| BackgroundChronic periodontitis is one of the most common type of periodontitis. More than95%Periodontitis is chronic periodontitis. It is also the main reason result in the tooth be lost and periodontal tissue destraction. A large amount of studies indicated, the plaque and bacteria attached to the tissue that is the the most important factor lead to chronic periodontitis, and A lot of studies indicated that the attachment of dental calculus and plaque is the main factor leading to attachment loss of periodontal tissue.SRP can eliminate the calculous and plaque of the teeth surface,subgingival area, and root surface. It is the most common method to treat chronic periodontitis.But, SRP contains some limitations. For example, it is a blind operation. We can not eliminate the Inflammatory substances thoroughly in a visual environment. Sufficient experience and skill of the operator may affect the efficiency easily. With development of technology, perioscopy plays an increasingly important role, and it can help to improve the efficiency to clear the calculous and plaque.Some studies indicated, endoscope is one of the minimal traumatic treatment to orgnization. It can creat a visul operating environment. Endosope was widly used in surgery in some parts such as viseral, joint or mucles. For the past few year, endoscope was used in subgingival scaling and root planing. It not only improve to visalize the subgingival environment but also help the oprators to remove the calculous and plaque more efficiently. So, subgingival scaling with periodontal has an advantage in visual operating vision relative to general reneral subgingival scaling. However, relative to periodontal flap surgery, subgingival scaling with periodontal not only can remove calculous and plaque efficently, but also no need to under local anesthesia or cut apart the gingival tissue when proceeding. It could avoid the risk of the anesthesia and wounds would be infectioned.Objects1. Collect the patients who visited to the dentist in Stomatology Hospital of Guang Dong Province, select the single-root teeth (5-5). All of these teeth are very loose (level III), these teeth are pointless to reserve and need to be extracted. Probling depth of these teeth must be with2or more sites are equal or greater than5mm.2. Compare to the two groups with smoking, and precede Group comparison to analysis whether smoking is an influencing factor in calculous residule.3. Compare to the two groups w ith bleeding of probling (BOP), to probing and dtermine the bleeding sites, to analysis whether BOP is an influencing factor in calculous residule.4. Compare to the two groups with probling depth (PD), to probing and dtermine the bleeding sites, to analysis whether PD is an influencing factor in calculous residule.Methods1. Collected the subjects:All patients were recruited from outpatients referred to Guangdong Provincial Stomatological Hospital, of Southern Medical University. Atotal of16individuals(10males and6females; age range:42to71years) were used for this study. Patient had single-rooted (incisor, lateral incisor, canine, and bicuspid) teeth with a hopeless periodontitis and at least1site with PD>5mm, and the teeth had to extracted. A total of26teeth in16individuals, including12incicors,6laterial incicors,8bicuspids.2. Inclusion criteria: All patients (subjects) were healthy and not suffering from some severe system diseases such as hypertension, diabetes, cardiopathy, nerhropathy, hematopathy.; All patients didn’t reveive periodontal SRP or periodontal therapy in preceding6month; All patients of the study suffered severe chronic periodontitis, whose teeth at least1site with PD>5mm, blooding of probing; tooth mobility:level III; Alveolar bone of these single-root teeth(incisor, lateral incisor, canine, and bicuspid) were absorbed the length of the1/2root, hopless to retain anf need to be extracted. Subjects were given signed the content, including the risks, benefits, expected time requirement.3. Operational processes:The study was conducted with the principle of double-blind and randomized. All teeth were classified into2groups:experimental group:SRP with periodontal endoscope; contral group:general SRP. Brfore operation, we had to record the age of patients, sex, smoking, teeth locations,PD and BOP in the6sites of these teeth. All teeeth were treated by the same dentist. At first, anesthetized locally with articaine hydrochloride, scaled the teeth during10min and extracted them, and soaked them into the saline for1hour, recoeded the tooth position and the number of them, within1hour of submission.4. Laboratory operating:After extracted the teeth, soaked them into the saline for1hour,and rinsed them by water for5mins to remove the periodontal tissue, granulation, and connective tissue. Then recored the teeth locations, and put the teeth into the plastic tubes to save.Taked the1.0g powder of methylene-blue on the weighing instrument to weigh, and mixed with100g of water to dissolve the powder. After cooling, put the teeth respectively into the solution of1%methylene-blue for20seconds to dye. And then, rinsed them for3mins to