Non-surgical periodontal therapy: evidence on manual scaling and ultrasonic debridement

Abstract

The objective of this study is to analyze and synthesize scientific evidence regarding the performance of scaling and root planing (SRP) and ultrasonic debridement (UD) in the control of inflammatory periodontal disease. This study is a narrative literature review conducted using the descriptors “manual scaling,” “ultrasonic debridement,” “non-surgical periodontal therapy,” “periodontal scaling,” “periodontitis,” and “periodontal disease,” according to DeCS. The search was carried out in the SciELO, PubMed, and BVS databases, covering publications from 2000 to 2025. Original articles, clinical trials, and systematic reviews comparing both approaches in patients with periodontitis were included, while studies without comparative data or addressing other therapeutic modalities were excluded. Both techniques are effective in reducing periodontal inflammation, although they present distinct characteristics. Manual scaling provides greater precision in hard-to-reach areas, whereas ultrasonic debridement offers faster treatment and improved patient comfort. Evidence also suggests that combining both strategies may enhance clinical outcomes. It is concluded that the choice of technique should be individualized, taking into account the clinical condition, the practitioner’s expertise, and patient preference, in order to optimize therapeutic effectiveness and the overall periodontal treatment experience.

Keywords: Ultrasonic debridement; Manual scaling; Periodontal scaling; Non-surgical periodontal therapy; Periodontal disease; Periodontitis.