OBJECTIVE: To compare the treatment effects of periodontal endoscope-assisted and traditional subgingival scaling on residual pockets.
METHODS: A total of 13 patients with periodontitis from Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University were recruited. After 4-6 weeks of initial treatment, the residual pockets with a probing depth (PD) of ≥4 mm and attachment loss (AL) of ≥4 mm and bleeding on probing were examined with traditional (control group) and periodontal endoscope-assisted subgingival scaling (endoscopy group) in a randomly controlled split-mouth design. At baseline and 6 weeks and 3 months after treatment, plaque index (PLI), PD, AL, and bleeding index (BI) were measured. Differences in these clinical parameters within and between groups and patient-reported outcomes were compared.
RESULTS: A total of the 694 sites of 251 teeth were included in this trial. Both groups showed significant improvement in each periodontal parameters 6 weeks and 3 months after treatment (P<0.001). For sites in a single-rooted tooth, sites with PD≥5 mm, and sites without vertical alveolar bone resorption and furcation involvement, the PD in endoscopy group was significantly lower than that in the control group at 6 weeks and 3 months after treatment (P<0.05).
CONCLUSIONS: Periodontal endoscope-assisted subgingival scaling resulted in better effects than traditional subgingival scaling when the residual pockets were in a single-rooted tooth, with a PD of ≥5 mm but without vertical alveolar bone resorption and furcation involvement.
目的: 探究牙周内窥镜辅助龈下刮治和传统龈下刮治对非手术治疗后残存牙周袋的临床疗效差异。方法: 收集2019年6—12月于四川大学华西口腔医院牙周病科就诊的牙周炎患者13例，以基础治疗后4~6周再评估时探诊深度（PD）≥4 mm、附着丧失（AL）≥4 mm且探诊出血的残存牙周袋为研究对象，进行分口设计的单盲随机对照试验，口内一侧行传统龈下刮治（对照组），另一侧行牙周内窥镜辅助龈下刮治（内窥镜组）。在基线、治疗后6周和治疗后3月分别测量菌斑指数（PLI）、PD、AL及出血指数（BI），比较治疗前后2组各项牙周指标的变化和组间差异，并比较2组患者报告结局的差异。结果: 共251颗患牙的694个位点纳入临床试验。治疗后6周和3月2组各项牙周指标均显著改善（P<0.001）。对于单根牙、探诊深度≥5 mm的位点以及牙槽骨无角形吸收且无根分叉病变的位点，治疗后6周及3月内窥镜组的PD均低于对照组（P<0.05）。结论: 牙周内窥镜辅助龈下刮治对单根牙、PD≥5 mm及牙槽骨无角形吸收且无根分叉病变的残存牙周袋的疗效优于传统龈下刮治。.

OBJECTIVE: To evaluate the efficacy of scaling and root planing (SRP) with a periodontal endoscope in the treatment of residual pockets in patients with periodontitis after initial periodontal therapy.
METHODS: Patients with residual pockets [probing depth (PD)≥5 mm] were included and randomly assigned to the endoscope group (SRP with a periodontal endoscope) or SRP group (SRP alone). The PD, attachment loss (AL), and bleeding on probing (BOP) of residual pockets were recorded before treatment and at 3 and 6 months after treatment. Data were analyzed with SPSS 20.0 software.
RESULTS: Compared with the baseline values, the percentage of PD≥5 mm sites, PD, AL, and BOP (+)% in the endoscope group and SRP group at 3 and 6 months after treatment decreased (P<0.05). Compared with the values at 3 months after treatment, the percentage of PD≥5 mm sites, PD, AL, and BOP (+)% at 3 and 6 months after treatment decreased in the endoscope group (P<0.05), whereas no statistical difference in these values was observed in the SRP group (P>0.05). Compared with those in the SRP group, the percentage of PD≥5 mm sites and PD at 3 and 6 months after treatment and AL and BOP (+)% at 6 months after treatment in the endoscope group decreased (P<0.05).
CONCLUSIONS: SRP with a periodontal endoscope shows a better effect in improving the PD, AL, and BOP of residual pockets (PD≥5 mm) in patients with periodontitis after initial periodontal therapy and has advantages in improving the long-term curative effect of this therapy.
目的 比较牙周内窥镜辅助龈下刮治和根面平整（SRP）与传统SRP对慢性牙周炎患者基础治疗后残留牙周袋的临床疗效。方法 将牙周基础治疗后口内每个区至少有1个位点探诊深度（PD）≥5 mm的患者纳入研究，随机分为内窥镜组和SRP组，分别对残留牙周袋位点进行内窥镜辅助SRP治疗和传统SRP治疗。在治疗前（基线）、治疗后3、6个月检查PD、探诊出血（BOP）和附着丧失（AL），采用SPSS 20.0统计学软件对数据进行统计分析。结果 与基线相比，治疗后3、6个月内窥镜组及SRP组PD≥5 mm位点百分比、PD、AL、BOP阳性位点百分比均降低（P<0.05）。治疗后6个月与3个月相比，内窥镜组PD≥5 mm位点百分比、PD、AL、BOP阳性位点百分比均降低（P<0.05），而SRP组差异无统计学意义（P>0.05）。与SRP组相比，内窥镜组治疗后3及6个月PD≥5 mm位点百分比、PD均降低，治疗后6个月AL、BOP阳性位点百分比降低（P<0.05）。结论 牙周内窥镜辅助SRP对于基础治疗后的残留牙周袋（PD≥5 mm）的临床疗效优于传统SRP，尤其具有更好的远期预后。.

