Subgingival polishing compared to scaling with steel curettes: a clinical pilot study

Background: Recently, we have developed teflon-coated sonic scaler inserts which remove plaque without removing tooth substance; they polish subgingiv ally. In a preclinical test, we showed that these modified inserts remove p laque nearly as effectively as do conventional sonic scaler inserts. The pr esent investigation was intended as a proof-of-principle of subgingival pol ishing. The aim was to study the effect of subgingival polishing on the res olution of gingival inflammation in comparison to conventional scaling. Material and methods: In 10 patients with moderate to advanced periodontal disease, who had at least 2 single-rooted teeth with a probing depth of >6 mm in each quadrant, all single-rooted teeth were subjected to one treatmen t regimen consisting of 2 instrumentation episodes (1st/2nd treatment): cur ette/curette, curette/teflon-coated sonic scaler, teflon-coated sonic scale r/teflon-coated sonic scaler, and an untreated control. The second treatmen t session was performed 3 months after the first instrumentation, and the f inal registration 3 months after the second instrumentation. Clinical measu rements included probing depth, change of clinical attachment level, bleedi ng upon probing, and plaque scores. Results: Probing depth, attachment level, and bleeding scores were reduced in the 3 instrumentation groups versus the control group in the Ist period; in the 2nd period, no further change occurred. Subgingival polishing with teflon-coated sonic scaler inserts was slightly less effective than convent ional scaling. Conclusion: Subgingival polishing with teflon-coated sonic scaler inserts s eems to be nearly as effective as conventional scaling. Thus, it may be the instrumentation of choice for maintenance treatment of residual pockets.