Background
Methods
Research question
Selection criteria
Study type
Participants
Intervention
Outcomes
Study | First Author, Year Outcomes Mean age (±SEM) Female/Male Country | PPD | Interventions | Follow Up | Inclusion criteria | Exclusion criteria | Smoker/Non-smokers ratio |
---|---|---|---|---|---|---|---|
Pilot study on the clinical and microbiological effect of subgingival glycine powder air polishing using a cannula-like jet [15] | - Kargas, K.2015 | moderate pockets | ultrasonic instrumentation (Piezonâ, Instrument A, EMS, Nyon, Switzerland), hand instruments (Gracey curettes 3/4, 11/12, 13/14, Hu-Friedy, Chicago, IL, USA) | 6 Months | (a) Must have been previously diagnosed with generalized chronic periodontitis (according to American Academy of Periodontology) and successfully treated; (b) Subsequently, entered the supportive treatment phase (SPT), with at least two non-bleeding residual pockets > 4 mm in each quadrant; (c) Have at least 20 natural teeth; (d) Non-smoker; (e) Could not taken an antibiotic, anti-inflammatory medication, corticosteroids or other immunosuppressive drugs during the previous 6 months; (f) Pregnant or lactating women were also excluded from this study. | None | No smoker |
- PPD, CAL | |||||||
- 52.50 ± 9.54 | |||||||
- 12/15 | |||||||
- Greece | |||||||
Er:YAG lasers versus ultrasonic and hand instruments in periodontal therapy: clinical parameters, intracrevicular micro-organism and leukocyte counts [13] | - Malali, E.2012 | 4-6 mm, > 7 mm | a magnetostrictive ultrasonic scaler (Cavitron Bobcat Pro, Dentsply International Inc., USA), manual periodontal curettes (Gracey, SG # 5/6, 7/8, 11/12, 13/14, Mini Five Gracey SAS # 5/6, 11/12, Hu-Friedy Ins. Co., USA) | 3 Months | Patients with generalized periodontal breakdown and who had at least four single-rooted teeth, two moderately deep (probing depth [PD] of 4–6 mm) and two deep pockets (PD ≥ 7 mm) that had no endodontic lesion and no crown, with mobility 0–2, and with bleeding on probing (BOP) were selected. | (a) Periodontal treatment within the last 6 months; (b) Any systemic disease that would influence the periodontal tissues; (c) Antibiotic used within last 6 months; (d) Pregnancy and smoking. | No smoker |
- PPD、CAL | |||||||
- 48.83 ± 7.23 | |||||||
- 11/19 | |||||||
- Turkey | |||||||
Hand instrumentation versus ultrasonic debridement in the treatment of chronic periodontitis: a randomized clinical and microbiological trial [12] | - Ioannou, I.2009 | < 4 mm, 4-6 mm, > 6 mm | UD: (EMS Piezon®, EMS, Nyon, Switzerland) with A and P instruments (Swiss InstrumentsPM, EMS) under water irrigation, SRP:Hu-Friedy Gracey Standard Curettes SG 3/4, 11/12, 13/14, After Five® Curettes SAS 3/4, 11/12, 13/14, Hu-Friedy. | 3 Months, 6 Months | (a) Existence of a minimum of four sites with PPD 5 mm in at least two quadrants of each of the patients, demonstrating bleeding on probing; (b) No periodontal treatment during the previous 6 months. | (a) Compromised medical condition; (b) Systemic antibiotics during treatment or for the last 3 months; (c) Ongoing drug therapy that might affect periodontal therapy; (d) Requirement for prophylactic antibiotic cover of the patient; (e) Use of chlorhexidine mouthwash or any other antimicrobial agent; (f) Pregnancy for female patients. | SRP: 50% of patients is smoker; |
- PPD, CAL | |||||||
- SRP:49.62 ± 2.07, UD:50.47 ± 2.58 | UD: 52.9% of patients is smoker. | ||||||
- SRP:50/50 UD:70.6/29.4 | |||||||
- Greece | |||||||
Non-surgical periodontal treatment with a new ultrasonic device (Vector™-ultrasonic system) or hand instruments a prospective, controlled clinical study [18] | - Sculean, A. 2004 | 4-6 mm, > 6 mm | VUS: Vector probe, (Durr Dental, Bietigheim-Bissingen,Germany) using straight and curved metal curettes and a polishing fluid (HA particles < 10um) according to the instructions given by the manufacturer, SRP:Hand instruments (Gracey Curettes, Hu-Friedy Co., Chicago, IL, USA). | 6 Months | (a) No treatment of periodontitis for the last 2 years; (b) No use of antibiotics for the 12 months prior to treatment; (c) No systemic diseases, and (d) Good level of oral hygiene. As criterion for a good level of oral hygiene a mean plaque index (PI) score < 1 was chosen. | None | Unclear |
- PPD、CAL | |||||||
- 54 | |||||||
- 24/14(VUS:10/9; SRP:11/8) | |||||||
-Germany | |||||||
