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Guided Biofilm Therapy Versus Conventional Polishing for Tooth Re-Staining

28. august 2026 oppdatert av: Mehmet Ali Tuna, Ataturk University

Guided Biofilm Therapy Versus Conventional Polishing for Extrinsic Tooth Re-Staining, Patient Comfort, and Procedure Time: A Randomized Split-Mouth Trial

This study compared Guided Biofilm Therapy with conventional polishing in adults with visible extrinsic tooth staining. Each participant received Guided Biofilm Therapy on one side of the mouth and conventional polishing on the other side.

The study evaluated whether the two methods differed in the amount of tooth re-staining after treatment, patient discomfort during the procedures, and total procedure time. Tooth color was measured with a spectrophotometer immediately after treatment, at 1 month, and at 2 months. Patient discomfort was recorded using a visual analog scale, and procedure time was measured with a stopwatch.

A total of 34 participants completed the study.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

This randomized split-mouth clinical trial was conducted in adults with visible extrinsic tooth staining. The aim was to compare Guided Biofilm Therapy (GBT) with conventional polishing in terms of post-procedural extrinsic tooth re-staining, patient discomfort, and procedure time.

Each participant received both interventions. One side of the mouth was assigned to GBT and the contralateral side to conventional polishing. The right-left allocation of the interventions was determined by randomization, with the two allocation sequences equally distributed among participants.

In the GBT intervention, dental biofilm was first disclosed and then removed using an air-water-powder system with a low-abrasive erythritol-based powder. Supragingival ultrasonic instrumentation was performed where necessary. In the conventional polishing intervention, supragingival instrumentation was followed by mechanical polishing with a brush and polishing paste.

Tooth color was assessed using a SpectroShade Micro spectrophotometer and the CIELAB color system. Measurements were performed immediately after treatment at baseline (T0), at 1 month (T1), and at 2 months (T2). Color change between assessment periods was calculated using ΔE*ab values.

Patient-reported discomfort was assessed immediately after each half-mouth procedure using a visual analog scale. Total procedure time for each intervention was recorded with a stopwatch.

The primary outcome was color change from immediately after treatment to 2 months. Secondary outcomes included color change from immediately after treatment to 1 month, color change from 1 month to 2 months, patient discomfort, and procedure time.

A total of 34 participants completed all study visits and follow-up assessments.

Studietype

Intervensjonell

Registrering (Faktiske)

34

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Tyrkia (Türkiye)
    • Erzurum
      • Erzurum, Erzurum, Tyrkia (Türkiye), 25080
        • Ataturk University

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Ja

Beskrivelse

Inclusion Criteria:

  • Age over 18 years.
  • Willingness to participate in the study and provision of written informed consent.
  • Good general health with no systemic disease.
  • Clinical presence of extrinsic staining on tooth surfaces at a level warranting professional polishing.
  • Right-handed tooth brushing.
  • No professional dental cleaning within the previous 6 months.

Exclusion Criteria:

  • Age under 18 years.
  • Diagnosis of periodontitis.
  • Current smoking.
  • Antibiotic use within the previous 3 months.
  • Presence of acute periodontal disease.
  • Allergy to polishing powders, specifically erythritol.
  • Presence of a communicable disease.
  • Teeth to be measured with restorations, caries, excessive wear, or structural defects that could affect measurement.
  • Active orthodontic treatment.
  • Developmental or structural anomalies affecting enamel and potentially increasing susceptibility to extrinsic staining, including hypomineralization, amelogenesis imperfecta, or dentinogenesis imperfecta.
  • Severe dental crowding preventing standardized measurements.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Crossover-oppdrag
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Sequence A: Right GBT / Left Conventional Polishing
Participants assigned to Sequence A received Guided Biofilm Therapy on the right half of the mouth and conventional polishing on the left half of the mouth. Both interventions were performed within the split-mouth study design.
Fremgangsmåte: Guided Biofilm Therapy
Dental biofilm was first disclosed to guide treatment. Supragingival biofilm and extrinsic staining were then removed using an air-water-powder system with a low-abrasive erythritol-based powder. Supragingival ultrasonic instrumentation was performed where necessary, followed by final surface control.
Andre navn:
  • GBT
Fremgangsmåte: Conventional Polishing
Supragingival instrumentation was performed as needed, followed by mechanical polishing with a prophylaxis brush and polishing paste at 2500 to 3000 rpm. The procedure was completed with final surface control.
Andre navn:
  • CONV
Eksperimentell: Sequence B: Right Conventional Polishing / Left GBT
Participants assigned to Sequence B received conventional polishing on the right half of the mouth and Guided Biofilm Therapy on the left half of the mouth. Both interventions were performed within the split-mouth study design.
Fremgangsmåte: Guided Biofilm Therapy
Dental biofilm was first disclosed to guide treatment. Supragingival biofilm and extrinsic staining were then removed using an air-water-powder system with a low-abrasive erythritol-based powder. Supragingival ultrasonic instrumentation was performed where necessary, followed by final surface control.
Andre navn:
  • GBT
Fremgangsmåte: Conventional Polishing
Supragingival instrumentation was performed as needed, followed by mechanical polishing with a prophylaxis brush and polishing paste at 2500 to 3000 rpm. The procedure was completed with final surface control.
Andre navn:
  • CONV

