Sonic and Ultrasonic Scalers in Periodontics^*

Abstract

Ultrasonic and sonic scalers appear to attain similar results as hand instruments for removing plaque, calculus, and endotoxin. Ultrasonic scalers used at medium power seem to produce less root surface damage than hand or sonic scalers. Due to instrument width, furcations may be more accessible using ultrasonic or sonic scalers than manual scalers. It is not clear whether root surface roughness is more or less pronounced following power-driven scalers or manual scalers. It is also unclear if root surface roughness affects long-term wound healing. Periodontal scaling and root planing includes thorough calculus removal, but complete cementum removal should not be a goal of periodontal therapy. Studies have established that endotoxin is weakly adsorbed to the root surface, and can be easily removed with light, overlapping strokes with an ultrasonic scaler. A significant disadvantage of power-driven scalers is the production of contaminated aerosols. Because ultrasonics and sonics produce aerosols, additional care is required to achieve and maintain good infection control when incorporating these instrumentation techniques into dental practice. Preliminary evidence suggests that the addition of certain antimicrobials to the lavage during ultrasonic instrumentation may be of minimal clinical benefit. However, more randomized controlled clinical trials need to be conducted over longer periods of time to better understand the long-term benefits of ultrasonic and sonic debridement.

A comparative evaluation of the efficacy of manual, magnetostrictive and piezoelectric ultrasonic instruments: an in vitro profilometric and SEM study

“…Studies investigating the differences between manual, piezoelectric and magnetostrictive ultrasonic systems are inconclusive 8,9 . The same has been corroborated by Lea and Walmsley's exhaustive review of literature specifically with respect to powered instruments.…”

Tumor Necrosis Factor-αand Interleukin-6: Potential Interorgan Inflammatory Mediators Contributing to Destructive Periodontal Disease in Obesity or Metabolic Syndrome

“…Gingivitis is an inflammatory reaction often induced by the pathogens residing in dental plaque (biofilm), which forms on the adjacent tooth surfaces [1]. Destructive periodontal disease results in an apical loss of epithelial attachment along with the periodontal soft and hard tissues [2]. Unlike gingivitis, which is cured following the removal of local etiological factors, destructive periodontal disease is irreversible.…”

Subgingival instrumentation to remove simulated plaque in vitro: influence of operators’ experience and type of instrument

“…To do so, scaling is performed using hand [7,8], ultrasonic [7,9,10] or sonic instruments [11,12]. Whilst hand instrumentation is both challenging and time-consuming but allows direct tactile control [13], power-driven instruments are easier to use and sometimes require less time than hand instruments to successfully debride root surfaces [14].…”

“…It is speculated that especially less experienced operators might not be sufficiently successful in removing subgingival plaque or calculus when using hand instruments, whilst inducing damages on the root surfaces with these instruments [15]. Currently, clinicians tend to prefer power-driven instruments, possibly due to their higher efficiency and advantageous ergonomics [9,14]. Consequently, a growing number of power-driven instruments are Electronic supplementary material The online version of this article (doi:10.1007/s00784-014-1319-x) contains supplementary material, which is available to authorized users.…”