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Objective@#To explore the clinical efficacy and imaging changes of minimally invasive nonsurgical periodontal therapy (MINST) assisted by endoscopy for deep intrabony defects and to compare its effectiveness with that of traditional scaling and root planning (SRP) to therefore provide a reference for clinical periodontal treatment.@*Methods@#Patients with deep intrabony defects ≥ 4 mm in size were selected and divided into two groups: the MINST (MINST, 20 cases, 81 sites) group and the classic scaling and root planing (SRP, 20 cases, 80 sites) group. Before treatment and 12 and 24 months after treatment, probing depth (PD) and clinical attachment loss (CAL) were examined. Moreover, changes in the depth and angle of the intrabony defects were analyzed. Follow-up examination and maintenance treatment should be conducted every 3 months for 12 months after the initial treatment and every 6 months thereafter until 24 months.@*Results@#The PD and CAL of patients in both groups continued to decrease (P<0.001), and imaging examinations revealed a decrease in defect depth and an increase in intrabony defect angle (P<0.001). The changes in the first 12 months were significantly greater than those in the last 12 months in both groups (P<0.001). The decreases in PD, CAL, and depth of intrabony defects and increase in angle in the MINST group were significantly greater than those in the SRP group (P<0.001). At 12 and 24 months after treatment, the PD and CAL in the MINST group were lower than those in the SRP group (P<0.001). The defect height of the MINST group decreased more than that of the SRP group (P<0.001), and the defect angle of the MINST group increased more than that of the SRP group (P<0.001).@*Conclusion@#Minimally invasive nonsurgical periodontal therapy can significantly promote the healing of deep intrabony defects and the regeneration of alveolar bone. Imaging reflects that alveolar bone healing is rapid at first and then slows. Compared with traditional SRP, endoscopically assisted MINST can yield better clinical indicators and imaging changes in intrabony defects.

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OBJECTIVES: To compare the treatment effects of periodontal endoscope-assisted and traditional subgingival scaling on residual pockets. METHODS: A total of 13 patients with periodontitis from Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University were recruited. After 4-6 weeks of initial treatment, the residual pockets with a probing depth (PD) of ≥4 mm and attachment loss (AL) of ≥4 mm and bleeding on probing were examined with traditional (control group) and periodontal endoscope-assisted subgingival scaling (endoscopy group) in a randomly controlled split-mouth design. At baseline and 6 weeks and 3 months after treatment, plaque index (PLI), PD, AL, and bleeding index (BI) were measured. Differences in these clinical parameters within and between groups and patient-reported outcomes were compared. RESULTS: A total of the 694 sites of 251 teeth were included in this trial. Both groups showed significant improvement in each periodontal parameters 6 weeks and 3 months after treatment (P<0.001). For sites in a single-rooted tooth, sites with PD≥5 mm, and sites without vertical alveolar bone resorption and furcation involvement, the PD in endoscopy group was significantly lower than that in the control group at 6 weeks and 3 months after treatment (P<0.05). CONCLUSIONS: Periodontal endoscope-assisted subgingival scaling resulted in better effects than traditional subgingival scaling when the residual pockets were in a single-rooted tooth, with a PD of ≥5 mm but without vertical alveolar bone resorption and furcation involvement.

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Objective @# To investigate the clinical effect of periodontal endoscope-assisted scaling and root planing (SRP) in treating advanced periodontitis. @*Methods@# Nineteen cases of grade Ⅲ and Ⅳ periodontitis selected from June 2017 to January 2019 in the Nanjing Stomatological Hospital, Medical School of Nanjing University were divided into the periodontal endoscope and control groups. In the periodontal endoscope group, SRP was performed under a periodontal microscope in one treatment after initial supragingival scaling; in the control group, SRP was performed under regular conditions, and additional SRP was conducted in positive bleeding on probing sites twice every other week as needed. Periodontal status, including probing depth (PD), bleeding on probing (BOP) and attachment loss (AL), was recorded by a Florida probe.@*Results@# For sites of 4<PD ≤ 6 mm, there was no significant difference in PD- and BOP-positive rates or AL between the two groups at baseline. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. PD in the endoscope group was smaller than that in the control group at 3 months (P < 0.05). There was no significant difference between the two groups at 6 months (P >0.05). There was no significant difference in the BOP positive rate or AL change between the two groups at 3 months and 6 months (P > 0.05). For sites with PD > 6 mm, at baseline, the positive rates of PD, BOP and AL in the endoscope group were more serious than those in the control group, and the differences were statistically significant. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. However, PD in the endoscope group became shallower than that in the control group (P < 0.05) after 3 and 6 months. There was no significant difference in the BOP positive rate or AL between the two groups (P>0.05). @*Conclusion @#When compared to regular SRP, periodontal microscope-assisted SRP achieves better improvement in PD and is more beneficial for reducing the BOP and AL of deeper sites.

