In Vitro, Clinical, and Microbiological Evaluation of a Linear Oscillating Device for Scaling and Root Planing

Impact of a two-stage subgingival instrumentation schemeinvolvingair-polishingon attachment gain after activeperiodontal therapy

BACKGROUND

To evaluate whether clinical attachment levelgain (ΔCAL) in deepuntreated periodontal lesionsmay be improved by a two-stage, subgingival instrumentation schemeinvolving air-polishing.

METHODS

This 6-month, randomized, controlled, examiner-blinded clinical trial was performed in 44 periodontitis patients with untreated periodontal lesions ≥ 6 mm. At baseline, day 28, 84, and 168 clinical attachment level (CAL), probing pocket depth (PPD), bleeding on probing (BoP) and plaque control record (PlaCR) were recorded. After baseline examination control grouppatients received full-mouth sub- and supragingival instrumentation using scalers and curettes. In the test group initial subgingival cleaningwas limited to the removal of soft bacterial deposits by air-polishing. Subgingival scaling and root planing was performed only after the first reevaluation at day 28.

RESULTS

In deep lesions ≥ 6 mm a significant reduction of mean CAL scores was observed at day 28 and at day 168 for both experimental groups. Differences between the groupshowever did not reach the level of significance. Mean PPD was also significantly reduced at day 28 and at 168 in both experimental groups, with no significant differences between the groups. Mean BoP scores did not change significantly in both groups during the 168-day observation period. Only in the test group mean PlaCR scores were significantly reduced at day 168 compared to baseline.

CONCLUSIONS

Subgingival instrumentation of untreated periodontal pockets ≥ 6 mm by air-polishing alone resultsin a significant short-term gain of CAL comparable to conventional scaling and root planing. Its sequential two-step combination with scaling and root planinghowever does not additionally enhancelong-termgain of CAL. (ClinicalTrials.gov: NCT03098498).

ONE-SENTENCE SUMMARY

A two-step combination of air-polishing and scaling and root planing does not improve attachment gain in untreated deep periodontal lesions. This article is protected by copyright. All rights reserved.

Influence of scaler tip design on root surface roughness, tooth substance loss and patients' pain perception: an in vitro and a randomised clinical trial

Background

The influence of scaler tip design on root surface roughness, tooth substance loss and patients’ pain perception is investigated.

Methods

This article was divided into the following parts: Part 1 Surface roughness and substance loss: an in vitro study, which involves intact extracted teeth sectioned and treated using a piezoelectric ultrasonic device (PM200 EMS Piezon, Switzerland) with a conventional scaler tip (FS-407) and a Perio Slim (PS) scaler tip (Perio Slim DS-016A). All sectioned samples for tooth surface roughness (n = 20) and tooth substance loss (n = 46) analyses were measured and compared using a 3D surface texture analyser and scanning electron microscope (SEM) respectively, at baseline and following scaling. Part 2 Pain Perception: a clinical study, which was a split mouth study design including 30 participants with gingivitis and/or mild chronic periodontitis; treated with supra-gingival scaling from teeth #13 to #23. Subjects were randomised to group A or group B. Group A was treated first with PS scaler tips, whereas group B was treated first with conventional scaler tips. Pain perception was recorded using the visual analogue scale (VAS).

Results

In vitro study: both scaler tips caused significant reduction in root substance roughness after scaling (p < 0.05), but no significant difference between the two scaler tips (p > 0.05) was observed. The PS scaler tip caused statistically significantly less root substance loss (p < 0.05) when the initial thickness of the tooth was < 1000 µm. Clinical study: the participants reported significantly lesser pain score during scaling using the PS scaler tip (median: 3) than when using the conventional scaler tip (median: 5) (p < 0.05).

Conclusions

In the in vitro study, using a slim scaler tip design causes less tooth substance loss compared to a wider scaler tip design. In the clinical study, less pain was observed compared than a wide (conventional) scaler tip design.

The effect of the Vector scaler system on human teeth: a systematic review

AIM

To review the available literature, considering the effect of instrumentation with the Vector ultrasonic scaler on human teeth in vitro and in vivo compared to conventional ultrasonic instruments and/or hand instrumentation. The assessed effects are calculus removal, time of instrumentation, root surface aspects, cell attachment, patients' perception, bleeding upon probing, pocket depth, clinical attachment loss and microbiological effects.

MATERIALS AND METHODS

MEDLINE-PubMed and the Cochrane Central register of controlled trials (CENTRAL) were searched up through January 2008 to identify appropriate studies.

RESULTS

Independent screening of the titles and abstracts of 270 MEDLINE-PubMed and 15 Cochrane papers resulted in 15 suitable publications. The studies differed in design and outcome, so this review summarizes the outcomes in a descriptive manner. Comparisons are presented against conventional ultrasonic system and scaling and root planing.

CONCLUSION

The Vector ultrasonic scaler provided comparable clinical and microbiological periodontal healing results as scaling and root planing and conventional ultrasonic system in moderately deep pockets. The Vector ultrasonic scaler may be used as a gentle root debridement device for supportive periodontal therapy, as an alternative to other conventional ultrasonic system. The operator should however consider the extra time needed for instrumentation.

Periodontal healing after non-surgical therapy with a new ultrasonic device: a randomized controlled clinical trial

AIM

The aim of this study was to compare the clinical and microbiological healing outcomes following non-surgical periodontal therapy using the new Vector ultrasonic system versus scaling and root planing (S/RP) with Gracey curettes.

MATERIAL AND METHODS

The study comprised 20 chronic periodontitis patients. Using a split-mouth design, both treatment modalities were randomly applied to one quadrant of the upper and the lower jaws each. Clinical and microbiological parameters were assessed at baseline, 4 weeks, and 6 months after treatment. Furthermore, post-operative hypersensitivity was assessed. The Wilcoxon signed rank test (alpha=0.05) was used for statistical analysis.

RESULTS

Both therapies provided statistically significant clinical and microbiological improvements of periodontal conditions after 4 weeks and 6 months. Hypersensitive teeth were found only 4 weeks after S/RP. Besides a significantly better bleeding on probing reduction in deep S/RP sites, no other clinical and microbiological parameters revealed significant differences between the sites treated with the Vector system or S/RP.

CONCLUSION

Both the Vector system and S/RP provided favourable periodontal healing results, although in deep pockets S/RP appeared to achieve a better resolution of inflammation.

A comparison of root surface instrumentation using two piezoelectric ultrasonic scalers and a hand scaler in vivo

BACKGROUND AND OBJECTIVE

This study compared the effectiveness of two piezoelectric ultrasonic scalers and a hand scaler for subgingival scaling and root planing in vivo.

MATERIAL AND METHODS

Fifteen patients with advanced periodontal disease and with teeth scheduled for extraction were selected for this study. Three experimental groups of 10 teeth each were treated with one of two piezoelectric ultrasonic scalers [Vector scaler and Enac scaler] or with a hand scaler. Instrumentation was continued until the root surface felt hard and smooth to an explorer tip. The root surface characteristics after instrumentation were examined using scanning electron microscopy, and the amount of remaining calculus, roughness and loss of tooth substance were estimated using the remaining calculus index and roughness loss of tooth substance index.

RESULTS

The remaining calculus index did not differ significantly among the three groups. The roughness loss of tooth substance index was significantly lower for the Vector scaler and Enac scaler groups than for the hand scaler group and also differed significantly between the Vector scaler and Enac scaler groups.

CONCLUSION

This study suggests that the Vector scaler produces a smooth root surface with minimal loss of tooth substance. It is a reasonable choice for gentle periodontal maintenance treatment.