Characteristics of the molar surface after removal of cervical enamel projections: comparison of three different rotating instruments

PURPOSE: The aim of this study was to evaluate and compare tooth surface characteristics in extracted human molars after cervical enamel projections (CEPs) were removed with the use of three rotating instruments. METHODS: We classified 60 extracted molars due to periodontal lesion with CEPs into grade I, II, or III, according to the Masters and Hoskins' criteria. Each group contained 20 specimens. Three rotating instruments were used to remove the CEPs: a piezoelectric ultrasonic scaler, a periodontal bur, and a diamond bur. Tooth surface characteristics before and after removal of the projections were then evaluated with scanning electron microscopy (SEM). We analyzed the characteristics of the tooth surfaces with respect to roughness and whether the enamel projections had been completely removed. RESULTS: In SEM images, surfaces treated with the diamond bur were smoothest, but this instrument caused considerable harm to tooth structures near the CEPs. The piezoelectric ultrasonic scaler group produced the roughest surface but caused less harm to the tooth structure near the furcation. In general, the surfaces treated with the periodontal bur were smoother than those treated with the ultrasonic scaler, and the periodontal bur did not invade adjacent tooth structures. CONCLUSIONS: For removal of grade II CEPs, the most effective instrument was the diamond bur. However, in removing grade III projections, the diamond bur can destroy both adjacent tooth structures and the periodontal apparatus. In such cases, careful use of the periodontal bur may be an appropriate substitute.

The clinical assessment of aggressive periodontitis patients

PURPOSE: Few epidemiologic studies have investigated aggressive periodontitis in Koreans, but such studies of disease prevalence and other clinical characteristics would be invaluable in providing proper treatment. The aim of this study was to assess the prevalence of aggressive periodontitis and to measure the extent of associated periodontal breakdown. METHODS: The study population consisted of 1,692 patients who visited the Department of Periodontology, Wonkwang Daejeon Dental Hospital from January to December, 2010. Clinical parameters (probing depth, gingival recession, periodontal attachment loss) were measured by a single examiner, and radiographic examination was performed at the baseline. RESULTS: Twenty-eight (1.65%) patients showed clinical features of aggressive periodontitis, of which 27 patients exhibited the generalized form, and 1 exhibited the localized form. There was no significant difference between the percentage of male and female patients. The probing pocket depth of the maxillary first molar was deeper than that of the other teeth and gingival recession was also the most serious at the maxillary first molar. The periodontal attachment loss was the highest at the maxillary first molar. The average number of missing teeth was 1.29 per subject. Loss of the second molar was prominent. CONCLUSIONS: Within the limitations of this study, the periodontal breakdown evaluated by attachment loss was found to be most severe at the first molars of aggressive periodontitis patients. However, further large scale multicenter studies are necessary to access more precise data, including prevalence.