Piezoled ultrasonic scaler

All subjects underwent an initial phase of nonsurgical periodontal therapy, which included education and instruction on proper oral hygiene, removal of supra‐ and subgingival deposits with piezoelectric ultrasonic instruments (PiezoLED ultrasonic scaler with Piezo Scaler tip 203 [KaVo Dental]), followed by scaling and root planing of sites with a PD of ≥5 mm, performed under local anesthesia (Ultracain©) with Gracey curettes (Hu‐Friedy).

Around 4 weeks prior to BS, patients were recalled for baseline examination by blinded experienced (RG) and periodontal therapy according to the randomized allocation done by an experienced therapist (ACK). All patients, regardless of allocation, received motivation and instruction in proper oral hygiene, which was reinforced at each visit. Subjects in TG received non-surgical periodontal therapy, i.e., the removal of supra- and subgingival deposits using piezoelectric ultrasonic instruments (PiezoLED ultrasonic scaler with Piezo Scaler tip 203 (KaVo dental, Biberach, Germany)), followed by scaling and root planning of sites with PD ≥ 5 mm under local anesthesia (Ultracain©, Hoechst, France) using Gracey curettes (Hu-Friedy, USA) and polishing with mechanical brush and professional toothpaste (Proxyt RDA 7 Ivoclar Vivadent). CG subjects received low-intensive supragingival plaque removal with a mechanical brush and professional toothpaste (Proxyt RDA 7 Ivoclar Vivadent). At 3 and 6 months after BS, patients we recalled for periodontal evaluation at the Dental Clinic and for evaluating systemic health at the Department of Abdominal Surgery. At the end of the study period, all patients in CG received non-surgical periodontal therapy, while patients in TG had repeated periodontal therapy or were referred for periodontal surgical therapy as necessary.