Periodontal healing after non-surgical therapy with a modified sonic scaler: A controlled clinical trial [17] | - Christgau, M. 2006 | < 4 mm, 4-6 mm, > 6 mm | UD:the modified sonic scaler system SonicFlex 2003 L (KaVo), SRP:Gracey-curettes #1/2, #7/8, #11/12, #13/14, HuFriedy, Chicago, IL, USA. | 6 Months, 1 Month (excluded) | All had generalized moderate to progressive chronic periodontitis, but were systemically healthy and had not received systemic antibiotics for at least 3 months before. Each patient had to show at least four teeth per quadrant with a PPD of at least 4 mm. | None | 14/6 |
- PPD, CAL | |||||||
- 45.6 ± 8.0 | |||||||
- 14/6 | |||||||
- Germany | |||||||
Full-mouth ultrasonic debridement versus quadrant scaling and root planing as an initial approach in the treatment of chronic periodontitis* [14] | - Wennström, J. L. 2005 | 5-6 mm, 7 mm | UD:EMS Piezon Master 400 with A + PerioSlim tips, water coolant and power setting to 75%; EMS, Nyon, Switzerland, SRP:LM-dental, Turku, Finland. | 3 Months, 6 Months | (a) A minimum of 18 teeth; (b) At least eight teeth must show probing pocket depths (PPD) of 5 mm and bleeding on probing (BOP). At least two of these teeth must have a PPD of 7 mm and at additional two teeth, the pockets must measure 6 mm; (c) Unremarkable general health according to medical history and clinical judgement; (d) Female patients must not be pregnant. | (a) Subgingival instrumentation within 12 months prior to the baseline examination; (b) The use of antibiotics within 3 months prior to the start of the study; (c) Compromised medical conditions requiring prophylactic antibiotic coverage; (d) Ongoing drug therapy that might affect the clinical signs and symptoms of periodontitis. | Italy: UD 4/11, SRP 4/10, Sweden: UD 7/10, SRP 6/11 |
- PPD、CAL | |||||||
- 25-75 years old, mean age 49.8 | |||||||
- 19/22(SRP11/10;UD8/12) | |||||||
- Italy, Sweden | |||||||
Effectiveness of ultrasonic instruments in the therapy of severe periodontitis: a comparative clinical-microbiological assessment with curettes [16] | - D’Ercole, S. 2006 | ≥6 mm | UD:a power-driven mechanism (Vector® System), SRP: the type of manual instuments is unclear | 3 Months, 6 Months, 1 Month (excluded) | (a) Positive for diagnosis of mild-to-severe chronic periodontitis; (b) Good general health according to their medical history; (c) Negative for the use of any antibiotic or antiinflammatory drugs within the 3 months preceding the beginning of the study; (d) Negative for periodontal therapy within 1 year preceding the beginning of the study; (e) Experimental sites (test and control) localized in the interproximal position of two different teeth in the same subject (split-mouth design); (f) Probing depth (PD) values equal to or more than 6 mm in the experimental sites; (g) Difference of PD in the experimental sites (test and control) not exceeding 2 mm; (h) Presence of at least ten teeth for each dental arch. Pregnant or nursing females were excluded from the study. | None | No-smoker |
- PPD、CAL | |||||||
- 40.8 ± 3.9 | |||||||
- 11/7 | |||||||
- Unclear |
Study | First Author, Year Outcomes Mean age (±SEM) Female/Male Country | PPD | Interventions | Follow Up | Inclusion criteria | Exclusion criteria | Smoker/Non-smokers ratio |
---|---|---|---|---|---|---|---|
Pilot study on the clinical and microbiological effect of subgingival glycine powder air polishing using a cannula-like jet [15] | - Kargas, K. 2015 | Moderate pockets | Ultrasonic instrumentation (Piezonâ, Instrument A, EMS, Nyon, Switzerland), Hand instruments (Gracey curettes 3/4, 11/12, 13/14, Hu-Friedy, Chicago, IL, USA) | 6 Months | (a) Must have been previously diagnosed with generalized chronic periodontitis (according to American Academy of Periodontology) and successfully treated; (b) Subsequently, entered the supportive treatment phase (SPT), with at least two non-bleeding residual pockets > 4 mm in each quadrant; (c) Have at least 20 natural teeth; (d) Non-smoker; (e) Could not taken an antibiotic, anti-inflammatory medication, corticosteroids or other immunosuppressive drugs during the previous 6 months; (f) Pregnant or lactating women were also excluded from this study. | None | No smoker |
- GR | |||||||
- 52.50 ± 9.54 | |||||||
- 12/15 | |||||||
- Greece | |||||||
Clinical evaluation of the speed and effectiveness of subgingival calculus removal on single-rooted teeth with diamond-coated ultrasonic tips [20] | - Yukna, R. A. 1997 | 5-6 mm, 7-8 mm | Hand curets, Plain ultrasonic | Extract the teeth after the treatment | Subjects had moderately deep probing depths (>5 mm in depth), had not received scaling and root planing for at least 6 months prior to the study, and exhibited clinically and/or radiographically evident subgingival calculus on the study teeth. | None | Unclear |
