Periodontitis is a chronic condition associated with the inflammatory destruction of the periodontal tissues ultimately leading to tooth loss. Clinically, it is identified by key features such as clinical attachment loss (CAL), bleeding upon probing (BOP), and an increase in probing pocket depth (PPD), and/or gingival recession. Periodontitis is mediated by polymicrobial dysbiosis with keystone pathogens affecting the virulence of the entire biofilm community. The removal of this biofilm and its retention factors is the ultimate goal of clinical treatment and oral measures applied. The elimination of the biofilm has traditionally been achieved with the use of either hand instruments or power driven devices. Promoting periodontal health or diminishing bacterial presence and calculus buildup on teeth can be accomplished with the same efficacy whether using manual scalers and curettes or ultrasonic scaling instruments. Both hand and ultrasonic instruments are characterized by being time- consuming and requiring technical skill, often causing patient discomfort and post-treatment pain, including hypersensitivity resulting from the loss of hard tissue when scaling the tooth surface. Ultrasonic instruments tend to leave a rougher surface behind compared to hand instruments. While effective the current techniques all have their disadvantages. The aim of this study is to evaluate changes in probing depth clinically, Bleeding on probing, Clinical attachment level, Plaque index, Calculus index, Patient pain/discomfort, Patient satisfaction, Cost effectiveness, Treatment time and Number of pockets closed after using AIRFLOW® Prophylaxis Master device with erythritol powder.
Systemically healthy patients.
Patients with an age range between 16 to 80 years.
Patients have a minimum of 20 teeth.
Periodontitis patients with at least one residual pocket with a probing depth ranging from 7 to 10 mm.
Pregnant and lactation females.
Patients reporting systemic conditions (eg: diabetes).
Patients with severe or unstable upper respiratory tract infections, chronic bronchitis/asthma.
Patients with severe inflammation and/or osteonecrosis.
Parallel
Hand and ultrasonic scalers and curettes
Procedure/SurgeryCombination of ultrasonic and hand instrumentation only. Pockets ≥7 mm will be subgingivally debrided using the piezo device according to manufacturer's instructions, and hand curettes will be used until the operator considers the surfaces to be sufficiently clean and free of deposits.
Electro Medical Systems AIRFLOW® Prophylaxis Master Device
Device(a) Disclosure of biofilm with erythrosine, (b) Removal of supragingival and subgingival (up to 10 mm) biofilm and stains with the use of AIRFLOW® Master Piezon® with AIRFLOW® PLUS powder (EMS-Dental, Nyon Switzerland). (c) Supra- and sub-gingival debridement by using the AIRFLOW® Master Piezon® device with Piezon NO PAIN® (EMS-Dental) technology.
Change in probing pocket depth
The PPD will be clinically measured by using UNC 15 periodontal probe from the gingival margin to the depth of the pocket.
Bleeding On Probing
The BoP will be clinically measured by using UNC 15 periodontal probe from the CEJ to the gingival margin.
Clinical Attachment Level
The CAL will be clinically measured using UNC 15 periodontal probe from the cemento-enamel junction (CEJ) to the depth of defect.
Plaque index
The PI will be evaluated by using modified O'Leary index teeth are stained with a disclosing solution, presence of plaque is scored on a dichotomous variable and the final score per individual is the sum of the plaque scores divided by the number of surfaces examined.
Calculus index
0 =absence of calculus 1. =supragingival calculus extending only slightly below the free gingival margin (not more than 1 mm.) 2. = moderate amount of supra and subgingival calculus or subgingival calculus alone 3. = an abundance of supra and subgingival calculus
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