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Objective @# To evaluate the effects of root calculus residue and root cement preservation by ultrasonic subgingival scaling and root planing (SRP) with or without perioscopy.@*Methods @# Twelve teeth extracted due to severe periodontitis were randomly divided into three groups with four teeth in each group: ① Endoscope-assisted SRP group. The root surfaces of the affected teeth were cleaned with an EMS ultrasonic treatment instrument. ② Traditional SRP group. The affected teeth were treated by ultrasonic subgingival scaling and hand root planing with a Gracey curette. ③ Untreat group. The above operations were performed by the same senior physician. Under local anesthesia, each tooth was scraped for 10 minutes and then extracted. The residual amount of calculus on the root surface after plaque staining was observed and recorded. The thickness of the retained cementum at 1/3 of the root neck was measured.@*Results@# The residual rate of calculus on the root surface was the lowest in the endoscope-assisted SRP group, which was significantly different from the traditional SRP group and the untreated group (P < 0.001). Histological observation showed that the mean residual cementum thickness at 1/3 of the root neck increased gradually from the cemento-enamel junction (CEJ), 2.5 mm below the CEJ and 5 mm below the CEJ. Ultrasound SRP assisted by endoscopy caused less damage to the cementum and preserved the cementum better than traditional subgingival scaling (P < 0.001). @*Conclusion@# Compared with traditional SRP therapy, endoscope-assisted SRP treatment can remove subgingival plaque and calculus more effectively and can better preserve the cementum of the root surface.

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OBJECTIVES@#To compare the treatment effects of periodontal endoscope-assisted and traditional subgingival scaling on residual pockets.@*METHODS@#A total of 13 patients with periodontitis from Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University were recruited. After 4-6 weeks of initial treatment, the residual pockets with a probing depth (PD) of ≥4 mm and attachment loss (AL) of ≥4 mm and bleeding on probing were examined with traditional (control group) and periodontal endoscope-assisted subgingival scaling (endoscopy group) in a randomly controlled split-mouth design. At baseline and 6 weeks and 3 months after treatment, plaque index (PLI), PD, AL, and bleeding index (BI) were measured. Differences in these clinical parameters within and between groups and patient-reported outcomes were compared.@*RESULTS@#A total of the 694 sites of 251 teeth were included in this trial. Both groups showed significant improvement in each periodontal parameters 6 weeks and 3 months after treatment (@*CONCLUSIONS@#Periodontal endoscope-assisted subgingival scaling resulted in better effects than traditional subgingival scaling when the residual pockets were in a single-rooted tooth, with a PD of ≥5 mm but without vertical alveolar bone resorption and furcation involvement.

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OBJECTIVE: To evaluate the efficacy of scaling and root planing (SRP) with a periodontal endoscope in the treatment of residual pockets in patients with periodontitis after initial periodontal therapy. METHODS: Patients with residual pockets [probing depth (PD)≥5 mm] were included and randomly assigned to the endoscope group (SRP with a periodontal endoscope) or SRP group (SRP alone). The PD, attachment loss (AL), and bleeding on probing (BOP) of residual pockets were recorded before treatment and at 3 and 6 months after treatment. Data were analyzed with SPSS 20.0 software. RESULTS: Compared with the baseline values, the percentage of PD≥5 mm sites, PD, AL, and BOP (+)% in the endoscope group and SRP group at 3 and 6 months after treatment decreased (P<0.05). Compared with the values at 3 months after treatment, the percentage of PD≥5 mm sites, PD, AL, and BOP (+)% at 3 and 6 months after treatment decreased in the endoscope group (P<0.05), whereas no statistical difference in these values was observed in the SRP group (P>0.05). Compared with those in the SRP group, the percentage of PD≥5 mm sites and PD at 3 and 6 months after treatment and AL and BOP (+)% at 6 months after treatment in the endoscope group decreased (P<0.05). CONCLUSIONS: SRP with a periodontal endoscope shows a better effect in improving the PD, AL, and BOP of residual pockets (PD≥5 mm) in patients with periodontitis after initial periodontal therapy and has advantages in improving the long-term curative effect of this therapy.

