Transforming Subgingival Scaling: Short-Term Efficacy of No-Incision Micro-Flap Technique in Periodontal Treatment.

内容摘要

Conventional subgingival scaling and root planing (SRP) is typically performed without direct visualization, relying solely on tactile feedback, which limits the efficacy of calculus removal-particularly in deeper periodontal pockets. This study aimed to introduce and evaluate the no-incision micro-flap technique (NMFT), a four-handed, non-surgical modification designed to enhance subgingival visibility without requiring additional equipment such as a periodontal endoscope. In this split-mouth randomized controlled trial, 20 patients with generalized chronic periodontitis (Stage II-III) underwent NMFT-aided SRP on one side and conventional SRP on the contralateral side. Periodontal parameters, including probing depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP), were assessed at baseline, 6 weeks, and 3 months post-treatment. A total of 1,629 sites with baseline PD &#x2265; 4 mm were analyzed. At 3 months, the NMFT group demonstrated a significantly greater mean PD reduction compared to the control group (between-group difference: 0.5 mm; 95% CI: 0.26-0.81; P = 0.007, with the most pronounced effect observed in moderate pockets (4-6 mm), where an additional 0.7 mm reduction was achieved (P < 0.001). BOP rates were also significantly lower in the NMFT group in both 6 weeks (between-group difference = 7.2%, P = 0.028) and 3 months (between-group difference = 9.1%, P = 0.003). However, no significant inter-group differences in CAL gain were found. These findings indicate that NMFT enhances short-term SRP efficacy by improving visualization and debridement thoroughness, particularly in shallow-to-moderate pockets, offering a practical and accessible alternative to conventional blind SRP in resource-limited settings. Larger-scale validation is warranted to support its broader clinical adoption.