Atomic force microscopy and scanning electron microscopy evaluation of efficacy of scaling and root planing using magnification: A randomized controlled clinical study

Magnification in Periodontics: An Overview

A plethora of changes in the concept and the techniques in dental sciences and an increase in patient awareness have spawned demand in advanced dental treatment encompassing elimination of disease with more precision and less discomfort. The use of magnification systems like microscopes is widespread in the medical field, and now it has successfully spread its wings in dentistry. Visual enhancement by using loupes or surgical microscopes can render refinement in the basic surgical procedures. Magnification periodontics refers to the wide range of procedures performed by the use of magnification systems like loupes and microscopes that allow convergence of ideas and efforts, which can make a huge impact on patients. Periodontal procedures are being increasingly performed nowadays that have enabled enhanced outcomes, which were difficult to achieve with the macrosurgery procedures when wound healing and tissue trauma are in consideration. The surgical operating microscope works within the microsurgical triad that includes illumination increased precision and magnification. The incorporation of smaller instruments and sutures and better visualization of the operating site enhance the surgical skills of the clinician. In the past decade, various periodontal procedures from the removal of calculus to the placement of dental implants have been performed using the surgical microscope, which have invariably provided favorable results. It is a topic of interest in the future of periodontal therapy.

Comparison of the effect of sodium bicarbonate and glycine air polishing systems on tooth surface roughness: An atomic force microscopic analysis

BACKGROUND

A variety of prophylactic materials are used in the dental office for the removal of stains and calculus.

OBJECTIVE

To evaluate tooth surface changes caused by the application of air abrasive powders (sodium bicarbonate, SBAP and glycine air powder, GPAP) along with scaling and root planing (SRP), under atomic force microscope (AFM) and to analyze the histological soft tissue changes caused by these agents, using light microscopy.

METHODS

This study was conducted in two phases: in vitro and in vivo. In the in vitro phase, hard tissue analysis was done under AFM following air powder polishing. Eighteen extracted teeth were chosen. SRP and tooth sectioning were carried out. Subsequently, each section of the tooth was mounted on a glass plate with self-cure acrylic resin and air polished using SBAP and GPAP. In the vivo phase, the soft tissue was analyzed under a light microscope for surface roughness. A biopsy specimen was taken from patients who had received phase I therapy, and flap surgery was planned using a modified Widman flap technique.

RESULTS

This study compared surface changes in enamel and cementum, under AFM, as indicated by RA after SRP, SRP and SBAP, and SRP and GPAP; comparisons were then drawn across the three groups. The mean AFM values were 108.5 and 144.7, 102.7 and 81.7, and 95.6 and 7.4, at the crown and root, for SRP, SRP and SBAP, and SRP and GPAP interventions, respectively. GPAP was the least rough on soft tissues.

CONCLUSION

SBAP and GPAP were better than hand instrumentation as indicated by AFM and histological section analysis.

Comparative evaluation of manual scaling and root planing with or without magnification loupes using scanning electron microscope: A pilot study

Aim:

The aim of the present study is to compare the amount of remaining calculus, loss of tooth substance, and roughness of root surface after scaling and root planing with or without magnification loupes using scanning electron microscope.

Materials and Methods:

In the study, 30 teeth indicated for extractions due to severe chronic generalized periodontitis were included in the study. In test Group I, scaling and root planing was performed without magnification loupes, and in test Group II, scaling and root planing was performed with magnification loupes before extraction. In control Group III, no procedure was performed. After scaling and root planing, teeth were extracted followed by preparation of specimens. Specimens were then sent for scanning electron microscope study.

Results:

Statistically significant (P ≤ 0.05) differences were found among different test groups. Results showed that test Group II with magnification loupes had less remaining calculus and smoother surface with lesser amount of loss of cementum layer.

Conclusion:

From this, it was concluded that test Group II was more efficient in root debridement than test Group 1, so scaling and root planing done with magnification loupes will cause less damage to the tooth surface.

Clinical Evaluation of Effects of Local Application of Aloe vera Gel as an Adjunct to Scaling and Root Planning in Patients with Chronic Periodontitis

STATEMENT OF THE PROBLEM

Aloe vera gel contains various components with antibiotic and anti-inflammatory characteristics, which may have potential advantages to treat periodontal diseases.

PURPOSE

The aim of this study was to evaluate the effects of local application of aloe vera gel as an adjunct to scaling and root planning in the treatment of patients with chronic periodontitis.

MATERIALS AND METHOD

This single-blind clinical trial, performed in a split mouth design, was conducted on 20 patients with moderate to severe chronic periodontitis. Following a baseline examination at first day which included the assessments of plaque index (PI), gingival index (GI), and probing depth (PD); patients randomly received either SRP in one quadrant (control group), or SRP combined with aloe vera gel in another quadrant (experimental group). All cases were examined again, assessing PI, GI, and PD at 30^th and 60^th day.

RESULTS

There was no significant difference in PI in the three stages between control and experimental groups. In all patients, there was a significant improvement in the three stages in GI and PD for both quadrants treated only with SRP or combination of SRP and aloe vera. However, experimental group presented significantly lower GI (p= 0.0001) and PD (p= 0.009) than the control group at the end of study period.

CONCLUSION

This study revealed that local application of aloe vera gel could be considered as an adjunctive treatment with scaling and root planning for chronic periodontitis.