remove the extra coloring. Finaly, wiped, dried these washed teeth, and photographed respectively on the basis of serial numbers.After that, edited the photos with professional retouching software and captured the region from cemental-enamel junction to the apical for each tooth surface. Wthin Image Pro Plus to measured the stained region of plaque and calcalous(Suml), and measured the total acreage of each tooth surface. Then we derived the residual rate of plaque and calcalous in each teeth surface by Sum1/Sum2. Then we averaged all of the4surfaces, we can get the residual rate of plaque and calcalous for each tooth. Statistical analysis:All analyses were performed using Statistical Package for Social Sciences (SPSS) for Windows, version13.0. All of the data on the experimental group or control group were performed using pared t-test to analyze. Group comparison of PD, BOP, smoking also were performed using t-test to analyze. However, group camparison of tooth type were performed using one-way-anova to analyze.Results:1. A comparison of experimental group and control group:All analyses indicated that the tooth surface(buccal, mesial, lingual, distal) residual rate of calculous and plaque on experimental group were12.79%,11.01%,13.0,13.55%, average was12.59%; The tooth surface residual rate of calculous and plaque on control group were8.36%,7.71%,7.84%,8.34%, average was8.07%. The results showed that the residual rate of calculous and plaque on experimental group were less than control group.(P<0.05)2. Group comparisons of smoking and the residual rate of calculous and plaque:All of the16patients, six were incorporated into experimental group, three had smoking habbit, the others were opposite; Otherwise, ten were incorporated into control group,seven had smoking habbit, the others were opposite. After statistical analysis, no matter in experimental group or control group, The teeth of the residual rate of calculous and plaque with smoking were higher than non-smoking ones.(P<0.05)3. Group comparisons of tooth type and the residual rate of calculous and plaqueDistinguished these26teeth, including11incisor,6lateral incisor,8bicuspid. There were5incisor,2lateral incisor,6bicuspid in the experimental group, and7incisor,4lateral incisor,2bicuspid in the control group. After statistical analysis, whether in experimental group or control group, the disparity of the residual rate of calculous and plaque were not obvious.(P>0.05)4. Group comparisons of BOP and the residual rate of calculous and plaque: All of the teeth were performed6-site probing, there were15teeth with BOP(+)>3sites, and11teeth with BOP (+)<3sites. And there were8teeth with BOP(+)>3sites,5teeth with BOP (+)<3sites in experimental group,10teeth with BOP(+)>3sites,3teeth with BOP (+)<3sites, After statistical analysis, no matter experimental group or control group, the teeth of the residual rate of calculous and plaque with BOP(+)>3sites were higher than BOP(+)<3sites ones.(P<0.05)5. Group comparisons of PD and the residual rate of calculous and plaque:All of the teeth were performed6-site probing, the rate of calculous and plaque with PD>5mm greater than3sites in experimental group were9.36%, and less than3sites in experimental group were6.05%; Other side, the rate of calculous and plaque with PD>5mm greater than3sites in control group were14.55%, and less than3sites in control group were9.57%. The results showed, the teeth with PD>5mm greater than3sites, the residual rate of calculous and plaque in which were higher than the teeth with PD>5mm less than3sites.(P<0.05)Conclusions:1. The comparisons of experimental group and control group, the residual rate of calculous and plaque on experimental group were less than the residual rate of calculous and plaque on control group.2. Group comparisons of smoking and the residual rate of calculous and plaque:After statistical analysis, no matter in experimental group or control group, The teeth of the residual rate of calculous and plaque with smoking were higher than non-smoking one.(P<0.05)3. Group comparisons of tooth type and the residual rate of calculous and plaque: After statistical analysis, whether in experimental group or control group, the disparity of the residual rate of calculous and plaque were not obvious.(P>0.05) We still can not prove a relationship between the tooth type and the residual rate of calculous and plaque.4. Group comparisons of BOP and the residual rate of calculous and plaque:After statistical analysis, no matter experimental group or control group, the teeth of the residual rate of calculous and plaque with BOP(+)>3sites were higher than BOP(+) <3sites ones.(P<0.05) So we can indentify that BOP and the residual rate of calculous and plaque are related.5. Group comparisons of PD and the residual rate of calculous and plaque:The results showed, the teeth with PD>5mm greater than3sites, the residual rate of calculous and plaque in which were higher than the teeth with PD>5mm less than3sites.(P<0.05) We can indentify that PD and the residual rate of calculous and plaque are related. |
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