Newer designs of powered instruments have not shown any benefit when compared with other ultrasonic devices in non-surgical periodontal therapy. New in vitro research shows there is variation in the performance of different tip designs and generators, but its clinical relevance remains unknown.
Ultrasonic scalers are used in dentistry to remove calculus and other contaminants from teeth. One mechanism which may assist in the cleaning is cavitation generated in cooling water around the scaler. The vibratory motion of three designs of scaler tip in a water bath has been characterised by laser vibrometry, and compared with the spatial distribution of cavitation around the scaler tips observed using sonochemiluminescence from a luminol solution. The type of cavitation was confirmed by acoustic emission analysed by a 'Cavimeter' supplied by NPL. A node/antinode vibration pattern was observed, with the maximum displacement of each type of tip occurring at the free end. High levels of cavitation activity occurred in areas surrounding the vibration antinodes, although minimal levels were observed at the free end of the tip. There was also good correlation between vibration amplitude and sonochemiluminescence at other points along the scaler tip. 'Cavimeter' analysis correlated well with luminol observations, suggesting the presence of primarily transient cavitation.
Metal scalers produce defects in titanium implant surfaces and load and power are important factors in the damage caused. Plastic-coated scaler probes cause minimal damage to implant surfaces and have a polishing action but can leave plastic deposits behind on the implant surface.
This study shows that there are differences between commercially available generators and that tip movement varies between tips of the same style as well as between the generator and tip design. Users of ultrasonic scalers should be made aware of this inherent variability that may influence clinical procedures.
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