Comparison Between Hand and Sonic/ Ultrasonic Instruments for Periodontal Treatment: Systematic Review with Meta-Analysis

Authors: Francisco Wilker Mustafa Gomes Muniz, Gerson Pedro José Langa, Roberto Pereira Pimentel, João Roig Martins, Daniela Haubman Pereira and Cassiano Kuchenbecker Rösing

Abstract

Aims: To systemically review the literature on the effect of hand and sonic/ultrasonic instruments used for the non-surgical treatment of periodontitis. Material and methods: Five databases were searched for randomized clinical trials that compared the results of periodontal treatment using hand and sonic/ultrasonic for nonsurgical periodontal treatment. Four meta-analyses were performed, using the calculated mean differences (MD) between baseline and 3-months or 6-months after periodontal treatment for clinical attachment level (CAL), and probing pocket depth (PPD). Results: Eighteen studies were included. All included studies showed significant improvement, in at least one periodontal parameter, in both tested periodontal therapies. The sonic/ultrasonic instruments spend significantly less time in comparison to manual instrumentation. At both 3- and 6-months after periodontal therapy, no statistically significant differences were detected for CAL gain between therapies (MD; 95%CI: 0.05; -0.21–0.30 and -0.23; -0.59–0.12). Similarly, no statistically significant differences were detected for PPD reduction between therapies at 3-months of follow-up (MD; 95%CI: -0.03; -0.34–0.28). After 6-months, the PPD reduction was 0.21 (95%CI: -0.43–0.00, p=0.05). Conclusions: Similar results may be expected for the periodontal treatment performed with hand and sonic/ultrasonic instruments. However, further studies with lower risk of bias are warranted.

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