Comparative Effectiveness of Ultrasonic and Hand Scaling for the Removal of Subgingival Plaque and Calculus

Abstract

The purpose of the study was two-fold: to determine the nature of stainable deposits on periodontally diseased root surfaces subsequent to in vivo scaling and root planing procedures, and to quantify the distribution of residual plaque on instrumented root surfaces. Thirty molar and 30 nonmolar teeth which were condemned for periodontal or prosthetic reasons and had proximal probing depths of 4 to 7 mm were treated. Half of these were instrumented with I.U. curettes and the other half with an ultrasonic scaling device. Instrumentation was continued until the root surface felt hard and smooth to an explorer tip. The location of the gingival margin was recorded by notching the treated proximal surface with a No. 1/2 round bur. Twenty control teeth, 10 molar and 10 nonmolar, were extracted without instrumentation. Control and experimental teeth were irrigated with saline and stored in a 2.5% glutaraldehyde fixative solution until the time of assessment. All teeth were stained with a 0.5% solution of toluidine blue, and the amount of residual stained material and calculus was assessed under the stereomicroscope using an eyepiece fitted with a 10 X 10 optical grid. Stained deposits were marked by placing small V-shaped notches in the adjacent root surface as an aid to identification after the specimens were processed for scanning electron microscopic (SEM) examination. The nature of stained deposits on selected teeth was then characterized using the SEM. Treated root surfaces were also surveyed in detail to assess the quantity and extent of residual plaque deposits. The findings showed that although a large percentage of the treated proximal root surface may possess stainable deposits, these surfaces were often unexpectedly free of microbial organisms. In this study, the majority of stained deposits were composed of adherent fibrin and instrumentation debris. When bacterial plaque was present, it was usually found in small "mini-colonies" smaller than 0.5 mm across. Such findings cast doubt on the validity of using histologic and disclosing stains as an indicator for the presence of bacterial plaque immediately after instrumentation. Although only partially effective in removing subgingival calculus, both methods of instrumentation in this study appeared to be remarkably effective in bacterial debridement of subgingival root surfaces.

Surface changes of metal alloys and high-strength ceramics after ultrasonic scaling and intraoral polishing

“…Scaling treatment removes dental plaque or calculus accumulated on the surfaces of teeth or restorations, resulting in the clean surfaces with low surface energy 4. The scaling is mainly conducted with either an ultrasonic scaler or a periodontal curette 567. However, the smooth surfaces of restorations are sometimes roughened by the use of an ultrasonic scaler,8910 which possibly increase the formation of microorganism colonies and the buildup of dental plaque 1112.…”

Effect of ultrasonic scaling of teeth involved with periodontal disease in dogs: a scanning electron microscopic study

“…Bacterial plaque is regarded as the most important etiological factor in the development of destructive periodontal disease (COLMERY; FROST, 1986;DOMINGUES et al, 1999;HARVEY;EMILY, 1993;GIOSO, 2007). Because of this, surgical treatment is frequently employed and more efficient techniques are being tested worldwide (BREININGER et al, 1987).…”

Control of gingival inflammation in a teenager population using ultrasonic prophylaxis

“…Several studies have evaluated the effects of hand and ultrasonic instrumentation on root surface topography and subgingival plaque and calculus removal, revealing that, although only partially effective in removing subgingival calculus, both methods of instrumentation appear to be effective for bacterial removal from subgingival root surfaces (10,11). After observation with scanning electron microscopy (SEM) of the tooth surfaces treated with both methods, the authors verified that at low magnification, the ultrasonic method produced greater disturbed root surface topography than hand instrumentation.…”