Efficacy of scaling and root planning with periodontal endoscopy for residual pockets in the treatment of chronic periodontitis: a randomized controlled clinical trial

Clin Oral Investig. 2022 Jan;26(1):513-521. doi: 10.1007/s00784-021-04029-w. Epub 2021 Jun 18.


Objectives: Residual pockets are a risk factor of periodontitis progression. This study evaluated the efficacy of periodontal endoscopy (PE) during scaling and root planning (SRP) of residual pockets in chronic periodontitis patients after initial periodontal treatment.

Materials and methods: A single-blinded, randomized controlled clinical trial was conducted in systemically healthy subjects presenting at least three residual pockets with a probing depth (PD) ≥ 5 mm in each quadrant. Subjects were randomly allocated to one of two trial groups using a computer-generated program: SRP + PE (test group) or SRP alone (control group). Clinical parameters (PD, clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PLI)) were then measured at baseline, 3-, and 6-month follow-up.

Results: A total of 1629 sites in 37 patients were examined. Both treatments significantly improved all clinical outcomes (PD, CAL, BOP, and PLI) from baseline to 6 months (P < 0.05), although greater reductions in PD and PLI were observed in the test group at both 3- (PD: 3.45 ± 0.56 vs. 4.14 ± 0.59 mm; PLI: 0.55 ± 0.23 vs. 0.73 ± 0.27) and 6-month follow-up (PD: 3.12 ± 0.63 vs. 4.0 ± 0.68 mm; PLI: 0.49 ± 0.21 vs. 0.72 ± 0.28, respectively; P = 0.001 for PD and P = 0.021 for PLI). No significant differences in CAL or BOP were observed.

Conclusions: SRP + PE resulted in significant reductions in PD and PLI compared to SRP alone in residual pockets with a PD ≥ 5 mm.

Clinical relevance: The findings highlight the benefits of SRP + PE, supporting use as an alternative strategy in nonsurgical periodontal treatment.

Keywords: Periodontal endoscopy; Periodontitis; Residual pockets; Scaling and root planning.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Chronic Periodontitis* / therapy
  • Dental Plaque Index
  • Dental Scaling
  • Endoscopy
  • Follow-Up Studies
  • Humans
  • Root Planing