Stage III Periodontitis
Conditions
Keywords
Periodontitis, scaling and root planing, life cycle assessment, patient-reported outcomes, environmental sustainability
Brief summary
This randomized clinical trial compares full-mouth and quadrant-wise scaling and root planing in patients with Stage III periodontitis. In addition to evaluating clinical effectiveness and patient-reported outcomes, the study investigates the environmental sustainability of both treatment protocols using life cycle assessment. The findings are expected to contribute to more sustainable and patient-centered periodontal treatment planning.
Interventions
PROCEDUREFull-Mouth Scaling and Root Planing
Full-mouth scaling and root planing was completed in a single treatment session using ultrasonic scalers and Gracey curettes. Standardized oral hygiene instructions were provided before treatment. Participants were re-evaluated at 1-, 3-, and 6-month follow-up visits, and additional non-surgical periodontal treatment was provided for sites requiring further therapy when clinically indicated.Clinical outcomes, patient-reported outcomes, and the environmental impact of the treatment protocol were assessed throughout the study.
PROCEDUREQuadrant-Wise Scaling and Root Planing
Quadrant-wise scaling and root planing was performed over four treatment sessions scheduled at one-week intervals using ultrasonic scalers and Gracey curettes. Standardized oral hygiene instructions were provided before treatment. Participants were re-evaluated at 1-, 3-, and 6-month follow-up visits, and additional non-surgical periodontal treatment was provided for sites requiring further therapy when clinically indicated. Clinical outcomes, patient-reported outcomes, and the environmental impact of the treatment protocol were assessed throughout the study.
Sponsors
Selcuk University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Age ≥18 years. Diagnosis of Stage III periodontitis according to the 2017 World Workshop -Classification of Periodontal and Peri-Implant Diseases and Conditions. Presence of at least four teeth in each quadrant, including at least one molar, excluding third molars. Absence of any systemic disease. No regular use of systemic medications. No history of periodontal treatment within the previous 6 months. No use of antibiotics, anti-inflammatory agents, or any other medications that could affect periodontal tissues within the previous 6 months. Non-smokers or individuals who had ceased smoking for at least 1 year prior to enrollment. Not pregnant or breastfeeding.
Exclusion criteria
Age \<18 years. Presence of any systemic disease. Regular use of systemic medications. History of periodontal treatment within the previous 6 months. Failure to complete the treatment protocol or attend scheduled follow-up visits. Current smoking. Use of antibiotics, anti-inflammatory agents, or any other medications that could affect the periodontal tissues within the previous 6 months. Requirement for antibiotic prophylaxis prior to dental treatment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Probing Pocket Depth (PPD) | Baseline, 1 month, 3 months, and 6 months | Mean probing pocket depth (PPD) was measured at six sites per tooth using a manual periodontal probe and recorded in millimeters (mm). Lower PPD values indicate improved periodontal status. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Attachment Level (CAL) | Baseline, 1 month, 3 months, and 6 months | Mean clinical attachment level (CAL) was measured at six sites per tooth using a manual periodontal probe and recorded in millimeters (mm). Lower CAL values indicate improved periodontal attachment. |
| Bleeding on Probing (BOP) | Baseline, 1 month, 3 months, and 6 months | Bleeding on probing (BOP) was assessed by recording the presence or absence of bleeding within 30 seconds after gentle periodontal probing at the buccal, lingual/palatal, mesial, and distal surfaces of each tooth. Results were expressed as the percentage (%) of bleeding sites, with lower values indicating reduced gingival inflammation. |
| Plaque Index (PI) | Baseline, 1 month, 3 months, and 6 months | Plaque Index (PI) was assessed on all teeth according to the Silness and Löe index and recorded as a mean index score. Lower PI scores indicate better plaque control. |
| Gingival Index (GI) | Baseline, 1 month, 3 months, and 6 months | Gingival Index (GI) was assessed on all teeth according to the Löe and Silness index and recorded as a mean index score. Lower GI scores indicate reduced gingival inflammation. |
| Periodontal Inflamed Surface Area (PISA) | Baseline, 1 month, 3 months, and 6 months | Periodontal Inflamed Surface Area (PISA) was calculated using a validated method based on clinical attachment level, gingival recession, and bleeding on probing measurements and recorded in square millimeters (mm²). Lower PISA values indicate a reduced periodontal inflammatory burden. |
| Periodontal Epithelial Surface Area (PESA) | Baseline, 1 month, 3 months, and 6 months | Periodontal Epithelial Surface Area (PESA) was calculated from clinical attachment level and gingival recession measurements and recorded in square millimeters (mm²). Lower PESA values indicate a smaller periodontal epithelial surface area. |
| Pain Intensity (Visual Analog Scale, VAS) | At the 1-month follow-up visit | Pain intensity following periodontal treatment was assessed using a 10-cm Visual Analog Scale (VAS), where 0 represented no pain and 10 represented the worst imaginable pain. Lower VAS scores indicate lower perceived pain intensity. |
| Oral Health-Related Quality of Life (OHIP-14) | At the 1-month follow-up visit | Oral health-related quality of life was assessed using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. |
| Analgesic Use | At the 1-month follow-up visit | The number of participants who reported using or not using analgesic medication following periodontal treatment was recorded for each treatment group. |
| Preference for Future Periodontal Treatment | At the 6-month follow-up visit | At the 6-month follow-up visit, participants were asked whether, based on their experience with the assigned treatment approach, they would prefer the alternative periodontal treatment approach if future periodontal treatment were needed. Responses were recorded for analysis. |
| Environmental Impact of Periodontal Treatment Approaches | During the 6-month study period | The environmental impacts of the periodontal treatment approaches were assessed using Life Cycle Assessment (LCA). |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORSefa Aydındoğan
Department of Periodontology, Faculty of Dentistry, Selcuk University
Outcome results
None listed