Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany.
Private Practice, Aachen, Germany.
J Clin Periodontol. 2021 Dec;48(12):1516-1527. doi: 10.1111/jcpe.13548. Epub 2021 Oct 4.
To evaluate the clinical efficacy of full-mouth scaling (FMS), full-mouth disinfection (FMD), and FMD with adjuvant erythritol air-polishing (FMDAP) compared to quadrant-wise debridement (Q-SRP) in patients with periodontitis stage III/IV.
In this four-arm parallel, prospective, randomized, controlled multi-centre study, changes of pocket probing depths (PPDs), clinical attachment level (CAL), bleeding on probing (BOP), and proportion of closed pockets (PPD ≤4 mm without BOP) were evaluated at baseline and after 3 and 6 months.
From 190 randomly participating patients, 172 were included in the final analysis. All groups showed significant (p < .05) improvements in all clinical parameters over 3 and 6 months. During the study period, FMDAP showed significantly higher reductions of mean PPD in teeth with moderate (PPD 4-6 mm) and deep (PPD > 6 mm) pockets and significantly increased proportions of pocket closure than Q-SRP. Patients treated with FMD had significantly greater PPD reduction in deep pockets and a higher percentage of pocket closure after 3 months but not after 6 months compared to Q-SRP. CAL and BOP changes did not significantly differ among all groups. Efficiency of treatment (time effort to gain one closed pocket) was significantly higher for FMDAP, FMD, and FMS compared to Q-SRP (6.3, 8.5, 9.5 vs. 17.8 min per closed pocket; p < .05).
All treatment modalities were effective, without significant differences between full-mouth approaches. FMDAP showed improved clinical outcomes over Q-SRP for moderate and deep pockets after 6 months. Full-mouth protocols were more time-efficient than conventional Q-SRP.
The trial was registered in a clinical trial database (ClinicalTrials.gov: NCT03509233).
评估全口洁治（FMS）、全口消毒（FMD）和 FMD 联合艾地糖醇空气抛光（FMDAP）与象限式龈下刮治（Q-SRP）治疗牙周炎 III/IV 期患者的临床疗效。
在这项四臂平行、前瞻性、随机、对照多中心研究中，在基线、3 个月和 6 个月时评估牙周袋探诊深度（PPD）、临床附着水平（CAL）、探诊出血（BOP）和封闭袋比例（无 BOP 的 PPD≤4mm）的变化。
在 190 名随机参与的患者中，有 172 名患者纳入最终分析。所有组在 3 个月和 6 个月时所有临床参数均有显著改善（p<.05）。在研究期间，FMDAP 在中（PPD 4-6mm）和深（PPD>6mm）袋中显著降低了平均 PPD，并且显著增加了封闭袋的比例，优于 Q-SRP。与 Q-SRP 相比，FMD 治疗的深袋 PPD 降低更显著，3 个月时封闭袋的比例更高，但 6 个月时无差异。CAL 和 BOP 变化在所有组之间无显著差异。与 Q-SRP 相比，FMDAP、FMD 和 FMS 的治疗效率（获得一个封闭袋的时间）显著更高（6.3、8.5、9.5 分钟/个封闭袋；p<.05）。
所有治疗方式均有效，全口治疗方式之间无显著差异。与 Q-SRP 相比，FMDAP 在 6 个月时对中、深袋具有更好的临床效果。全口方案比传统的 Q-SRP 更具时间效率。
该试验在临床试验数据库（ClinicalTrials.gov：NCT03509233）中注册。
