Radiographic Response of Intrabony Defects After Endoscopic-assisted Non-surgical Periodontal Therapy

Objectives: The primary goal of non-surgical periodontal therapy (NSPT) is to remove subgingival deposits. The recent introduction of endoscopy to this procedure has opened new opportunities. The aim of this work is to analyse the radiographic response of intrabony defects to endoscopic-assisted NSPT. Methods: This was a prospective study on patients with chronic periodontitis. The main study outcome was radiographic bone changes. Twenty-three sites, belonging to 13 consecutive patients (7 females, 6 males, age =50±11) were studied. All patients were affected by chronic periodontitis presenting at least one vertical intrabony defect affecting a single–rooted tooth. Intrabony defects associated with perio-endo pathology were excluded. All sites were treated with one session of endoscopic-assisted (Dental View-DV2, CA, USA) NSPT and then maintained with 3-monthly supportive periodontal therapy. Standardized x-rays were taken before and one year after treatment. Radiographs were scanned and evaluated using an image analyser (Scion Image Analyzer, Scion, Frederick, MD, USA). The following measurements were registered: the distance between interproximal cement-enamel junction (CEJ) and base of the defect (BD), the distance between bone crest (BC) and BD and the angle of the defect defined by the previous two lines. Results: Significant mean reduction of CEJ-BD and BC-BD distances were registered between baseline and 1-year follow-up: 1.13 ± 0.22 mm (95% CI:0.68-1.59) and 0.82 ± 0.19 mm (95% CI:0.42-1.22) respectively (Student T for paired data: p=0.0001). The defect angle showed a significant mean increase of 6.29 ± 2.71° (95% CI:0.67-11.92) (Student T for paired data: p=0.03). Conclusions: The present work shows a clear improvement of infrabony defects one year after therapy. The endoscopic-assisted NSPT therefore seems a promising therapeutic approach, leading to significant radiographic benefits in a minimally invasive way. Randomized controlled studies are strongly required to test this treatment against other NSPT modalities.