Microbiological findings after periodontal therapy using curettes, Er:YAG laser, sonic, and ultrasonic scalers.
OBJECTIVE
To evaluate and compare the microbiological effects of hand instruments, Er:YAG-laser, sonic, and ultrasonic scalers in patients with chronic periodontitis. Patient perception of each treatment was documented.


METHODS
From 72 patients, bacterial samples were collected from the deepest pocket in each quadrant (total: 288 sites). A polymerase chain reaction kit estimated the amount of Aggregatibacter (Actinobacillus) actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythensis (Tf), and Treponema denticola (Td) at baseline as well as 3 and 6 months after therapy. One quadrant in each patient was randomly assigned to curettes (H-group), Er:YAG laser (L-group), sonic device (S-group), or ultrasonic device (U-group).


RESULTS
Three months post-operatively, the amounts of Pg, Pi, Tf, and Td were significantly reduced in all groups. Laser and sonic instrumentation failed to reduce Aa. Six months after therapy, significant differences were still detected for Pg (L- and U-group), for Pi and Tf (S-group), and for Td (L-, S- and U-group). Patients rated ultrasonic treatment as more preferable than hand and laser instrumentation.


CONCLUSIONS
The various treatment methods resulted in a comparable reduction of the evaluated periodontal pathogens, and bacterial increase was only partially different 6 months post-operatively. Ultrasonic instrumentation caused less discomfort.
Derdilopoulou
Foteini V
FV
Department of Operative Dentistry and Periodontology, University School of Dental Medicine, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany.
Nonhoff
Jörg
J
Neumann
Konrad
K
Kielbassa
Andrej M
AM
D000328:Adult; D000368:Aged; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D001294:Attitude to Health; D001439:Bacteroides / Q000302:isolation & purification; D002908:Chronic Disease; D015169:Colony Count, Microbial; D003475:Curettage / Q000295:instrumentation*; D012534:Dental Scaling / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007834:Lasers; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010514:Periodontal Pocket / Q000382:microbiology / Q000628:therapy; D010518:Periodontitis / Q000382:microbiology* / Q000628:therapy; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D018713:Prevotella intermedia / Q000302:isolation & purification; D016037:Single-Blind Method; D048373:Treponema denticola / Q000302:isolation & purification; D014464:Ultrasonic Therapy / Q000295:instrumentation*