Impact of Surgical Microscopes Versus Ergonomic Loupes (Admetec™) on Root Planing Precision and Clinical Outcomes in Periodontal Therapy: A Randomized Controlled Trial

Abstract Aim: Professional mechanical plaque removal is central to periodontal therapy, yet limited visualization may affect the treatment efficacy. Magnification devices may enhance root surface debridement, though comparative evidence remains limited. This trial compared clinical outcomes of root planing performed under a surgical operating microscope (SOM) versus ergonomic loupes (Admetec™) in Stage II/III, Grade B/C periodontitis patients over 4 weeks. Methods: This single-blinded randomized controlled trial included 60 systemically healthy adults (25–55 years) with Stage II/III, Grade B/C periodontitis. Participants were allocated to SOM ( n = 30) or loupes ( n = 30) groups. The primary outcome was probing pocket depth (PPD); secondary outcomes included plaque index (PI), gingival index (GI), and early wound healing index (EWHI). Measurements were recorded at baseline, 2 weeks (EWHI), and 4 weeks. Intra-examiner reliability was high (ICC >0.85). Statistical analysis used paired and independent t tests ( α = 0.05). Results: Both groups showed significant intra group PPD reduction from baseline to 4 weeks (SOM: 7.30 ± 1.42 to 3.87 ± 0.94 mm; loupes: 6.77 ± 1.17 to 3.50 ± 0.63 mm; both P < 0.001). SOM showed intra group improvements in PI ( P = 0.005) and GI ( P = 0.003), whereas the loupes group did not show intra group improvements. However, inter group differences were not statistically significant for any outcome (PPD at 4 weeks: mean difference 0.37 mm, P = 0.081). EWHI scores were similar between groups ( P = 0.591). Conclusions: Both SOM and ergonomic loupes significantly improved periodontal parameters, with no clinically or statistically significant inter group differences. While SOM produced greater intra group improvements, the overall short-term outcomes were comparable. Ergonomic loupes remain a practical and cost-effective option for routine periodontal therapy. Long-term studies are needed to evaluate sustained differences.