Pocket-X® Gel in non-surgical periodontal treatment

The Situation

An adult female patient (age 37 years, systemically healthy, non-smoker) in supportive periodontal therapy (Step 4 according to EFP guideline, first re-evaluation after active periodontal treatment 4 months before) presented with persistent periodontal pockets 4-6 mm with recurring bleeding on probing in posterior regions. The primary goal was to establish clinical periodontal health and periodontal stability, at the patient’s request preferably without means of surgical interventions.

The Approach

As part of regular supportive periodontal therapy, subgingival re-instrumentation of the still inflamed sites was planned. After recording of periodontal parameters, supra- and subgingival biofilm removal was performed using Airflow®/Perioflow® with Erythritol powder, followed by removal of the mineralised deposits using ultrasonic instruments. Pocket-X® Gel was then instilled in all periodontal pockets with probing depths ≥4 mm and bleeding on probing, or probing depths ≥5 mm.

The Outcome

In the present case study, it was shown that the adjunctive use of a thermosensitive gel containing hyaluronic acid in the form of Pocket-X® Gel improved the healing result after subgingival debridement during non-surgical periodontal treatment. Pocket-X® Gel has shown to exceed the commonly reported results on the reduction of probing depths and attachment level gain known from classical studies (e.g., Cobb, 1996).¹

Keys to Success

• Minimally invasive, atraumatic subgingival instrumentation
• Thorough biofilm removal
• Minimal tissue trauma
• Filling pockets completely with Pocket-X® Gel
• Instructing the patient on aftercare and compliance

Instruments and materials used

Instruments for biofilm control:

• Airflow®/Perioflow® with Erythritol powder (Airflow® plus)

Instruments for calculus removal (supra- and subgingival):

• Piezon® Handpiece with PSL/PSR instruments
• Optional supplementary at selected sites: Mini-five curettes

Rinsing /Irrigation:

• No additional irrigation was used

Adjunctive treatment:

• Pocket-X® Gel

Reference

1. Cobb CM: Annals of Periodontology 1996; 1(1): 443–90.