The effect of instrumentation technique on the outcome of treatment for periodontitis

Paterson, Michael (2021) The effect of instrumentation technique on the outcome of treatment for periodontitis. MSc(R) thesis, University of Glasgow.

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Objective: This study sought to investigate clinical, systemic inflammatory and patient-reported outcomes comparing non-surgical treatment for periodontal disease using exclusively hand instruments, ultrasonic instruments or a combination approach. Cost implications of periodontal treatment within a UK NHS Dental Hospital are described.
Methods: Fifty-five patients were treated between two studies (randomised controlled trial and cohort study) for generalised periodontitis using non-surgical periodontal therapy using hand instruments (HI), ultrasonic instruments (UI) or a combination approach (CI) with a 90 day follow up. Comparative analysis was carried out with respect to instrumentation technique at day 90. Success of treatment was objectively assessed against published criteria. Financial implications and patient reported outcomes of non-surgical periodontal therapy are explored by descriptive analyses.
Results: Non-surgical periodontal treatment was clinically effective across all instrumentation approaches at Day 90 follow up (p<0.05). Inter-group comparisons demonstrated no clinically significant differences in clinical or systemic inflammatory outcomes. UI required less time to complete treatment compared to HI, mean difference 21.51 minutes (p<0.003; 95% CI 9.22 to 34.62) Objective criteria of success demonstrated a lack of agreement in defining successful clinical endpoints. UI had least associated reprocessing and maintenance costs.
Conclusions: Clinical and systemic inflammatory outcomes were comparable between HI, UI and CI. Comparing HI and UI, UI had a shorter treatment time. UI was least costly on a recurring basis. Patients reported satisfaction with periodontal treatment.

Item Type: Thesis (MSc(R))
Qualification Level: Masters
Keywords: hand instruments, periodontal treatment, randomized controlled trial, clinical outcomes, patient reported outcomes, systemic inflammation, ultrasonic instruments, combination approach.
Subjects: R Medicine > RK Dentistry
Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
Supervisor's Name: Culshaw, Professor Shauna and Sherriff, Dr. Andrea
Date of Award: 2021
Depositing User: Mr Michael Paterson
Unique ID: glathesis:2021-81911
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 11 Jan 2021 09:53
Last Modified: 12 Jan 2021 15:04
Thesis DOI: 10.5525/gla.thesis.81911
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