Guided biofilm therapy versus conventional protocol—clinical outcomes in non-surgical periodontal therapy

Abstract

Abstract Background The aim of the randomized controlled clinical trial study was to evaluate the effectiveness in reducing pathologically increased pocket probing depths (PPD > 3 mm) using the Guided Biofilm Therapy (GBT) protocol (adapted to the clinical conditions in non-surgical periodontal therapy (NSPT): staining, air-polishing, ultrasonic scaler, air-polishing) compared to conventional instrumentation (staining, hand curettes/sonic scaler, polishing with rotary instruments) both by less experienced practitioners (dental students). Methods All patients were treated according to a split-mouth design under supervision as diseased teeth of quadrants I/III and II/IV randomly assigned to GBT or conventional treatment. In addition to the treatment time, periodontal parameters such as PPD and bleeding on probing (BOP) before NSPT (T0) and after NSPT (T1: 5 ± 2 months after T0) were documented by two calibrated and blinded examiners (Ethics vote/ Trial-register: Kiel-D509-18/ DRKS00026041). Results Data of 60 patients were analyzed (stage III/IV: n = 36/ n = 24; grade A/ B/ C: n = 1/ n = 31/ n = 28). At T1, a PPD reduction of all diseased tooth surfaces was observed in 57.0% of the GBT group and 58.7% of the control group (p = 0.067). The target endpoint (PPD ≤ 4 mm without BOP) was achieved in 11.5% for GBT (conventional treatment: 11.2%; p = 0.714). With the exception for number of sites with BOP, which was at T1 15.9% in the GBT group and 14.3% in the control group (p < 0.05) no significant differences between the outcomes of the study were found. At 30.3(28.3) min, the treatment time was significantly shorter in GBT than in the control group at 34.6(24.5) min (p < 0.001). Conclusions With both protocols (GBT/ conventional instrumentation) comparably good clinical treatment results can be achieve in NSPT in stage III-IV periodontitis patients. Trial registration The study was registered before the start of the study and can be found under the number DRKS00026041 in the German Clinical Trials Register. The registration date was 19/08/2021.

Keywords

• Biofilm
• Dental polishing
• Erythritol
• Non-surgical therapy
• Periodontitis
• Scaling and root planing