Aim: The aim of this randomized control clinical trial was to compare the soft tissue response to mechanical root instrumentation procedures performed using periodontal curettes with different-sized working parts.
Materials and methods: Twenty patients affected by Stage 3 Grade B periodontitis – a total of 109 teeth – were treated with either Mini-Five Gracey Curettes (MFC) or Conventional Gracey Curettes (CGC). Measurements were performed by a blinded examiner at baseline and at 6 weeks. Outcome measurements included pocket depth (PD), recession depth (RD), and difference in RD (∆RD).
Results: The use of MFC significantly reduced soft tissue shrinkage (1.5 ± 1 vs 2.4 ± 1.3; difference: -0.9 mm; P < 0.001). Patients in the MFC (test) group experienced lower gingival recession (GR), especially in both thin (2 ± 0.4 mm vs 3.1 ± 0.5 mm; difference: -1.1; P < 0.001) and medium (1.6 ± 0.5 mm vs 2.6 ± 0.6; difference: -1 mm; P = 0.010) periodontal phenotypes. Severe periodontal pockets (PD ≥ 7 mm) of patients in the MFC group experienced significantly lower soft tissue shrinkage than those in the CGC (control) group, regardless of periodontal phenotype.
Conclusion: The use of MFC resulted in a greater PD reduction and lower rate of GR in the short term. Nonsurgical periodontal treatment performed with CGC led to more soft tissue shrinkage, particularly when performed in patients with a thin periodontal phenotype.