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Does minimally invasive non-surgical therapy improve outcomes in splinted mandibular incisors? Results from a
Shaimaa Hamdy1,2, Mohammed Turky3,4, Ahmed Y Gamal5,6
1Department of Oral Medicine, Oral Diagnosis and Periodontology, Faculty of Dentistry, Nahda University, Beni Swef, Egypt. shimaa.hamdy@nub.edu.eg.
Background:
Conventional non-surgical periodontal therapy (CNST) is an effective method for managing mild to moderate periodontitis. However, in cases of severe periodontitis, CNST may leave residual pockets. Severe periodontitis, particularly in stages III and IV, often involves significant tooth mobility, which may require the use of a permanent splint. Minimally invasive non-surgical techniques (MINST) have been proposed to deliver better results and enhance patient satisfaction. However, current evidence does not decisively evaluate the outcomes of splinted teeth following MINST. Therefore, this research aimed to address the knowledge gap by assessing the clinical outcomes of MINST compared to CNST in the treatment of splinted teeth affected by stage III and IV periodontitis.
Methods:
A parallel-arm, single-blind randomized controlled trial was conducted on 39 patients (46 sites) with stage III-IV periodontitis and grade II-III mobility of mandibular incisors. Participants were randomly assigned to conventional non-surgical therapy (CNST) or minimally invasive non-surgical therapy (MINST), both of which included splinting. Outcomes were assessed at baseline, 3, and 6 months. The primary outcome was pocket reduction, assessed by changes in probing pocket depth (PPD) from baseline to follow-up. Secondary outcomes included pocket closure (PC), defined as the proportion of sites with PPD ≤ 4 mm and no bleeding on probing (BOP), derived from these measurements; clinical attachment level (CAL); defect bone fill (DBF); and patient satisfaction.
Results:
Both groups showed significant reductions in probing pocket depth and gains in CAL (p < 0.001). Pocket closure occurred more frequently in the MINST group (65.2%) compared to the CNST group (39.1%) at 6 months (p = 0.015). Radiographic bone fill improved significantly in both groups, with no intergroup difference. Patient satisfaction was similar (NPS: CNST = 38; MINST = 42; p = 0.39).
Conclusion:
Both MINST and CNST with splinting improved periodontal outcomes, but MINST achieved a higher rate of pocket closure, while radiographic bone fill and patient satisfaction were comparable between groups.
Trial Registration:
Current Controlled Trials: NCT06772506. The date of registration in the (2025-01-03) "Retrospectively registered".