Comparative analysis between a modified ultrasonic tip and hand instruments on clinical parameters of periodontal disease

Ultrasonic debridement of contaminated facial wounds

Contaminated facial wounds can be debrided with the Piezon ultrasonic scaler. The fine scaler tip provides efficient, rapid, precise and thorough removal of ingrained subdermal dirt and grit without the loss of viable facial tissue.

Position paper: sonic and ultrasonic scalers in periodontics. Research, Science and Therapy Committee of the American Academy of Periodontology

Ultrasonic and sonic scalers appear to attain similar results as hand instruments for removing plaque, calculus, and endotoxin. Ultrasonic scalers used at medium power seem to produce less root surface damage than hand or sonic scalers. Due to instrument width, furcations may be more accessible using ultrasonic or sonic scalers than manual scalers. It is not clear whether root surface roughness is more or less pronounced following power-driven scalers or manual scalers. It is also unclear if root surface roughness affects long-term wound healing. Periodontal scaling and root planing includes thorough calculus removal, but complete cementum removal should not be a goal of periodontal therapy. Studies have established that endotoxin is weakly adsorbed to the root surface, and can be easily removed with light, overlapping strokes with an ultrasonic scaler. A significant disadvantage of power-driven scalers is the production of contaminated aerosols. Because ultrasonics and sonics produce aerosols, additional care is required to achieve and maintain good infection control when incorporating these instrumentation techniques into dental practice. Preliminary evidence suggests that the addition of certain antimicrobials to the lavage during ultrasonic instrumentation may be of minimal clinical benefit. However, more randomized controlled clinical trials need to be conducted over longer periods of time to better understand the long-term benefits of ultrasonic and sonic debridement.

Working parameters of a magnetostrictive ultrasonic scaler influencing root substance removal in vitro

This study assessed defect depth and volume resulting from root instrumentation using a magnetostrictive ultrasonic scaler with a slim scaling tip (P 12) in vitro. Combinations of the following working parameters were analyzed: lateral forces of 0.5 N, 1 N, and 2 N; tip angulations of 0 degrees, 45 degrees, and 90 degrees; power settings of low, medium, and high; and instrumentation time of 10, 20, 40, and 80 seconds. Defects were quantified using a 3-dimensional optical laser scanner. Lateral force had the greatest influence on defect volume compared to tip angulation and power setting (beta-weights 0.53+/-0.04, 0.17+/-0.04, and 0.19+/-0.04, respectively). Lateral force and tip angulation had similar effects on defect depth, but both effects were greater compared to power setting (beta-weights 0.43+/-0.04, 0.49+/-0.04, and 0.19+/-0.04, respectively). The various combinations of the assessed working parameters showed synergistic effects resulting in a wide range of defect depths (14.1+/-1.7 microm to 410.5+/-51.1 microm) and volumes (0.0084+/-0.0057 mm3 to 1.3+/-0.079 mm3). Severe root damage (defect depth >50 microm) at 40 seconds instrumentation time occurred under most combinations of lateral force, angulation, and power settings. The only exceptions were combinations of: 1) 0 degrees angulation, 0.5 N and 1 N lateral force at any power setting and 2) 45 degrees angulation, 0.5 N lateral force at low and medium power setting. The efficacy of the assessed magnetostrictive ultrasonic scaler may be adapted to the various clinical needs by adjusting the lateral force, tip angulation, and power setting.

Fluoride use in periodontal therapy: a review of the literature

Although the relationship between fluoride and dental caries has been widely studied and definitively determined, the relationship between fluoride and periodontal health and disease is not clear. Conflicting studies in the literature either suggest routine fluoride usage as an adjunct to conventional periodontal therapy or argue against topical fluoride use on periodontally involved teeth. This review summarizes the literature that addresses the utility of fluoride in patients with periodontal disease and aims to advance a rational criterion for the use of fluorides in the management of periodontal diseases.

The bactericidal effects of dental ultrasound on Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. An in vitro investigation

This study investigated the possible bactericidal acoustic effects of the dental ultrasonic scaler. Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis suspensions, were subjected to the vibrations of a Cavitron P1 insert for 2.5 and 5.0 min in an acoustically-simulated pocket model and the survivors enumerated. The extent of any cavitation occurring within the pocket model to which the statistically significant bactericidal activity observed might be attributed, was determined by 'sonoluminescence', which was then investigated by photomultiplication techniques. However, these failed to detect any sonoluminescence within the pocket space and, moreover, the necessary deflection of the water coolant away from the insert tip, to avoid flooding of the experimental pocket, proved to result in temperatures of 47.6 degrees C and 52.3 degrees C at the respective time intervals, and thereby constituted an alternative possible bactericidal mechanism. Examination of the effects of such temperature changes on the target bacteria then revealed statistically significant differences in the viable counts of both microorganisms after 5.0-min periods, and as such were comparable to those previously detected in relation to the pocket model. Whilst it must be presumed that the bacteriolytic effect observed in the main investigation was due to the incidental temperature changes, in the absence of acoustic cavitation the influence of any associated acoustic microstreaming cannot be discounted. Further investigations to assess the bactericidal potential of acoustic phenomena using a modified experimental to exclude any hyperthermic effects are therefore necessary.