The role of periodontal endoscope in the subgingival instrumentation training. A pilot study on dental hygiene students

Background & Aim: Non-surgical periodontal treatment focuses on the removal of bacterial plaque using manual/mechanical instrumentation. Anatomic limitations associated with the access to subgingival areas could reduce the effectiveness of a thorough instrumentation. The opportunity of endoscopic self-assessment can improve the instrumentation ability of the clinician. The aim of this pilot study was to evaluate if self-assessment by periodontal endoscope could improve quality of non-surgical instrumentation in dental hygiene students. Methods: Four dental hygiene students were randomly assigned to the Study or Control Group. Each group included a trained operator, attending the third year of course, and an untrained operator, attend-ing the second year. Participants worked with a predefined ultrasonic tip. Teeth #41 and #47 with standardized root deposits were treated on a typodonts with compromised periodontal anatomy. After the initial instrumentation (T0), the Study Group underwent a self-assessment of the root surfaces with dental endoscope (DV2, DentalView®). A second instrumentation T1 was then performed. Quantitative analysis of residual deposits after T0 and T1 was carried out for all teeth surfaces by using a dedicated software (ImageJ®). The effect of group, instrumentation, operator, tooth and surface was evaluated by means of multilevel analysis, using a mixed effects model.Results: A decrease in percentage of residual deposits between T0 andT1 was observed in both operators of Study Group. The only significant effect in multilevel analysis was the tooth #41 presenting a stronger decrease than #47 (p=0.01). Self-assessment also led to a significant increase of effectiveness in instrumentation of apical areas (p=0.04).