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OBJECTIVE: To evaluate the effectiveness of periodontal endoscope as an adjuvant therapy for the non-surgical periodontal treatment of patients with severe and generalized periodontitis. METHODS: Patients (n=13) were divided into three groups: patients treated with conventional subgingival scaling and root planing (SRP) (n=7, 408 sites) (group A), SRP using periodontal endoscope (n=4, 188 sites) (group B) or SRP with periodontal endoscope 3 months after initial SRP (n=2, 142 sites) (group C). Two subgroups were divided into 2 subgroups according to PD at the baseline: 46 mm as subgroup 2. Probing depth (PD), attachment loss (AL), gingival recession (GR) and bleeding on probing (BOP) were recorded. RESULTS: The results of 3 months after treatment showed all PD, AL, and GR values in group A1 were less than those in group B1 (P<0.05), but no significant difference in BOP was found between the two groups. The decrease in PD, BOP in group B2 was more obvious than those in group A2 (P<0.000 1), and the GR values in group B2 were more than those in group A2 (P<0.000 1). But the improvement of AL showed no statistical difference between the two groups (P=0.296 8). In group C1, no significant difference in PD, AL, and GR was observed after endoscopy-assisted therapy, but it was more effective for BOP (P<0.000 1). In group C2, the improvement in PD and AL was significantly different from the improvement in SRP alone (P=0.000 5, P=0.000 2) and was accompanied by more GR (P=0.000 5). CONCLUSIONS: In non-surgical treatment of severe and generalized periodontitis, SRP can achieve good therapeutic effect on sites with 46 mm, the application of periodontal endoscopy can increase the effect, reducing PD and GR, which may be an effective supplement to the current non-surgical periodontal treatment.

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OBJECTIVE@#To evaluate the effectiveness of periodontal endoscope as an adjuvant therapy for the non-surgical periodontal treatment of patients with severe and generalized periodontitis.@*METHODS@#Patients (n=13) were divided into three groups: patients treated with conventional subgingival scaling and root planing (SRP) (n=7, 408 sites) (group A), SRP using periodontal endoscope (n=4, 188 sites) (group B) or SRP with periodontal endoscope 3 months after initial SRP (n=2, 142 sites) (group C). Two subgroups were divided into 2 subgroups according to PD at the baseline: 46 mm as subgroup 2. Probing depth (PD), attachment loss (AL), gingival recession (GR) and bleeding on probing (BOP) were recorded.@*RESULTS@#The results of 3 months after treatment showed all PD, AL, and GR values in group A1 were less than those in group B1 (P6 mm, the application of periodontal endoscopy can increase the effect, reducing PD and GR, which may be an effective supplement to the current non-surgical periodontal treatment.

