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

Abstract

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.

Effects of a new magnetostrictive ultrasonic scaler and a traditional piezoelectric ultrasonic scaler on root surfaces and patient complaints

“…However, Busslinger et al 9 demonstrated that the scaling efficiency of piezoelectric ultrasonic scalers is significantly greater than that of magnetostrictive ultrasonic scalers. This difference in results may be attributed to variations in the brands, working tips, and lateral forces of the periodontal instruments used in our experiments 29 – 31 .…”

“…The generator produces an electric or magnetostrictive field, and the transducer converts high-frequency electric or electromagnetic energy into ultrasonic vibrations. However, the mechanical friction of the scaler tips can cause scratches or minor damage to the tooth surface 29 . Furthermore, ultrasonic scaling produces noise and vibration, which may cause temporary discomfort or pain to patients.…”

“…According to the previous literature, the estimated difference and standard deviation values of the two groups of VAS values were calculated. The corresponding values based on the preliminary experimental and data analysis results presented in published articles were used for the calculation 8 , 25 , 29 . The sample size was determined to be seventy-seven, accounting for a 10% loss to follow-up rate.…”

Clinical Benefits of Minimally Invasive Non-Surgical Periodontal Therapy as an Alternative of Conventional Non-Surgical Periodontal Therapy—A Pilot Study

“…They found that the use of Mini-Five Gracey curettes resulted in greater PD reduction and lower gingival recession. Regarding power-driven devices, a recent randomized clinical trial compared three different sizes of piezoelectric ultrasonic scaler tips for in vitro and clinical analyses [ 47 ]. The results showed that using a slim-designed scaler tip caused less tooth substance loss and less pain experience for patients than a conventional wide scaler tip.…”