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One-Stage Full Mouth Instrumentation (OSFMI): Clinical Outcomes of an Innovative Protocol for the Treatment of Severe Periodontitis

Mensi M, Feres M, Calza S, Sordillo A, Scotti E, Garzetti G

Journal of the International Academy of Periodontology 22 (0) :1-8 (2020)

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Abstract

Aims: This case series study aimed to assess the clinical outcomes of a novel protocol for the treatment of patients with severe periodontitis.

Materials and Methods: Twenty (20) patients with severe periodontitis underwent a single session of One-Stage Full-Mouth Instrumentation (OSFMI) involving supra- and sub-gingival air-polishing with erythritol and chlorhexidine powder and ultrasonic root surface debridement and calculus removal, in association with systemic amoxicillin and metronidazole. Pocket Probing Depth (PPD), Clinical Attachment Level (CAL), Recession (REC), Bleeding on Probing (BOP) and Plaque Index (PI) were collected at baseline (T0), 6 weeks (T1), 3 months (T2) and 6 months (T3).

Results: At 6 months, 30% of subjects reached the primary clinical endpoint (≤ 4 sites with PD ≥ 5 mm). The percentage of BOP decreased from 49.08 (CI95% 36.06; 62.1) at T0 to 12.97 (CI95% 7.57; 18.37) at T3. The mean number pockets with PPD≥ 5 mm and PPD≥ 7 mm decreased significantly, from 46.0 and 20.6 at T0 to 11.5 and 2.8 at T3 respectively (p < 0.001).

Conclusions: The OSFMI protocol led to clinical results comparable to those obtained with traditional SRP. Researchers are encouraged to test this protocol in randomized clinical trials with longer periods of observation.

Keywords

severe generalized periodontitisactive treatmentair-polishingnon-surgical therapyperiodontal treatmentOSFMIerythritolfull-mouth instrumentation

Citazione

Mensi M, Feres M, Calza S, Sordillo A, Scotti E, Garzetti G. One-Stage Full Mouth Instrumentation (OSFMI): Clinical Outcomes of an Innovative Protocol for the Treatment of Severe Periodontitis. Journal of the International Academy of Periodontology. 2020;22(0):1-8.

Study Highlights

This case series introduced the OSFMI (One-Stage Full-Mouth Instrumentation) protocol for severe periodontitis treatment. Key findings:

  • Protocol: Single-session full-mouth treatment combining supra/subgingival air-polishing (erythritol + CHX powder) + ultrasonic debridement + systemic antibiotics (AMX 500mg + MTZ 250mg, 7 days)
  • Treatment time: ~3-4 hours per session
  • Primary outcome: Mean sites with PPD ≥5mm reduced from 46.0 to 11.5 at 6 months (p<0.001)
  • BOP reduction: From 49.08% to 12.97% (approaching the 10% low-risk threshold)
  • Pocket closure: 76.39% of sites with PPD ≥5mm reduced to ≤4mm
  • Deep pockets: Sites with PPD ≥7mm reduced from 20.6 to 2.8

First study to apply full-mouth supra- and subgingival air-polishing as primary instrumentation (not adjunct to SRP) in active periodontal therapy.