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BACKGROUND: For this systematic review, the authors evaluated and synthesized the available scientific evidence related to the effects of periodontal endoscopy on the treatment of periodontitis. METHODS: The authors searched PubMed, Embase, Cochrane Library, Chinese Scientific Journals database, China National Knowledge Infrastructure, and Chinese Medicine Premier's Wanfang database for articles about periodontal endoscopy that were published through January 2017. The authors considered the percentage of residual calculus, average treatment time, bleeding on probing (BOP), gingival inflammation (GI), and probing depth (PD) as outcome measures. The authors extracted data and performed meta-analyses for groups of articles for which it was appropriate. RESULTS: The authors identified 8 articles as being suitable for this systematic review. The investigators of 3 studies reported results related to BOP and GI that revealed some advantages of periodontal endoscopy over traditional scaling and root planing (SRP). The investigators of 4 studies explored PD and found no difference between periodontal endoscopy and traditional SRP. The authors could not perform meta-analyses on the study results related to BOP, GI, or PD. The percentage of residual calculus after periodontal endoscope-aided debridement was significantly less than the percentage of residual calculus after traditional SRP (mean difference, -3.18; 95% confidence interval, -4.86 to -1.49; P = .002; heterogeneity I2 = 74%). The authors found that periodontal endoscopy took significantly more time than traditional SRP (mean difference, 6.01 minutes; 95% confidence interval, 4.23 to 7.8; P < .00001; heterogeneity I2 = 0%). CONCLUSIONS AND PRACTICAL IMPLICATIONS: Periodontal endoscopy may provide additional benefits for calculus removal compared with traditional SRP, although it could take more time to perform. With respect to BOP, GI, and PD, the authors found no sufficient evidence to support the difference between the use of periodontal endoscopy and traditional SRP. The authors concluded that additional scientific research is required to assess the effects of periodontal endoscopy on the treatment of periodontitis.

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PURPOSE: Endoscopic technology has been developed to facilitate imagery for use during diagnostic and therapeutic phases of periodontal care. The purpose of this study was to compare the level of subgingival calculus detection using a periodontal endoscope with that of conventional tactile explorer in periodontitis subjects. METHODS: A convenience sample of 26 subjects with moderate periodontitis in at least 2 quadrants was recruited from the University of Minnesota School of Dentistry to undergo quadrant scaling and root planing. One quadrant from each subject was randomized for tactile calculus detection alone and the other quadrant for tactile detection plus the Perioscope ™ (Perioscopy Inc., Oakland, Cali). A calculus index on a 0 to 3 score was performed at baseline and at 2 post-scaling and root planing visits. Sites where calculus was detected at visit 1 were retreated. T-tests were used to determine within-subject differences between Perioscope™ and tactile measures, and changes in measures between visits. RESULTS: Significantly more calculus was detected using the Perioscope™ vs. tactile explorer for all 3 subject visits (p<0.005). Mean changes (reduction) in calculus detection from baseline to visit 1 were statistically significant for both the Perioscope™ and tactile quadrants (p<0.0001). However, further reductions in calculus detection from visit 1 to visit 2 was only significant for the Perioscope™ quadrant (p<0.025), indicating that this methodology was able to more precisely detect calculus at this visit. CONCLUSION: It was concluded that the addition of a visual component to calculus detection via the Perioscope™ was most helpful in the re-evaluation phase of periodontal therapy.

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PURPOSE: The purpose of this study was to determine if the use of a periodontal endoscope improves periodontal outcomes of scaling/root planing when compared to scaling/root planing alone. METHODS: Thirty subjects with moderate periodontitis were recruited from the University of Minnesota School of Dentistry. Of these, 26 completed the study. A randomized split mouth design was used to evaluate periodontal outcomes at 6 to 8 weeks and 3 month intervals after sites within 2 quadrants of each subject were scaled and root planed with or without the use of the Perioscope™. Paired t-tests were used to test whether there were within-patient differences in improvement between Perioscope™ and non-Perioscope™ sites as measured by periodontal measurements (probing depth, clinical attachment level) and indices of gingival inflammation, including bleeding on probing (BOP) and gingival inflammation (GI). P-values less than 0.05 were declared to be statistically significant. RESULTS: Less BOP and GI were found in the Perioscope™ sites at visit 1 and visit 2. Reduction in pocket depth and clinical attachment loss was achieved for all sites but probing depth and clinical attachment level changes were found to be unrelated to the use of the Perioscope™. Mean probing depth (SD) was reduced from 5.29 mm (0.4) to 3.55 mm (0.8) in the Perioscope™ sites and 5.39 mm (0.5) to 3.83 mm (1.2) in non-Perioscope™ sites from baseline measurements to visit 2. CONCLUSION: The adjunctive use of the periodontal endoscope improved periodontal outcomes with respect to gingival inflammation and bleeding upon probing. The adjunctive use of the Perioscope™ was not found to be superior to traditional scaling and root planing with regard to pocket depth reduction and clinical attachment loss.

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