Clinical comparison of instrumentation systems for periodontal debridement: A randomized clinical trial

Objective: To compare clinical efficacy, chairside time and post-treatment hypersensitivity of four instruments used for subgingival periodontal debridement. Materials & Methods: Seventeen patients with stage II and III periodontitis were enrolled in this randomized clinical trial using a split-mouth design. Quadrants were randomly divided into four treatment groups: Group A: Gracey curettes-Hu-Friedy®; Group B: piezoelectric ultrasonic (Satelec®) with No.1S insert; Group C: diamond burs 40 µm (Intensiv Perioset®); and Group D: piezosurgery ultrasonic (Mectron®) with PP1 insert. Clinical outcomes, chairside time and hypersensitivity were assessed at 1, 2, 4 and 8 weeks after treatment. The primary outcome variable was improvement in clinical attachment level. Results: At 8 weeks post-treatment, Gracey curettes, piezoelectric ultrasonic (Satelec®) and piezosurgery ultrasonic (Mectron®) were statistically more effective than diamond burs in increasing attachment level and reducing probing pocket depth. Comparison of piezoelectric ultrasonic (Satelec®) and piezosurgery ultrasonic (Mectron®) with the other instruments showed a statistical difference (p < 0.001) in chairside time. Regarding post-treatment hypersensitivity, no statistical differences were observed in any of the groups. Conclusions: Gracey curettes, piezoelectric ultrasonic (Satelec®) and piezosurgery ultrasonic (Mectron®) were clinically more effective than diamond burs 40 µm. The ultrasonic instruments showed a significant reduction in chairside time.