Effect of instrumentation using curettes, piezoelectric ultrasonic scaler and Er,Cr:YSGG laser on the morphology and adhesion of blood components on root surfaces: a SEM study

Abstract

This study used scanning electron microscopy (SEM) to evaluate the morphology and adhesion of blood components on root surfaces instrumented by curettes, piezoelectric ultrasonic scaler and Er,Cr:YSGG laser. One hundred samples from 25 teeth were divided into 5 groups: 1) Curettes; 2) Piezoelectric ultrasonic scaler; 3) Curettes plus piezoelectric ultrasonic scaler; 4) Er,Cr:YSGG laser; 5) Curettes plus Er,Cr:YSGG laser. Ten samples from each group were used for analysis of root morphology and the other 10 were used for analysis of adhesion of blood components on root surface. The results were analyzed statistically by the Kruskall-Wallis and Mann-Whitney tests with a significance level of 5%. The group treated with curettes showed smoother surfaces when compared to the groups were instrumented with piezoelectric ultrasonic scaler and the Er,Cr:YSGG laser. The surfaces instrumented with piezoelectric ultrasonic scaler and Er,Cr:YSGG laser, alone or in combination with hand scaling and root planing, did not differ significantly (p>0.05) among themselves. No statistically significant differences (p>0.05) among groups were found as to the adhesion of blood components on root surface. Ultrasonic instrumentation and Er,Cr:YSGG irradiation produced rougher root surfaces than the use of curettes, but there were no differences among treatments with respect to the adhesion of blood components.

The effect of the angle of instrumentation of the Piezoelectric Ultrasonic Scaler on root surfaces

“…In our study, after analysing the MRS of the samples after the treatments, it was observed that the root surfaces treated with MC exhibited a smooth surface with occluded dentinal tubules and the presence of a smear layer, and this morphology pattern resembles those found in other studies . This morphological aspect is due to the extensive contact area between the cutting face of the MC and the sample, which facilitates the achievement of a root surface that is more uniform and regular .…”

Lasers and the treatment of periodontitis: the essence and the noise

“… and Tsurumaki et al. , determined that although Er,Cr:YSGG laser irradiation produced rougher root surfaces than treatment with scaling and root planing, there was no significant difference between treatments regarding adhesion of blood components. Therefore, three of four in vitro studies suggest that treatment with the Er:YAG laser, the Er,Cr:YSGG laser or the diode laser (one study) has little impact on adherence of blood components to laser‐irradiated root surfaces.…”

“…With respect to the phenomenon of laser‐induced fibrin sealing of periodontal pockets, it is interesting to note that only four in vitro studies and no in vivo studies could be identified as having studied the impact of various modes of root surface treatment on the adherence of blood components . Theodoro et al.…”

“…With respect to the phenomenon of laser-induced fibrin sealing of periodontal pockets, it is interesting to note that only four in vitro studies and no in vivo studies could be identified as having studied the impact of various modes of root surface treatment on the adherence of blood components (52,91,363,372). Theodoro et al (363) evaluated a diode laser vs. the Er:YAG laser, both used at two different energy densities, and reported that laser treatment of root surfaces did not significantly increase adhesion of blood components.…”

In vitro evaluation of gingival fibroblasts proliferation and smear layer formation in pre-conditioned root surfaces

“…Root surface conditioning of a tooth affected by periodontal disease aims to remove dental calculus, bacterial biofims and their toxins 2,[8][9] , which consequently contributes to a reduced inflammatory process, periodontal tissue repair [10][11][12] including formation of new supporting tissues [12][13][14] . However, mechanical debridement procedures are known to create a layer of organic, mineralized waste, also known as smear layer, which covers the prepared root surface and obstructs the dentinal tubules [14][15] , serving as substrate for bacterial growth and making periodontal attachment to the root surface more difficult 11 . Therefore, an alternative method to remove the smear layer is the combination of debridment and chemical root conditioning, which may be capable of decontaminating, detoxifying and demineralizing the root surface, thus opening the dentinal tubules and exposing the collagen matrix 2,[11][12][13][14]16 , which is fundamental for recolonization of cells involved in periodontal repair 2,[10][11][12]14 , promoting a urface that is biologically compatible with both epithelial and connective issues 2,12,14,[17][18] .…”