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Tooth Color From Immediately After Treatment to 2 Months Assessed by CIELAB ΔE*ab Using a SpectroShade Micro Spectrophotometer
Tidsramme: Immediately after treatment (Day 1) and at 2 months
Tooth color was measured using a SpectroShade Micro spectrophotometer according to the CIELAB color system. Color change between immediately after treatment (T0) and 2 months (T2) was calculated as ΔEab using the formula: ΔEab = [(ΔL*)² + (Δa*)² + (Δb*)²]^(1/2). ΔEab is a continuous color-difference measure, with 0 indicating no color difference and higher values indicating greater color change. Therefore, lower ΔEab values indicate greater color stability.
Immediately after treatment (Day 1) and at 2 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Tooth Color From Immediately After Treatment to 1 Month Assessed by CIELAB ΔE*ab Using a SpectroShade Micro Spectrophotometer
Tidsramme: Immediately after treatment (Day 1) and at 1 month
Tooth color was measured using a SpectroShade Micro spectrophotometer according to the CIELAB color system. Color change between immediately after treatment (T0) and 1 month (T1) was calculated as ΔEab using the formula: ΔEab = [(ΔL*)² + (Δa*)² + (Δb*)²]^(1/2). ΔEab is a continuous color-difference measure, with 0 indicating no color difference and higher values indicating greater color change. Therefore, lower ΔEab values indicate greater color stability.
Immediately after treatment (Day 1) and at 1 month
Change in Tooth Color From 1 Month to 2 Months
Tidsramme: At 1 month and 2 months
Tooth color was measured using a SpectroShade Micro spectrophotometer according to the CIELAB color system. Color change between 1 month (M1) and 2 months (M2) was calculated as ΔE*ab using the formula: ΔE*ab = [(ΔL*)² + (Δa*)² + (Δb*)²]^(1/2). Lower ΔE*ab values indicate less color change.
At 1 month and 2 months
Patient-Reported Discomfort Assessed Using a 10-cm Visual Analog Scale
Tidsramme: Immediately after completion of each half-mouth intervention (Day 1)
Patient-reported discomfort was assessed immediately after each half-mouth procedure using a 10-cm visual analog scale ranging from 0 to 10, where 0 indicated no discomfort and 10 indicated unbearable discomfort. The score reflected the overall perception of pain or sensitivity, heat, pressure or vibration, and discomfort related to water spray or aerosol. Lower scores indicate greater patient comfort.
Immediately after completion of each half-mouth intervention (Day 1)
Total Procedure Time Measured Using a Digital Stopwatch
Tidsramme: Periprocedural
Total procedure time for each intervention was recorded using a digital stopwatch. Timing began with the first clinical step of the relevant intervention and ended after completion of the final surface check. Patient preparation, isolation, and oral hygiene instruction were excluded. Procedure time was recorded in minutes and seconds, with shorter times indicating greater procedural efficiency.
Periprocedural

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Ataturk University

Etterforskere

  • Studieleder: Recep Orbak, DDS, PhD, Ataturk University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

5. januar 2026

Primær fullføring (Faktiske)

1. juni 2026

Studiet fullført (Faktiske)

8. juni 2026

Datoer for studieregistrering

Først innsendt

18. august 2026

Først innsendt som oppfylte QC-kriteriene

28. august 2026

Først lagt ut (Faktiske)

2. september 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

2. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

28. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 926

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

JA

IPD-planbeskrivelse

De-identified individual participant data underlying the results reported in the published article will be shared. These data may include participant-level demographic variables, treatment allocation, ΔE*ab color-change outcomes, visual analog scale scores, and procedure-time data necessary to reproduce the reported analyses.

IPD-delingstidsramme

Data and supporting information will be available beginning 6 months after publication of the study results and will remain available for 5 years.

Tilgangskriterier for IPD-deling

Qualified researchers may request access from the corresponding author for scientifically justified research purposes. Requests should include a brief research proposal describing the purpose of the analysis and the data requested. Access will be considered following review of the proposed use and applicable ethical and confidentiality requirements. Only de-identified data relevant to the approved request will be shared electronically.

IPD-deling Støtteinformasjonstype

  • STUDY_PROTOCOL

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

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