Efficacy versus health risks: An in vitro evaluation of power-driven scalers

Abstract

Background:Power-driven instrumentation of root surfaces during supportive periodontal therapy is an alternative to hand instrumentation. The purpose of this pilot in vitro study was to investigate the efficacy of sub- and supragingival plaque removal with a sonic (AIR: Synea, W and H, Bürmoos, Austria) and two ultrasonic devices (TIG: Tigon+, W and H, Bürmoos, Austria; VEC: Vector, Dürr, Bietigheim-Bissingen, Germany) as well as the health-risk for dental professionals during treatment.Materials and Methods:The power-driven devices were utilized to remove plaque from model teeth in dummy heads. The percentage of residual artificial plaque after 2 min of supra- or subgingival instrumentation was calculated by means of image-processing techniques at four sites (n = 576) of each tooth. The Health-Risk-Index (HRI: spatter/residual plaque quotient) with the different power-driven devices was assessed during treatment.Results:The smallest amounts of residual plaque were found for the sonic device AIR (8.89% ± 10.92%) and the ultrasonic scaler TIG (8.72% ± 12.02%) (P = 0.707). Significantly more plaque was remained after the use of the ultrasonic scaler VEC (18.76% ± 18.07%) (P < 0.001). Irrespectively of the scaler, efficacy was similar sub- (10.7% ± 11.6%) and supragingivally (13.5% ± 17.2%) (P = 0.901). AIR/TIG demonstrated equal residual amounts of plaque sub- (P = 0.831) as well as supragingivally (P = 0.510). However, AIR/VEC and TIG/VEC were significantly in favor of AIR and TIG (P < 0.001). In contrast, the lowest HRI was found after using VEC (0.0043) and differed considerably for AIR (0.2812) and TIG (0.0287).Conclusion:Sonic devices are as effective as ultrasonic devices in the removal of biofilm but bear a higher risk to the dental professional's health concerning the formation of spatter.

Comparison of the clinical and microbiological effects ofantibiotic therapy in periodontal pockets following laser treatment: An in vivo study

“…The success of these treatments can be attributed to the efficient removal of the subgingival biofilm and the eradication of bacteria from the root surface. 12 Similarly to the findings of Lopes et al, our trial showed a significant reduction in the percentage of sites with Pi and Pg after erbium laser irradiation. 14 However, there is a fundamental difference in the response to PDT between Gram-positive and Gram-negative bacteria.…”

“…10,11 However, root architecture and its particular anatomical variations are an obstruction in establishing effective protocols for debridement in non-surgical periodontal therapy, which uses traditional tools, such as curettes or ultrasonic scalers. 12 Therefore, different devices (e.g., lasers) have been used in non-surgical periodontal treatment as alternative or adjunct methods to mechanical scaling and root planing (SRP). Many clinical studies have confirmed the effectiveness of the 2940 nm erbium-doped yttrium aluminium garnet laser (Er:YAG laser -ERL) in periodontal therapy, with or without additional SRP.…”

Dental Aerosol as a Hazard Risk for Dental Workers

“…The second important subject of the study was to assess whether ultrasonic scaling significantly increases the aerosol particles in the air of the office. Graetz et al in their study [ 40 ] showed that ultrasonic and sonic devices are useful in eliminating biofilm but bear a greater risk to the dental workers concerning the production of splatter. Furthermore, Harrel et al [ 41 ] observed that ultrasonic scalers, even when working without coolant, could spread the airborne material for at least 18 inches from the operative site [ 4 ].…”

Removal of simulated biofilm: a preclinical ergonomic comparison of instruments and operators

“…Given this current ambiguity, the disadvantages of powered compared with hand instruments should also be mentioned, despite not being quantified in our study. Operators found powered instruments significantly louder than hand instruments, and both operators and patients complained about aerosol and spatter when using powered devices [31][32][33]. Moreover, operators found tactile feedback to be reduced when using powered devices.…”