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Evaluation of an ex vivo porcine model to investigate the effect of low abrasive airpolishing

Petersilka, Heckel, Koch, Ehmke, Arweiler

Petersilka, Heckel, Koch, Ehmke, Arweiler

Sun. 23 September 2018

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To assess the usability of pig jaws periodontal treatment model for low abrasive air polishing and to histologically gauge the effect of various instrumentation techniques.

Material and methods

- From 120 Pig mandibles, the buccal part of one molar was chosen randomly and fixed in a way allowing controlled instrumentation. 

- Four modes of instrumentation were evaluated.

Group A: Low Abrasive airpolishing using glycine of 25 μm (EMS Perio Powder, EMS, Nyon, Switzerland). 

Group B: Low Abrasive airpolishing using erythritol powder of 14 μm EMS PLUS Powder, EMS, Nyon, Switzerland). 

- EMS Air Flow Master was used with a standard handpiece at a distance of 5mm to the gingival tissue in a continuously sweeping way for 5 s like subgingival biofilm removal 

Group C:  Piezoceramic scaling using Perio Slim PS instrument (EMS)

- EMS Piezon Master was used at medium power and water setting

- The instrument was kept parallel to the root surface at a pressure of approx. 1 N for 10 s 

Group D: 7/8 Gracey Curette (Deppeler, Rolle, Switzerland) 

- Five strokes of curette applied with a pressure of approximately 3 N

Group E: Untreated biopsy samples served as negative control

- Following instrumentation, the soft tissue alongside the tooth was removed and graded.

1 - No lesion: undamaged epithelium and connective tissue

2 - Minor lesion: disruption of superficial epithelial layers, undamaged basal membrane

3 - Medium lesion: superficial layers of the epithelium removed, basal membrane partially damaged

4 - Severe lesion: epithelium and basal membrane completely removed, connective tissue exposed

Results

- Hand instrumentation had the most pronounced damage 

- Hand instrumentation and ultrasonic scaling caused higher tissue destruction  than both airpolishing powders

- Ultrasonics was slightly less traumatic than hand instrumentation with no statistically significant difference  

- Between the low abrasive airpolishing powders, glycine showed  slightly lesser destruction, however, no statistically significant difference was observed between glycine and erythritol

- The porcine model is apt for use in histological evaluation

Conclusion

- Pig jaws could be used to assess the histological effects of different instrumentations on periodontal tissues before conducting studies on humans 

- Low abrasive airpolishing powders had an overall low potential of soft tissue damage and could be used safely to remove biofilm subgingivally.

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