A comparison of magnetostrictive and piezoelectric ultrasonic scaling devices: an in vitro study

Differences Between Two Devices With Function of Periopolishing and Piezoelectric Scaler: A Randomized Clinical Trial

Dental procedures often cause anxiety and apprehension in patients due to potential discomfort and pain. Understanding patient sensitivity and comfort is critical to providing effective dental care. The aim of this study was to compare patient and operator comfort between two devices with the function of periopolishing and piezoelectric scaler during guided biofilm therapy (GBT) sessions. A randomized controlled trial was conducted involving 20 patients and operators. Primary outcomes, including pain, sensitivity, and operator comfort, were assessed using a visual analog scale (VAS), while periodontal indices served as secondary outcomes. The results showed comparable levels of patient and operator comfort between the two devices, with higher airflow comfort reported for the Mectron Combi Touch and higher ultrasonic handpiece comfort showed for the EMS Prophylaxis Master. Both devices effectively reduced periodontal parameters without significant differences. These results indicate that both Mectron Combi Touch and EMS Prophylaxis Master offer viable options for efficient and patient-friendly periodontal treatment. The study provides valuable insights for improving patient experience and treatment outcomes in the dental office. Considerations for device selection based on clinical needs and patient comfort are discussed, as well as future perspectives for advancing preventive dental care. This research contributes to the ongoing topic of improving dental procedures to ensure optimal patient satisfaction and oral health outcomes. Trial Registration: ClinicalTrials.gov identifier: NCT05263622.

Effects of a new magnetostrictive ultrasonic scaler and a traditional piezoelectric ultrasonic scaler on root surfaces and patient complaints

Tooth wear and pain are the primary concerns of patients undergoing periodontal scaling. The aims of this study were to compare the effects of a new magnetostrictive ultrasonic scaler and a traditional piezoelectric ultrasonic scaler on tooth surface roughness and calculus removal and to determine their impacts on patient discomfort during supragingival cleaning. This article had two parts: an in vitro study and a clinical study. In the in vitro study, thirty teeth with subgingival calculus were randomly assigned to two scaling treatment groups: magnetostrictive scalers (n = 15) and piezoelectric scalers (n = 15). Surface roughness measurements were taken at baseline and after scaling, and the root samples were visualised by SEM after scaling. Additionally, a single-centre randomised split-mouth clinical trial was conducted. Eighty-five participants diagnosed with chronic gingivitis or periodontitis were randomly assigned to receive supragingival scaling. The magnetostrictive scaler was used in half of the mouths (n = 85), and the piezoelectric scaler was used in the other half of the mouths (n = 85). Data on pain, noise, and vibration were collected using a VAS questionnaire, and the operating time was recorded. In both in vitro and clinical studies, magnetostrictive scalers were reported to be more effective than piezoelectric scalers in removing dental deposits (P < 0.05). Additionally, the root surface after scaling with the magnetostrictive scaler was smoother than that after scaling with the piezoelectric scaler in the in vitro study (P = 0.02). SEM examination also revealed that fewer dental materials were lost after instrumentation with the magnetostrictive scaler than after instrumentation with the piezoelectric scaler. Piezoelectric scalers caused less discomfort to patients in terms of pain, noise, and vibration than magnetostrictive scalers (P < 0.05). According to this clinical study, the magnetostrictive scaler caused more discomfort during supragingival scaling than the piezoelectric scaler. Moreover, the magnetostrictive scaler was also more efficient and produced a smoother root surface with less material loss after scaling than the piezoelectric scaler, as demonstrated in the in vitro study.

Assessing the effect of piezoelectric ultrasonic scaler tip wear on root surface roughness under influence of various working parameters: A profilometric and atomic force microscopic study

Background

Assessing the effect of scaler tip wear on the root surface roughness using piezoelectric ultrasonic scaling device under influence of various working parameters, i.e. power setting, lateral force, and instrumentation time.

Materials and Methods

An experimental study was conducted using 160 single-rooted tooth samples divided into two groups of new (n = 80) and worn tips (n = 80). Samples were prepared to examine the root surface roughness after being instrumented by new and worn piezoelectric ultrasonic tips (8 new/8 worn) at different parameters. The erosion ratio (ER) of the new/worn tip was examined under an atomic force microscope and roughness over root surface was measured by a contact surface profilometer. One-way analysis of variance test, post hoc Tukey's test, and independent t-test were used for intragroup, pair-wise multiple comparisons and intergroup comparison of average roughness (Ra) value.

