The Mechanical Irrigation Using Ultrasonic Scaler Tips for Subgingival Plaque Control; A Case Report

Abstract

The purpose of this case report was to describe the long-term effect of subgingival mechanical irrigation, that is irrigation with mechanical debridement using ultrasonic scaler tips, in a patient with moderate to advanced periodontitis.
A 46-year-old male patient without any systemic disease, whose chief complaint was severe mobility of the right maxillary incisor, was referred to the Department of Periodontics, Kagoshima University School of Dentistry, on June 1986. Severe swelling of the gingiva and bone resorption, was observed and diagnosed as moderate to advanced adult-type periodontitis.
After initial examination, O'Leary plaque control records were maintained at less than 10% during initial treatment, and subgingival mechanical irrigation was performed vigorously using ultrasonic scaler tips on minimum power once a week for one month. Re-examination was performed to assess the healing response of the periodontal tissue after one month of irrigation treatment. Further subgingival mechanical irrigation was perfomed once a week for seven months. Follow-up evaluation was performed eight months after initial examination. Scaling and root planing using hand instruments were performed there after.
At initial examination, the mean probing pocket depth (PPD) and frequency of bleeding on probing (BOP) was 2.7mm and 82%, respectively. After one month of subgingival irrigation, the mean PPD and BOP was 2.5mm and 31% respectively. After eight months of subgingival irrigation, the mean PPD and BOP was 2.0mm and 22% respectively and marked reduction of probing pocket depth was observed. At the third examination, and after scaling and root planing, the mean PPD and BOP was 1.9mm and 9% respectively.
It was noted that the remarkable healing of periodontal tissue was observed without scaling and root planing. A'so, the findings suggest that the subgingival mechanical irrigation using ultrasonic scaler tips mey be a potential healing aid, without involving cumbersome instruments. Further study is required to assess the effects of subgingival irrigation in a clinical application.