammation. Efficiency was assessed by mean time needed to treat one tooth. Results: From a total of 419 abstracts, 27 articles were included for the review. The weighted kappa score for agreement between the two reviewers was 0.77, 95% CI: 0.65-0.89, indicating substantial agreement. No study reported on the selected primary outcome variables. Using clinical attachment gain, probing pocket depth reduction or bleeding on probing reduction as outcome variables, there appeared to be no differences between ultrasonic/sonic and manual debridement. No major differences in the frequency or severity of adverse effects were found. However no meta-analysis could be performed on any of the previously mentioned parameters. Ultrasonic/sonic debridement was found to take significantly less time, i.e. 36.6%, than debridement using hand instruments (P = 0.0002, 95% CI of the standardized effect estimate: 0.39-1.37, heterogeneity P = 0.77). Conclusions: With respect to clinical outcome measures, the available data do not indicate a difference between ultrasonic/sonic and manual debridement in the treatment of chronic periodontitis for single-rooted teeth; however, the evidence for this is not very strong. In addition, ultrasonic/sonic subgingival debridement requires less time than hand instrumentation. Further research is needed to assess the efficacy of machine-driven debridement on multirooted teeth and clinical outcome variables having tangible benefit to the patients should be used. © Blackwell Munksgaard, 2002.
Persistent Identifierhttp://hdl.handle.net/10722/199896
ISSN
2015 Impact Factor: 3.915
2015 SCImago Journal Rankings: 1.848
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTunkel, Jochen-
dc.contributor.authorHeinecke, Achim-
dc.contributor.authorFlemmig, Thomas Frank-
dc.date.accessioned2014-07-26T23:10:53Z-
dc.date.available2014-07-26T23:10:53Z-
dc.date.issued2002-
dc.identifier.citationJournal of Clinical Periodontology, 2002, v. 29, n. SUPPL. 3, p. 72-81-
dc.identifier.issn0303-6979-
dc.identifier.urihttp://hdl.handle.net/10722/199896-
dc.description.abstractObjectives: The purpose of this systematic review was to determine the efficacy of machine-driven compared with manual subgingival debridement in the treatment of periodontitis. Background: Mechanical debridement of the periodontal pocket plays a pivotal role in the treatment of periodontitis. Methods: A literature search for controlled clinical trials with at least 6 months' follow-up comparing machine-driven instruments with hand instruments for the treatment of chronic periodontitis was performed up to April 2001. Screening of titles and abstracts as well as data extraction was conducted independently by two reviewers (J.T. & T.F.F.). As primary outcome variable, the prevention of tooth loss was used; secondary outcome variables were the prevention of disease progression, the resolution of anatomical defects and the resolution of gingival inflammation. Efficiency was assessed by mean time needed to treat one tooth. Results: From a total of 419 abstracts, 27 articles were included for the review. The weighted kappa score for agreement between the two reviewers was 0.77, 95% CI: 0.65-0.89, indicating substantial agreement. No study reported on the selected primary outcome variables. Using clinical attachment gain, probing pocket depth reduction or bleeding on probing reduction as outcome variables, there appeared to be no differences between ultrasonic/sonic and manual debridement. No major differences in the frequency or severity of adverse effects were found. However no meta-analysis could be performed on any of the previously mentioned parameters. Ultrasonic/sonic debridement was found to take significantly less time, i.e. 36.6%, than debridement using hand instruments (P = 0.0002, 95% CI of the standardized effect estimate: 0.39-1.37, heterogeneity P = 0.77). Conclusions: With respect to clinical outcome measures, the available data do not indicate a difference between ultrasonic/sonic and manual debridement in the treatment of chronic periodontitis for single-rooted teeth; however, the evidence for this is not very strong. In addition, ultrasonic/sonic subgingival debridement requires less time than hand instrumentation. Further research is needed to assess the efficacy of machine-driven debridement on multirooted teeth and clinical outcome variables having tangible benefit to the patients should be used. © Blackwell Munksgaard, 2002.-
dc.languageeng-
dc.relation.ispartofJournal of Clinical Periodontology-
dc.subjectPeriodontitis-therapy-
dc.subjectSonication-
dc.subjectSubgingival curettage-
dc.subjectSystematic review-
dc.subjectUltrasonics-
dc.subjectDental-scaling-
dc.subjectMeta-analysis-
dc.titleA systematic review of efficacy of machine-driven and manual subgingival debridement in the treatment of chronic periodontitis-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1034/j.1600-051X.29.s3.4.x-
dc.identifier.pmid12787208-
dc.identifier.scopuseid_2-s2.0-0038266224-
dc.identifier.volume29-
dc.identifier.issueSUPPL. 3-
dc.identifier.spage72-
dc.identifier.epage81-
dc.identifier.isiWOS:000181967900008-

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