Amino acid buffered sodium hypochlorite (NaOCl) gel have been known to destroy the microbial biofilm. The use of NaOCl gel plus minimally invasive nonsurgical therapy (MINST) displayed exceptional clinical outcomes in patients with untreated periodontitis with deep periodontal pockets.

To examine the effectiveness of MINST of periodontal pockets with or without local treatment of NaOCl gel.

Overall, 40 untreated patients with severe/advanced, stage III/IV periodontitis and a slow/moderate rate of progression (grade A/B) were divided in 2 treatment groups as:

• Test group: MINST and NaOCl gel used for treatment of periodontal pockets
• Control group: MINST alone

Different clinical parameters - Gingival recessions (GR); Full-mouth plaque scores (FMPS) and bleeding on probing scores (BoP); probing depths (PD) and clinical attachment levels (CAL) were evaluated at starting and at 6 months following the therapy.

The decrease in PD at sites with PD ≥ 5 mm at baseline was considered as the primary outcome.

Statistically significant differences were found between the two groups concerning the variation in PD and CAL at 6 months. Number of locations with PD greater than equal to 5 mm and BoP (+) reduced considerably (p = 0.001), i.e. from 85.3 to 2.2% in the test group and 81.6 to 7.3% in the control group. At 6 months, statistically significant differences between both the groups were noted. A significant reduction in the likelihood of residual PDs ≥ 5 mm without and with BoP in test group as compared to control group was observed as displayed in the following table:

MINST usage may prove to be a clinically valuable approach for nonsurgical therapy of periodontal pockets. The usage of NaOCl gel along with MINST further adds up to improving the clinical outcomes than MINST alone.