Description

A total of thirty patients were included in the study, Inclusion Criteria: -

• Patients with stage III pericdontitis, according to the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) periodontal classification system .
• Medically free patients.
• Non-smokers
• Patients with good oral hygiene. Exclusion Criteria: -
• Pregnant or lactating females.
• Patients with systemic diseases that might affect periodontal health
• previous periodontal treatment within 6 months before baseline examination.
• prior antibiotic regimen use within 1 month before baseline examination All participants will receive oral hygiene instructions including toothbrushin, interdental cleaning, and plaque control behavior reinforcement with oral hygiene self-care regimens to be followed at home.
• On the conventional non-surgical periodontal therapy side, a power-driven piezo•electric ultrasonic scaling device with scaling tips will be used the majority of the time to debride subgingival biofilm and calculus. and manual standard gracey curette instruments will be used to refine residuals from root surfaces.
• Conversely, the treatment protocol of the minimally invasive non-surgical periodontal therapy side will be followed as in the previous study (5).
• Briefly. the root surface of teeth will be thoroughly debrided by a minimally invasive approach using specific thin and delicate piezo-electric scaling tips (Woodpecker � Tip P3. Am Perfect sp. z o .• � Poland) and manual miniature periodontal curettes {� Dent Solutions. Cairo. Egypt) for reducing periodontal tissue trauma. Adjunctive use of magnification loupes will be performed.
• Both modalities will be performed under local anesthesia.
• All patients will be recalled 1 and 3 months after tre.alment for re-ev.almtion and professional supra-gingival plaque control

study parameters are plaque index bleeding of probing periodontal pocket depth clinical attachment loss gingival index