Efficiency of Non-Surgical Treatments in Periodontal Patients Integrated into the Dr. René Puig Bentz Clinic of the Universidad Nacional Pedro Henríquez Ureña, May-August 2023
Description
Non-surgical periodontal treatment involves removing hard or soft biofilm deposits to achieve a healthy periodontal state. Two techniques are available: manual instruments and ultrasonic instruments. The aim of this study was to compare the clinical effectiveness of non-surgical periodontal treatment using manual instruments versus ultrasonic instruments in periodontal patients treated at the Dr. René Puig Bentz clinic in Santo Domingo, Dominican Republic, between May and August 2023. This was a prospective analytical and experimental study. Thirty-one patients were selected and randomly assigned to either group A or group B. Group A consisted of 15 patients who were treated solely with manual instruments, while group B consisted of 16 patients with periodontitis who were treated solely with ultrasonic instruments. Plaque controls were conducted at each appointment using disclosing liquid to measure the amount of accumulated plaque, following the O'Leary Index formula. Periodic monitoring was performed every three days, during which various questions were asked to ensure adherence to treatment, regardless of the group selected. The results indicate that the ultrasonic instrumentation intervention group led to a reduction of inflammation in 75% of cases, which persisted in 25%. Additionally, the average O'Leary index decreased to 12.25% and the average number of pockets reduced to less than 1. It was observed that total resolution of periodontitis was achieved in 31% of cases. Although the hand instrument intervention group reduced inflammation in 60% of cases, it persisted in 40%. The average O'Leary index decreased to 10.67%, and the average number of pockets reduced to less than 1. While total resolution of periodontitis was achieved in 20% of cases. The study confirms that non-surgical periodontal treatment with ultrasound is more time-efficient in controlling periodontitis than manual instrumentation, based on the obtained results and reviewed literature.
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The study compared the effectiveness of two non-surgical therapeutic treatments in periodontal patients undergoing treatment with ultrasound versus manual instruments. It was conducted at the Dr. René Puig Bentz dental clinic at the Universidad Nacional Pedro Henríquez Ureña in Santo Domingo, Dominican Republic, from May to August 2023. The study population comprised of men and women diagnosed with periodontitis who attended the Dr. René Puig Bentz dental clinic. The research sample size was determined using a simple random sampling process and included patients admitted to the clinic with periodontitis. To calculate the sample size, we applied a power analysis formula based on the 'Hazard Ratio' (risk ratio) for a two-tailed survival analysis, using the statistical software STATA 17 (StataCorp, USA). Where: a= type l error rate; threshold probability for rejecting the null hypothesis. b= type II error rate; probability of not rejecting the null hypothesis under the alternative hypothesis. q1= proportion of subjects who are exposed in group 1 q0= proportion of subjects that are exposed in group 0 = (1-q1) RH= Relative hazard a= 0.10 b= 0.2 q1= 0.4 q0= (1-q1) = 0.6 HR= 0.5 za= 1.6449 zb= 0.8416 The sample consisted of at least 50 patients diagnosed with periodontitis who were admitted to the Dr. René Puig Bentz clinic and were divided into two groups of 25 each for hypothesis testing. However, patient recruitment was reduced due to changes in the clinical department. Specifically, a restriction was implemented that prohibited students in earlier clinics from using ultrasound, which significantly limited the availability of patients for the study. Despite the reduction in sample size to 31 patients, data analysis proceeded and yielded a confidence level of 0.11. This reduction was considered valid and acceptable for several reasons. Firstly, the study did not involve any clinical risk to the participants, which minimized the potential impact of a smaller sample. Furthermore, as this was a primary study, there were no previous results to base sample size calculations on. Therefore, it was deemed that the small sample size still provided a sufficient basis for drawing meaningful conclusions within the context of the research.