OBJECTIVE: To evaluate the effectiveness of periodontal endoscope as an adjuvant therapy for the non-surgical periodontal treatment of patients with severe and generalized periodontitis.
METHODS: Patients (n=13) were divided into three groups: patients treated with conventional subgingival scaling and root planing (SRP) (n=7, 408 sites) (group A), SRP using periodontal endoscope (n=4, 188 sites) (group B) or SRP with periodontal endoscope 3 months after initial SRP (n=2, 142 sites) (group C). Two subgroups were divided into 2 subgroups according to PD at the baseline: 46 mm as subgroup 2. Probing depth (PD), attachment loss (AL), gingival recession (GR) and bleeding on probing (BOP) were recorded.
RESULTS: The results of 3 months after treatment showed all PD, AL, and GR values in group A1 were less than those in group B1 (P<0.05), but no significant difference in BOP was found between the two groups. The decrease in PD, BOP in group B2 was more obvious than those in group A2 (P<0.000 1), and the GR values in group B2 were more than those in group A2 (P<0.000 1). But the improvement of AL showed no statistical difference between the two groups (P=0.296 8). In group C1, no significant difference in PD, AL, and GR was observed after endoscopy-assisted therapy, but it was more effective for BOP (P<0.000 1). In group C2, the improvement in PD and AL was significantly different from the improvement in SRP alone (P=0.000 5, P=0.000 2) and was accompanied by more GR (P=0.000 5).
CONCLUSIONS: In non-surgical treatment of severe and generalized periodontitis, SRP can achieve good therapeutic effect on sites with 4<
PD≤6 mm. For sites with PD>6 mm, the application of periodontal endoscopy can increase the effect, reducing PD and GR, which may be an effective supplement to the current non-surgical periodontal treatment.
目的 评估牙周内窥镜在辅助治疗年轻患者的重度广泛型牙周炎非手术治疗中发挥的作用。方法 观察了13例重度广泛型牙周炎患者738个位点，在经过牙周非手术治疗前后各项牙周指标的差异。根据所接受的治疗分为3组：A组龈下刮治术+根面平整术（SRP）治疗（n=7，408个位点）；B组内窥镜辅助下行SRP治疗（n=4，188个位点）；C组SRP治疗后3个月在内窥镜辅助下再次行SRP治疗（n=2，142个位点）。根据每个位点的基线PD值再将各组分为2个亚组：46 mm记为亚组2。记录各组的牙周探诊深度（PD）、附着丧失（AL）、牙龈退缩程度（GR）、探诊出血（BOP）。结果 治疗后3个月，A1组PD、AL和GR的改善程度比B1组更明显（P<0.05），但2组的BOP值则无明显差异；B2组的PD下降量显著高于A2组（P<0.001），并且BOP的改善情况优于A2组（P<0.000 1），GR值则大于A2组（P<0.000 1），但A2、B2组治疗前后AL的差异无统计学意义（P=
0.296 8）。C1组在内窥镜辅助治疗前后的PD、AL及GR均无明显差异，但治疗有效降低了BOP（P<0.000 1）。C2组PD以及AL值在内窥镜辅助治疗后有所改善，并且与仅行SRP治疗时相比，差异有统计学意义（P=0.000 5，P=
0.000 2），同时其GR更为明显（P=0.000 5）。结论 在使用非手术方式治疗年轻患者重度广泛型牙周炎时，对于4~6 mm深的牙周袋，仅采用单纯的SRP治疗已可以获得较好的治疗效果；对于大于6 mm深的牙周袋，采用牙周内窥镜辅助治疗时可以增加其疗效，这可能是对当前牙周非手术治疗方案的一个有效补充。.

