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

OBJECTIVES: The debridement of diseased root surface is usually performed by mechanical scaling and root planing using manual and power driven instruments. Many new designs in ultrasonic powered scaling tips have been developed. However, their effectiveness as compared to manual curettes has always been debatable. Thus, the objective of this in vitro study was to comparatively evaluate the efficacy of manual, magnetostrictive and piezoelectric ultrasonic instrumentation on periodontally involved extracted teeth using profilometer and scanning electron microscope (SEM). MATERIAL AND METHODS: 30 periodontally involved extracted human teeth were divided into 3 groups. The teeth were instrumented with hand and ultrasonic instruments resembling clinical application. In Group A all teeth were scaled with a new universal hand curette (Hu Friedy Gracey After Five Vision curette; Hu Friedy, Chicago, USA). In Group B CavitronTM FSI - SLI TM ultrasonic device with focused spray slimline inserts (Dentsply International Inc., York, PA, USA) were used. In Group C teeth were scaled with an EMS piezoelectric ultrasonic device with prototype modified PS inserts. The surfaces were analyzed by a Precision profilometer to measure the surface roughness (Ra value in µm) consecutively before and after the instrumentation. The samples were examined under SEM at magnifications ranging from 17x to 300x and 600x. RESULTS: The mean Ra values (µm) before and after instrumentation in all the three groups A, B and C were tabulated. After statistically analyzing the data, no significant difference was observed in the three experimental groups. Though there was a decrease in the percentage reduction of Ra values consecutively from group A to C. CONCLUSION: Within the limits of the present study, given that the manual, magnetostrictive and piezoelectric ultrasonic instruments produce the same surface roughness, it can be concluded that their efficacy for creating a biologically compatible surface of periodontally diseased teeth is similar.

A clinical evaluation of bioactive glass particulate in the treatment of mandibular class II furcation defects

Bioactive glass particulate has been applied to dentistry in the treatmentof bone defects, ridge preservation and periodontal bone defectsincluding the furcation defects. The aim of this study was to comparethe clinical attachment gain and vertical and horizontal bone fillobtained with open flap debridement (OFD) alone and OFD withbioactive glass particulate in the treatment of mandibular Class IIfurcation defects. Twenty mandibular class II furcation defects wereselected in 16 systemically healthy patients out of which 10 defectswere treated with OFD alone (Group I) and other 10 defects weretreated with OFD and bioactive glass particulate (Group II). Eachdefect was randomly assigned to Group I and Group II. The softtissue and hard tissue measurements including vertical probing depth,horizontal probing depth, clinical attachment level, gingival recession,vertical depth of the furcation defects, and horizontal depth of thefurcation defects were recorded at baseline and six months post surgery.At 6 months evaluation, both treatment procedures resulted insignificant improvement in soft tissue and hard tissue parameterswhen compared to the baseline. There was no significant differencebetween the two groups with respect to soft tissue changes (p>0.05)like probing depth reduction (3.30 mm versus 2.90 mm), clinicalattachment level gain (2.90 mm Vs 2.80 mm) and gingival recession.Vertical defect fill were significantly greater in the bioactive glass sites(1.50 mm) compared to control sites (0.80 mm). There was highlysignificant reduction in horizontal probing depth of the defect (1.80mm Vs 1.10 mm, p< 0.05) after 6 months post surgery. In conclusion,bioactive glass showed significant improvement in clinical parameterslike vertical and horizontal defect fill in mandibular class II furcationdefects when compared to OFD.