Efficacy of therapeutic ultrasound as an adjunct to periodontal therapy in cats with early-stage periodontal disease

Periodontal disease is the most prevalent inflammatory condition in cats, and early therapeutic intervention is critical to prevent progression to irreversible tissue destruction. Therapeutic ultrasound (TU) has demonstrated periodontal regenerative effects in canine and human models, yet its clinical efficacy in feline patients remains unclear. This study evaluated the adjunctive benefit of TU, alone or combined with chlorhexidine, in cats with early-stage periodontal disease. Twenty-one client-owned cats (age 11 months–4 years; weight 3.0–4.9 kg) diagnosed with American Veterinary Dental College (AVDC) stage 1–2 periodontal disease were randomly assigned to chlorhexidine alone (CLX, n = 7), TU (n = 7), or combined therapy (CLX+TU, n = 7). All cats underwent professional scaling under general anesthesia on day 0, followed by once-daily treatments for seven days. Periodontal parameters, including probing pocket depth (PPD), gingival index (GI), and plaque index (PI), were recorded on days 0 and 8, together with gingival surface temperature obtained via infrared thermography, Colorado Pain Scale scores, and plasma TNF-α, IL-1β, and IL-6 concentrations. Significant improvements in periodontal measures were observed in both TU and CLX+TU groups compared with CLX (ΔPPD −0.82 ± 0.67 and −0.57 ± 0.33 vs +0.13 ± 0.50; ΔGI −0.80 ± 0.71 and −0.82 ± 0.63 vs −0.19 ± 0.52; ΔPI −0.85 ± 0.80 and −0.57 ± 0.69 vs +0.01 ± 0.67). Gingival temperature decreased markedly in TU (−2.02 ± 1.48 °C) and CLX+TU (−2.41 ± 1.53 °C) but not in CLX (−0.03 ± 1.70 °C). Cytokine concentrations and pain scores showed no significant between-group differences. These findings indicate that adjunctive TU enhances short-term improvements in periodontal parameters and reduces gingival inflammation in cats with early-stage disease, offering a practical non-invasive addition to routine dental care.