Results

A statistically significant difference was found between the ER of new and worn scaler tips (P < 0.001). Intragroup comparison between subgroups 1 and 8 showed a higher Ra value in both the groups (P < 0.005). There was a significantly higher Ra value of worn tips compared to new tips (P < 0.05). Significantly higher mean Ra value was shown when lateral force changed from 50 g to 100 g (P < 0.005).

Conclusions

Increasing value of power setting, lateral force, and instrumentation time caused more surface roughness in worn-out scaler tips compared to new scaler tips. Lateral force and instrumentation time proved to be a major factor influencing surface roughness.

Effect of nonsurgical periodontal therapy on salivary melatonin levels in patients with periodontal disease

Context

Periodontitis is an inflammatory disease in which periodontal tissues are damaged as a result of an imbalance in the oxidant/antioxidant systems. Melatonin is one hormone that controls circadian rhythms and is also an antioxidant and immune modulator.

Aim

The present study was aimed to evaluate the effect of scaling and root planing (SRP) on salivary melatonin levels (SM) in patients with periodontal disease.

Settings and Design

A single-center clinical trial was conducted to evaluate the effect of SRP on SM levels in patients with periodontal disease.

Materials and Methods

Forty-five participants of age 30-60 years were equally divided into three groups: 15 healthy participants, 15 participants with gingivitis, and 15 participants with periodontitis. Unstimulated salivary samples were collected from all the participants at baseline and 1 month after SRP from participants of gingivitis and periodontitis group and SM levels were determined by commercially available ELISA kit.

Statistical Analysis Used

Group comparisons were made using t-test. The level of significance was set at a P < 0.05 for all tests.

Results

SM levels were significantly lower in the chronic periodontitis group. There was a significant improvement in clinical parameters and SM levels in both chronic periodontitis and gingivitis groups after SRP.

Conclusion

This study determined that there is a negative correlation between SM levels and the severity of periodontal disease and showed a significant increase in SM levels after SRP, suggesting that melatonin might have a protective role against periodontal disease and can be considered as an effective biomarker.

Shear Bond Strength and Mode of Failure of Polypropylene Fibers in Orthodontic Flash-Free Adhesive

The purpose of this research is to evaluate the effects of magnetostrictive and piezoelectric scalers on the shear bond strength (SBS), failure mode of the polypropylene fiber adhesive brackets, and the load of both scaler tips. The adhesive precoated (APC) Flash-Free brackets were placed on the buccal surfaces of sixty maxillary first premolars, which were divided into three equal groups of 20 specimens each, following the control group (no scaling), the magnetostrictive group, and the piezoelectric group. All specimens were measured for SBS value by using a universal testing machine at a crosshead speed of 0.75 mm/minute. The mode of failure was examined under a×10 magnification light microscope digital camera and scores for the adhesive remnant index (ARI) were recorded and measured load between the magnetostrictive and piezoelectric groups. For statistical analysis, ANOVA and multiple comparison, as well as unpaired t-test and chi-square tests, at the 0.05 significance level were used. The results showed that the average SBS value of the control group was greater than that of the magnetostrictive group and the piezoelectric group. However, the SBS was not significantly influenced by ultrasonic instruments (p > 0.05). The ARI score and load showed no significant differences among the groups (p > 0.05). In conclusion, the SBS of the APC Flash-Free bracket wasn’t affected by using ultrasonic instrumentation around the base of the bracket.

The Effect of Ultrasonic Scaling and Air-Powder Polishing on the Roughness of the Enamel, Three Different Nanocomposites, and Composite/Enamel and Composite/Cementum Interfaces

We aimed to assess the effects of ultrasonic scaling and air-powder polishing on the roughness of enamel, three nanocomposites (Premise, Herculite Ultra, Harmonize), and composite/enamel and composite/cementum interfaces. Class V cavities were restored in 99 extracted third molars with one of the three nanocomposites and treated with ultrasonic scaler or air-powder polishing device (calcium carbonate or sodium bicarbonate powders). The roughness (Ra) of the investigated surfaces was measured with contact profilometer before and after treatment. The data were analyzed using repeated measures ANOVA. Specimens' Ra values before instrumentation were near the clinically acceptable 0.2 μm threshold. All techniques increased the roughness of the tested surfaces; however, the enamel was slightly affected. The mean Ra values after prophylaxis for composite, composite/cementum and composite/enamel surfaces were 0.32-0.55, 1.33-1.73, and 1.25-1.36, respectively. The extent of composite surface damage was material dependent. Premise surface was not altered by ultrasonic scaling significantly. Air-powder polishing with both powders produced a greater increase in surface roughness of composite resin and restorations margins than ultrasonic scaling. The Ra values after both types of air polishing for Herculite Ultra and Harmonize were approximately 1.5 and 2 times higher, respectively, than those after ultrasonic scaling (p < 0.05).

