Comparative in vitro effectiveness of closed root debridement with fine instruments on specific areas of mandibular first molar furcations. I. Root trunk and furcation entrance

DIAGNOdent Pen versus tactile sense for detection of subgingival calculus: an in vitro study

The objective of this study is to compare the performance of the DIAGNOdent laser fluorescence (LF) Pen to conventional periodontal probing for detection of subgingival calculus under defined laboratory conditions. Extracted teeth with various levels of subgingival deposits of calculus were mounted anatomically in stone casts, and an impression material was used to replicate periodontal soft tissues. The casts were examined for the presence of subgingival calculus at eight surfaces per tooth (240 sites) using LF and a periodontal probe. Sites were rescored after 1 and 3 weeks. Direct imaging of the root surfaces under magnification was the gold standard. As a result, for an experienced operator, LF was more accurate than tactile assessment (across all sites, 84.0% vs. 59.8%). The performance difference was greater for multi-rooted teeth (85.8% vs. 56.9%) than single-rooted teeth (77.2% vs. 66.7%). The performance of LF in this laboratory trial was influenced strongly by clinician skill and experience. When used by an experienced operator, LF was more sensitive (75.1% vs. 69.2%), specific (92.6% vs. 86.3%), and accurate (84% vs. 77.9%) than for an inexperienced operator. In conclusion, under the defined laboratory conditions used, LF had better performance than tactile examination, particularly for multi-rooted teeth. This method may have value clinically as an adjunct for detecting subgingival deposits of calculus in clinical practice. The usefulness of the method improves with operator experience.

The use of a disclosing agent during resective periodontal surgery for improved removal of biofilm

A total removal of the bacterial deposits is one of the main challenges of periodontal therapy. A surgical approach is sometimes required in order to allow a correct access to the areas not thoroughly reached during the initial therapy. The present study focuses on the surgical scaling effectiveness in root deposits removal; the potential support of a disclosing agent during this procedure is also evaluated. Forty surgical periodontal patients were randomly divided between surgeries where the operator was informed about a final examination of the residual root deposits and surgeries where the operator was not informed. Straight after scaling procedures a supervisor recorded the O'Leary Plaque Index of the exposed roots by mean of a disclosing agent and the percentage of teeth with residual biofilm. After the stained deposits removal, a second chromatic examination was performed and new data were collected. Mann-Whitney U-test and Wilcoxon test for paired samples were used for comparisons respectively between the two surgery groups and the first and the second chromatic examination; one-sided p-value was set at 0.05. At first examination no significant differences between the two groups were observed regarding Plaque Index (p=0.24) and percentages of teeth with residual biofilm (p=0.07). The 100% removal of roots deposits was never achieved during the study but a significant reduction of 80% of root deposits was observed between first and second examination (p=0.0001). Since root deposits removal during periodontal surgery resulted always suboptimal, the use of a disclosing agent during this procedure could be a useful and practical aid.

Sonic and ultrasonic scalers in periodontal treatment: a review

Periodontal therapy aims at arresting periodontal infection and maintaining a healthy periodontium. The periodic mechanical removal of subgingival microbial biofilms is essential for controlling inflammatory periodontal disease. Mechanical periodontal therapy consists of scaling, root planing and gingival curettage. The sonic and ultrasonic scalers are valuable tools in the prevention of periodontal disease. The vibration of scaler tips is the main effect to remove the deposits from the dental surface, such as bacterial plaque, calculus and endotoxin. However, constant flushing activity of the lavage used to cool the tips and cavitational activity result in disruption of the weak and unattached subgingival plaque. The aim of the study was to review the safety, efficacy, role and deleterious side-effects of sonic and ultrasonic scalers in mechanical periodontal therapy.

The Effectiveness of InGaAsP Diode Laser Radiation to Detect Subgingival Calculus as Compared to an Explorer

BACKGROUND

The aim of the present study was to compare the ability of the diode laser to detect residual calculus with that of an explorer.

METHODS

The root surface of 40 extracted human teeth, each partially covered with subgingival calculus, was instrumented with curets under simulated clinical conditions in a manikin. The samples were randomly assigned to two study groups. In group A, the root surface was treated with an explorer until it appeared free of mineralized deposits upon examination. The samples in group B were instrumented until the relative intensity of fluorescence as induced with diode laser radiation was below a threshold value of 5. The root surface of each sample was then examined for residual calculus using standardized digital images. The statistical analysis was performed with a non-paired t test at a level of significance of 5% (P < 0.05).

RESULTS

The root surface of single-rooted teeth showed residual calculus on 0.19 +/- 0.37 x 10(7) microm2 in the laser group and on 0.11 +/- 0.26 x 10(7) microm2 in the explorer group (P = 0.19). For multirooted teeth, the mean calculus-covered area was 0.50 +/- 0.48 x 10(7) microm2 for the teeth evaluated with an explorer and 0.27 +/- 0.43 x 10(7) microm2 for the diode laser group (P = 0.02).

CONCLUSION

The present findings indicate that the detection of subgingival calculus is significantly improved using 655 nm diode laser radiation compared to an explorer for molars but not for single-rooted teeth.

Effect of Loading on the Vibration Characteristics of Thin Magnetostrictive Ultrasonic Scaler Inserts

BACKGROUND

The ultrasonic scaler market has seen an increase in availability of thin inserts for periodontal pocket access. While such thin inserts may have advantages in negotiating the periodontal pocket, the relatively narrow structure may be prone to damping under load. The purpose of this study was to assess the vibration characteristics under load of thin, straight, ultrasonic scaler inserts.

METHODS

Five types of thin inserts were each obtained from three manufacturers and were operated using an ultrasonic generator at medium power and low water. The displacement amplitude of the scaling tip was measured via a scanning laser vibrometer (SLV). Increasing forces up to 1.0 N were applied either to the base of the tip (up through its center) or while it was loaded from the side. Displacement measurements were obtained using the SLV under these loading conditions.

RESULTS

Under loading, there was a drop in displacement amplitude of all tips. Furthermore, loading of the tips resulted in large variations of displacement amplitudes recorded. The mean tip displacements recorded ranged from 10 to 30 microm when unloaded and 7 to 25 microm when loaded. The fundamental frequency of the ultrasonic tips' oscillation was at 30 kHz. However, loading resulted in the production of additional subharmonic frequencies in the region of 6 to 10 kHz.

CONCLUSIONS

Thin ultrasonic scaler tips are susceptible to loading. This results in a reduction in the displacement amplitude that shows variation not only between tips of different design but also between those of the same design made by the same manufacturer. Clinicians and researchers should be aware of this variability, which may influence both clinical procedures and future research with thin ultrasonic scaling tips.

Assessment of the ultrasonic dental scaler insert

The ultrasonic dental scaler is an invaluable tool in the fight against dental calculus and periodontal disease. The purpose of this study was to assess the natural frequency of the straight internal ultrasonic scaler insert 30K FSI-SLI-10S (Dentsply International, York, USA) and to measure the displacement observed at the tip when operated under different generator settings. Two approaches were used: finite element analysis and scanning laser vibrometry. The Finite Element Analysis method was employed to calculate the expected modes of vibration of the insert. Scanning laser vibrometry was used to measure displacements of the tip during operation. It was found the insert had two modes of vibration around the operating frequency of 30 kHz; these modes were first order bending in two orthogonal planes.