An exploratory study of the clinical efficiency of combined, machine-driven periodontal curettage and comparison with the conventional manual method

Abstract

Mild to moderate cases of periodontitis are usually efficiently treated in a nonsurgical way (i.e. subgingival curettage).
The conventional approach uses hand instruments, which, however, is time-consuming and some patients may find it
extremely uncomfortable, even in spite of anesthesia. Machine-driven curettage (especially sand-blasting) is not yet part
of the everyday routine. Our aim was to share our initial experience with a new, combined, machine-driven approach to
subgingival curettage that we have lately introduced in our practice, in comparison with the conventional method. The
new approach combines ultrasonic debridement and sand-blasting. We retrospectively analyzed the patients’ files who
had undergone curettage with either method in the period June, 2019 to February, 2020. Only non-smoking patients with
mild to moderate periodontitis treated by the same periodontist and free of any systemic disease were eligible. Clinical
attachment level, mean pocket depth, plaque index, gingival bleeding index, treatment duration and patient satisfaction
were analyzed. Regarding their efficiency in reducing the indicators of inflammation, the two methods proved to be comparable:
both caused significant reduction in almost all indicators. However, treatment duration was significantly shorter
with the machine-driven approach, and patients reported markedly less discomfort in connection with this approach.
Within the limitations of our study, we conclude that machine-driven subgingival curettage (combined or not) may be
a good alternative to the conventional manual approach in mild to moderate periodontitis, especially because it is more
time-efficient, less invasive and more comfortable to the patients.