The Efficacy Of Glycine Powder Air Polishing Combined With Scaling And Root Planning In The Treatment Of Periodontitis

Objective:To investigate the difference between glycine powder air polishing(GPAP)combined with SRP and SRP alone when remove subgingival plaque.,a randomized controlled clinical study was conducted.This study was performed to provide experimental data and a new selection of subgingival plaque removal for patients with chronic periodontitis in the future.Methods:1.Experimental subject:Patients admitted to the stomatological hospital of hebei medical university due to chronic periodontitis between March 2018 to November 2018 were selected.24 patients included in the study were aged from 29 to 64 years old.there were 14 males and 10 females.The same periodontist provided complete periodontal basic treatment and then entered supportive periodontal therapy.2.Grouping:The test and control group were established by self-control design principles.Test group was treated with full-mouth supragingival and subgingival glycine powder air-polishing(GPAP)combined with SRP as the GPAP+SRP group,and the control group only used SRP to remove subgingival plaque and calculus as the SRP group.3.Experimental methods:The clinical indicators including probing the depth,bleeding on probing,attachment loss,plaque index were comparatively analyzed between before treatment and after treatment.In the test group,full-mouth supragingival and subgingival glycine powder air-polishing was adopted.Among all sites with the periodontal depth of 4~6mm,2 sites were randomly selected to be included in the experiment,and gingival crevicular fluid samples were collected.Samples of gingival crevicular fluid were collected at baseline,7days after baseline,7 days and 30 days after operation.In the control group,2 sites with a depth of 4-6mm were randomly selected to collect gingival sulcus fluid samples at baseline,after GPAP,7 days and 30 days after operation.Real-time PCR was used to detect the percentage of porphyromonas gingivalis(Pg)in the subgingival plaque of each gingival sulcus fluid sample.Results:1.Clinical observation: according to the comparison between the experimental group and the control group,sand blasting on the gingiva and subgingiva can cause transient bleeding at the gingival margin.Without treatment,bleeding symptoms disappear quickly.2.Clinical indicators: there was no significant difference in clinical indicators between the experimental group and the control group before treatment,and all clinical indicators were significantly changed 30 days after surgery,with statistical significance within the group(P<0.05).PLI,PD,BOP and AL all showed a downward trend after treatment,but there was no statistical difference between the two groups(P>0.05).3.Changes in Pg relative total bacteria content: the content of Pg relative total bacteria in the experimental group was lower than that before treatment after sand blasting on the upper and lower gingival of glycine(P<0.05).In the control group without any treatment,there was no statistical difference in Pg relative total bacteria content before and after treatment.Before and after treatment,Pg relative total bacteria content was significantly reduced in the experimental group and the control group,but there was no significant difference between the two treatment schemes(P>0.05).4.In the clinical treatment of 24 patients,there were no subcutaneous emphysema and other side effects.Only one patient with gingival atrophy and root surface exposure showed tooth sensitivity symptoms during subgingival grit blasting of glycine.Conclusion:1.In the periodontal basic treatment stage,the application of glycine powder air polishing can reduce the content of Pg relative to the total bacteria and clear the subgingival plaque.GPAP can be used as an effective treatment for chronic periodontitis.2.For the treatment of chronic periodontitis,GPAP combined with SRP and SRP alone have the same changes in clinical indicators,which can effectively control inflammation.3.Glycine powder air polishing combined with SRP and SRP alone can significantly reduce the relative content of Pg in periodontal pocket,which has the same efficacy.