The Systemic Inflammatory Response Following Hand Instrumentation vs Ultrasonic Instrumentation - A Randomised Controlled Trial
Abstract
Objective: This study sought to investigate whether the immediate systemic inflammatory response following full mouth debridement differs following use of hand compared with ultrasonic instruments.
Methods: Thirty-nine periodontitis patients were randomised to treatment with full-mouth debridement using either hand or ultrasonic instrumentation completed within 24 hours. Serum and periodontal clinical parameters were collected at baseline, day 1, day 7 and day 90 post-treatment. Differences in systemic inflammatory markers were assessed using general linear models at each time-point, corrected for age, gender, smoking status, body mass index and baseline levels of each marker.
Results: Across all patients, serum C-reactive protein increased at day 1, with no differences between hand and ultrasonic groups (p(adjusted)=0.22). There was no difference between groups in interleukin-6 (p(adjusted)=0.29) or tumour necrosis factor α (p(adjusted)=0.53) at day 1. Inflammatory markers returned to baseline levels by day 7. Treatment resulted in equal and marked improvements in clinical parameters in both groups; however, total treatment time was on average shorter for ultrasonic instruments (p(adjusted)=0.002).
Conclusions: Ultrasonic instrumentation resulted in shorter treatment time with comparable clinical outcomes. Levels of serum C-reactive protein at day 1 were similar following debridement with hand or ultrasonic instruments.
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