Comparative evaluation of hand and power-driven instruments on root surface characteristics: A scanning electron microscopy study

Abstract

Aim:The aim of this study was to compare root surface characteristics following root planing with various hand- and power-driven instruments.Materials and Methods:A total of 20 single, rooted teeth were used in this study; two specimens were used as control (no instrumentation done) and the remaining 18 specimens were equally divided into three groups. Specimens from each group were then subjected to root planing by one of the following instruments: (1) a Gracey curette, (2) ultrasonic tip and (3) a Rotary bur. In each case, the time required for scaling and root planing and surface roughness using the Roughness and Loss of Tooth Substance Index (RLTSI) was measured.Result:The mean RLTSI scores for the Gracey curette, ultrasonic and rotary instrument groups were 2.5, 2.0 and 0.667, respectively. The mean scores of time spent for scaling and root planing by the Gracey curette, ultrasonic and rotary instrument groups in seconds were 42.50, 35.83 and 54.50, respectively.Conclusions:All the three instruments, namely Gracey curette, ultrasonic tip and rotary bur, were effective in mechanical debridement of the root surface. The results favored the use of rotary instruments for root planing to achieve a smooth, clean root surface; however, the use of rotary instrument was more time consuming, which might limit its use in clinical practice.

Root surface alterations following manual and mechanical scaling: A comparative study

“…These results are in accordance with the study by Solís Moreno et al., in which piezoelectric devices produced the smoothest surface compared with manual curettes and diamond burs. In another study, a greater amount of root substance removal, more surface cracks and morphological alterations were observed after using curettes . Other authors however reported similar surface alterations using manual and ultrasonic instruments .…”

Efficiency of professional tooth brushing before ultrasonic scaling

“…The ultrasonic scaler is a safe and convenient device when properly used on a sound tooth surface at the correct tip angulations, lateral pressure and power level . However, dental injury may be generated by inappropriate power control, instrument contact time, angulations and tip shape, tip to tooth surface angle, power level of the unit, sharpness of the cutting edge, lateral pressure on the tooth surface and other factors.…”

“…Moreover, this scaler relieves clinician fatigue and easily reduces subgingival microflora . However, an ultrasonic scaler causes patient discomfort because of pain, vibration, noise and a large volume of water coolant; excessive operation of the instrument may also prove to be detrimental to periodontal health by roughening the root surface .…”

Scanning electron microscopic study on characteristics of tooth surface when using gracey curet and ultrasonic scaler

“…하지만 이 방법은 많은 시간이 소요되고 특히 4 mm이상의 깊은 치주낭의 치근면에는 도달하기 어렵기 때문에 효과적인 손기술의 운영이 고려되어야 한다 [3]. 이렇듯 외과적인 술식 에 비해 비외과적 시술인 ultrasonic scaler와 hand scaler를 이용하여 치석을 제거하는 것이 치은연하 치석에 대한 접근도 가 떨어지기는 하지만, 많은 연구에서 이러한 비외과적 술식이 효과적이며 임상적으로 두 술식 간의 치료 결과에 차이가 없음 이 발표되어 왔다 [6,7].…”

“…치석제거에 사 용되는 기구는 손으로 하는 기구(hand scaler)와 동력기구 (motor driven instrument)로 분류할 수 있는데 전통적인 수기 구로는 curette, sickle, hoe, file, chisel 등의 기구가 있으며, 동력기구로는 대표적으로 ultrasonic scaler가 있다 [9]. 최근에 이 동력기구는 직경이 작은 tip과 보다 긴 길이의 연결부 (shank)가 개발되어 보다 깊은 부위의 접근이 가능해져 보다 효율적으로 치은연하부위의 치석제거가 가능해졌지만 두 가 지 방법 모두 술자가 기구조작을 잘못하게 되면 치아 물질들의 손실을 일으킨다는 사실은 잘 알려져 있다 [3]. 치석제거술은 치과위생사의 대표적인 주 업무로 치과위생사를 양성하는 교 육기관이나 치과진료실에서 이 시술은 중요하게 시행되고 있 다 [10].…”