For this systematic review, the authors evaluated and synthesized the available scientific evidence related to the effects of periodontal endoscopy on the treatment of periodontitis.
The authors searched PubMed, Embase, Cochrane Library, Chinese Scientific Journals database, China National Knowledge Infrastructure, and Chinese Medicine Premier\'s Wanfang database for articles about periodontal endoscopy that were published through January 2017. The authors considered the percentage of residual calculus, average treatment time, bleeding on probing (BOP), gingival inflammation (GI), and probing depth (PD) as outcome measures. The authors extracted data and performed meta-analyses for groups of articles for which it was appropriate.
The authors identified 8 articles as being suitable for this systematic review. The investigators of 3 studies reported results related to BOP and GI that revealed some advantages of periodontal endoscopy over traditional scaling and root planing (SRP). The investigators of 4 studies explored PD and found no difference between periodontal endoscopy and traditional SRP. The authors could not perform meta-analyses on the study results related to BOP, GI, or PD. The percentage of residual calculus after periodontal endoscope-aided debridement was significantly less than the percentage of residual calculus after traditional SRP (mean difference, -3.18; 95% confidence interval, -4.86 to -1.49; P = .002; heterogeneity I2 = 74%). The authors found that periodontal endoscopy took significantly more time than traditional SRP (mean difference, 6.01 minutes; 95% confidence interval, 4.23 to 7.8; P < .00001; heterogeneity I2 = 0%).
Periodontal endoscopy may provide additional benefits for calculus removal compared with traditional SRP, although it could take more time to perform. With respect to BOP, GI, and PD, the authors found no sufficient evidence to support the difference between the use of periodontal endoscopy and traditional SRP. The authors concluded that additional scientific research is required to assess the effects of periodontal endoscopy on the treatment of periodontitis.

OBJECTIVE: Endoscopic technology has been developed to facilitate imagery for use during diagnostic and therapeutic phases of periodontal care. The purpose of this study was to compare the level of subgingival calculus detection using a periodontal endoscope with that of conventional tactile explorer in periodontitis subjects.
METHODS: A convenience sample of 26 subjects with moderate periodontitis in at least 2 quadrants was recruited from the University of Minnesota School of Dentistry to undergo quadrant scaling and root planing. One quadrant from each subject was randomized for tactile calculus detection alone and the other quadrant for tactile detection plus the Perioscope ™ (Perioscopy Inc., Oakland, Cali). A calculus index on a 0 to 3 score was performed at baseline and at 2 post-scaling and root planing visits. Sites where calculus was detected at visit 1 were retreated. T-tests were used to determine within-subject differences between Perioscope™ and tactile measures, and changes in measures between visits.
RESULTS: Significantly more calculus was detected using the Perioscope™ vs. tactile explorer for all 3 subject visits (p<0.005). Mean changes (reduction) in calculus detection from baseline to visit 1 were statistically significant for both the Perioscope™ and tactile quadrants (p<0.0001). However, further reductions in calculus detection from visit 1 to visit 2 was only significant for the Perioscope™ quadrant (p<0.025), indicating that this methodology was able to more precisely detect calculus at this visit.
CONCLUSIONS: It was concluded that the addition of a visual component to calculus detection via the Perioscope™ was most helpful in the re-evaluation phase of periodontal therapy.

OBJECTIVE: The purpose of this study was to determine if the use of a periodontal endoscope improves periodontal outcomes of scaling/root planing when compared to scaling/root planing alone.
METHODS: Thirty subjects with moderate periodontitis were recruited from the University of Minnesota School of Dentistry. Of these, 26 completed the study. A randomized split mouth design was used to evaluate periodontal outcomes at 6 to 8 weeks and 3 month intervals after sites within 2 quadrants of each subject were scaled and root planed with or without the use of the Perioscope™. Paired t-tests were used to test whether there were within-patient differences in improvement between Perioscope™ and non-Perioscope™ sites as measured by periodontal measurements (probing depth, clinical attachment level) and indices of gingival inflammation, including bleeding on probing (BOP) and gingival inflammation (GI). P-values less than 0.05 were declared to be statistically significant.
RESULTS: Less BOP and GI were found in the Perioscope™ sites at visit 1 and visit 2. Reduction in pocket depth and clinical attachment loss was achieved for all sites but probing depth and clinical attachment level changes were found to be unrelated to the use of the Perioscope™. Mean probing depth (SD) was reduced from 5.29 mm (0.4) to 3.55 mm (0.8) in the Perioscope™ sites and 5.39 mm (0.5) to 3.83 mm (1.2) in non-Perioscope™ sites from baseline measurements to visit 2.
CONCLUSIONS: The adjunctive use of the periodontal endoscope improved periodontal outcomes with respect to gingival inflammation and bleeding upon probing. The adjunctive use of the Perioscope™ was not found to be superior to traditional scaling and root planing with regard to pocket depth reduction and clinical attachment loss.