Controlled release of iodine from cross-linked cyclodextrin metal-organic frameworks for prolonged periodontal pocket therapy

Effective therapeutic system to periodontitis was designed using cross-linked cyclodextrin metal-organic framework (COF) as carrier for iodine and further suspended in hydroxyethyl cellulose gel as I2@COF-HEC hydrogel. Inclusion of iodine within the COF was demonstrated by SR-FTIR spectral and characteristic DSC and TGA changes. Molecular modelling identified the interaction of iodine with both COF central cavity and individual cyclodextrin moieties of COF. In vitro results of study demonstrated that iodine release in artificial saliva from I2@COF-HEC hydrogel could be extended up to 5 days, which was slower than I2@COF particles. Using an in vivo rat model of periodontitis, micro-computed tomography of alveolar bone morphology demonstrated that I2@COF-HEC hydrogel showed similar effects in decreasing periodontal pocket depth and alveolar bone resorption to minocycline ointment, a periodontitis antibiotic. The I2@COF-HEC hydrogel is a novel local delivery device of iodine as a broad spectrum antimicrobial use for treatment of periodontitis.

In vitro comparison of root surface roughness and bacterial adhesion following treatment with three different instruments

BACKGROUND

A novel device, piezoelectric 11 Gracey curet tip, reportedly combines benefits of a piezoelectric device and manual curet. The primary objective of this study was to compare root surface roughness outcomes between traditional manual curets and piezoelectric devices, as compared with this novel device. The secondary aim was to assess the level of adhesion of Streptococcus mutans on the root surface after instrumentation.

METHODS

The groups consisted of the following: 1) Gracey curet; 2) piezoelectric scaler; 3) piezoelectric 11 Gracey curet tip; and 4) untreated control. Root specimens were obtained from extracted human teeth and randomly assigned to each group. Surface roughness measurements (Ra and Rz) were taken with a profilometer before and after instrumentation. After instrumentation, root specimens were inoculated with S. mutans and biofilm was dislodged. Various dilutions of resuspended biofilm were incubated on blood agar plates and colony forming units (CFU) values were measured.

RESULTS

The experimental device resulted in significantly lower Ra and Rz compared with other groups (P < 0.01), and the Gracey curet was significantly lower than the piezoelectric tip and untreated control (P < 0.05). The Gracey curet and experimental device tip had significantly lower CFU values compared with the control (P < 0.05). There were no significant CFU value differences between the Gracey curet and both the piezoelectric and experimental device tips. There were no significant CFU differences between piezoelectric tip and both experimental device and control. There was no correlation between Ra and CFU values for Gracey curet, piezoelectric tip, or the control. However, correlation between Ra values and CFU approached significance for the experimental device (correlation = 0.66, P = 0.05).

CONCLUSIONS

Piezoelectric 11 Gracey curet tip is effective at resulting in a significantly smoother surface compared with traditional piezoelectric and hand instruments. CFU values with piezoelectric 11 Gracey curet tip were significantly lower than non-instrumented surfaces, but there were no significant differences compared with conventional methods.

Comparison of Root Surface Wear and Roughness Resulted from Different Ultrasonic Scalers and Polishing Devices Applied on Human Teeth: An In-Vitro Study

The aim of the present study was to compare the root surface wear and roughness, resulted from the professional dental hygiene instruments, including ultrasonic dental scalers, rubber prophy cups, and nylon bristle brushes, on the extracted human mandibular incisor teeth. Teeth (n = 80) were randomly assigned into eight groups according to the applied scaler type (Ma = Magnetostrictive, Pi = Piezoelectric), degree of power (M = Medium, F = Full), and angulation (0° and 45°). In the second stage, the specimens (n = 40) were further divided into two groups according to the applied polishing device (nylon bristle brush or rubber prophy cup). Laser scanner and contact profilometer devices were used for the surface analysis. Both ultrasonic instruments tested in our study produced rougher surfaces when full power was used at a 0° angle (p < 0.01). The highest wear (0.82 ± 0.07 mm3) and roughness values (0.30 ± 0.01 µm) were detected in the PiF0 group. Polishing performed with a rubber prophy cup resulted in almost twice the wear as well as a smoother surface when compared to polishing performed with a nylon bristle brush (p < 0.001). Variations in the application parameters of ultrasonic scalers and the type of polishing instrument might lead to significantly different root-surface characteristics.