- The mean percent of calculus remaining | |||||||
- Unclear | |||||||
- Unclear | |||||||
- America | |||||||
The effectiveness of the Titan-S sonic scaler versus curettes in the removal of subgingival calculus. A human surgical evaluation [21] | - Gellin, R. G. 1986 | < 3 mm, 4-5 mm, 6-12 mm | Ultrasonic instrument (Titan-S), Hand instrument (Gracey curette and the McCall’s) | Extract the teeth after the treatment | Exhibit radiographie evidence of subgingival calculus or a clinically detectable ledge of subgingival calculus on at least one interproximal surface per quadrant, and have no systemic disease contraindicating periodontal therapy or the use of local anesthetics. | None | Unclear |
- The percentage of surfaces with residual calculus | |||||||
- Unclear | |||||||
- Unclear | |||||||
- America | |||||||
Non-surgical periodontal treatment with a new ultrasonic device (Vector™-ultrasonic system) or hand instruments a prospective, controlled clinical study [18] | - Sculean, A. 2004 | 4-6 mm, > 6 mm | UD: Vector probe, (Durr Dental, Bietigheim-Bissingen,Germany) using straight and curved metal curettes and a polishing fluid (HA particles < 10um) according to the instructions given by the manufacturer, SRP:Hand instruments (Gracey Curettes, Hu-Friedy Co., Chicago, IL, USA). | 6 Months | (a) No treatment of periodontitis for the last 2 years; (b) No use of antibiotics for the 12 months prior to treatment; (c) No systemic diseases; (d) Good level of oral hygiene. As criterion for a good level of oral hygiene a mean plaque index (PI) score < 1 was chosen. | None | Unclear |
- GR, BOP | |||||||
- 54 | |||||||
- 24/14(VUS:10/9; SRP:11/8) | |||||||
-Germany | |||||||
Periodontal healing after non-surgical therapy with a modified sonic scaler: A controlled clinical trial [17] | - Christgau, M. 2006 | < 4 mm, 4-6 mm, > 6 mm | UD:the modified sonic scaler system SonicFlex 2003 L (KaVo), SRP:Gracey-curettes #1/2, #7/8, #11/12, #13/14, HuFriedy, Chicago, IL, USA. | 6 Months, 1 Month (excluded) | All had generalized moderate to progressive chronic periodontitis, but were systemically healthy and had not received systemic antibiotics for at least 3 months before. Each patient had to show at least four teeth per quadrant with a PPD of at least 4 mm. | None | 14/6 |
- BOP, GR | |||||||
- 45.6 ± 8.0 | |||||||
- 14/6 | |||||||
- Germany | |||||||
Influence of fluorescence-controlled Er:YAG laser radiation, the Vector™ system and hand instruments on periodontally diseased root surfaces in vivo [19] | - Schwarz, F. 2006 | > 6 mm | UD:ultrasonic system (Vector™,Dürr,Bietigheim-Bissingen,Germany) and a polishing fluid (hydroxylapatite particles <10 μm) was used according to the instructions given by the manufacturer(70% power setting). SRP: Gracey curets (Hu-Friedy Co., Chicago,IL,USA) | Extract the teeth after the treatment | (a) Probing pocket depths (> 6 mm) on at least two aspects (mesio-buccal/mesio-lingual and disto-buccal/disto-lingual) as measured from the gingival margin to the bottom of the pocket; (b) No signs of carious or artificial damage on the root surface; (c) No periodontal root surface treatment within the last 12 months; (d) No root fractures or anatomical abnormalities. | Patients suffering from systemic diseases were excluded from the study. | Unclear |
- The roughness of cementum surface | |||||||
- 44.8 | |||||||
- 7/5 | |||||||
- Germany |
Search strategy
Data collection and analyses
Study selection and quality assessment
Statistical analyses
Sensitive analysis
Results
Study selection
Study characteristics
Study | Reasons |
---|---|
No UD-to-SRP comparisons. | |
Different PPD categories present in the same study or experimental group. | |
[56] | UD-SRP comparisons present and different PPD categories in the same study or experimental group. |
An in vitro study. | |
Uncertain sample size. | |
Study results were diagrams with unclear data. | |
[5] | There were treatments after the initial treatments during a follow-up period. |
[62] | Follow-up was 24 months which is a long enough period for tissue changes affected factors other than the interventions. The injured tissue may have completely recovered spontaneously. |
[63] | At each reassessment, study data was measured using different categories of PPD making it impossible to determine PPD change. |