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[Comparison of treatment effect between periodontal subgingival scaling with the special series of ultrasonic inserts and Gracey curette].

OBJECTIVE
To compare the special series of ultrasonic inserts with Gracey curettes in the effectiveness and efficiency for non-surgical periodontal treatment.


METHODS
A total of 30 patients with moderate to advanced chronic periodontal disease were treated with both ultrasonic inserts (ultrasonic group) and Gracey curettes (Gracey group) according to a prospective, randomized, controlled, one-blind, "split-mouth" design. Twenty-six cases were available for the whole follow-up period. Plaque index (PLI), bleeding index(BI), probing depth (PD), attachment loss (AL) were evaluated before and 6 weeks after treatment. Treatment time was recorded. The severity of pain during treatment and teeth sensitivity after treatment were evaluated by the visual analogue scale (VAS). Differences in clinical parameters were analyzed with the Wilcoxon signed ranks test and Mann and Whitney U-test.


RESULTS
No significant differences in any of the clinical parameters were observed at baseline between the two groups. The mean value of PD, BI, PLI, AL decreased in both ultrasonic group and Gracey group. At moderately deep site (initial PD between 4 mm and 5 mm), PD [M(Q(25), Q(75))] changed in the ultrasonic group from 4.0 (4.0, 4.5) mm to 3.0 (3.0, 3.0) mm (P < 0.001) and in the Gracey group from 4.0 (4.0, 5.0) mm to 3.0(3.0, 3.0) mm (P < 0.001). At deep sites (initial PD ≥ 6 mm) PD [M(Q(25), Q(75))] changed in the ultrasonic group from 7.0(6.0, 7.0) mm to 5.0(4.0, 7.0) mm (P < 0.001) and in the Gracey group from 7.0 (6.0, 7.0) mm to 5.0(4.0, 6.0) mm(P < 0.001). In the furcation area, PD [M(Q(25), Q(75))] changed from 5.0(4.0, 7.0) mm to 3.0(3.0, 5.0) mm (P < 0.001) in both Gracey group and ultrasonic group. However, the average time of active instrumentation was (2.41 ± 0.61) min/tooth in the ultrasonic scaling and (2.71 ± 0.61) min/tooth in the Gracey curette (P < 0.001). VAS scores [M(Q(25), Q(75))] of pain during treatment was 5.0(3.0, 6.7) in the ultrasonic group and 5.9 (4.9, 8.0) in the Gracey group (P = 0.001). VAS scores [M(Q(25), Q(75))] of sensitivity after treatment was 4.0 (1.8, 6.0) in the ultrasonic group and 4.9 (2.0, 8.0) in the Gracey group (P = 0.043).


CONCLUSIONS
Treatment with the special series of ultrasonic inserts was as effective as the Gracey curette during initial therapy period in all clinical parameters measured and has the advantage of being quicker.