Peer Review #2 of "The effect of supragingival glycine air polishing on periodontitis during maintenance therapy: a randomized controlled trial (v0.2)"

Abstract

Background. Glycine air polishing has been proved to be safe, comfortable and time-saving.Whether it could substitute ultrasonic scaling to remove dental plaque biofilm during periodontal maintenance remain unclear. The purposes of this study were to evaluate the effect of supragingival glycine air polishing on the subgingival periodontal pathogens during maintenance therapy and to check the association of periodontal pathogens and clinical parameters. Methods. Twenty-three chronic periodontitis patients during their maintenance therapy were enrolledin the 12-week study. According to randomized split-mouth design, the test side was treated with supragingival glycine (65μm) air polishing (SGAP), while the control side was treated with supragingival ultrasonic scaling and polishing with rubber-cup(SUSP). Clinical examination including plaque index(PLI),probing depth(PD), bleeding index(BI) were performed at baseline and 12 weeks posttreatment.Sampling of the subgingival plaque at each investigational site (mesiobuccal site of the mandibular first molar) was performed at baseline and 2, 4, 8, 12 weeks after maintenance treatment. Four periodontal pathogens including Porphyromonas gingivalis , Tannerella forsythia, Treponema denticola and Fusobacterium nucleatum were detected by 16S rDNA polymerase chain reaction (PCR). Results. Clinical status generally improved after treatment in both groups. PLI in both groups, PD in SGAP group and bleeding on probing (BOP) (%) in SUSP group significantly decreased after treatment (p <0.05). There was no significant difference of clinical parameters between two groups before and after treatment. The detection rates of P. gingivalis , T. denticola in both groups, T. forsythia in SUSP groupand F. nucleatum in SGAP group decreased after maintenance treatment in both groups, although no significant difference was found. And it rebound to baseline level at 12 weeks after maintenance treatment. There was no significant difference between SGAP group and SUSP group at any time point. T. denticola-positive sites had significantly greater BI than T.denticola-negative sites (p <0.05). Discussion. Supragingival glycine air polishing had reliable effect in removing subgingival dental plaque biofilm during maintenance period. And three months may be a proper maintenance interval for pockets not more than 5 mm.