Comparison of the effect of two disinfectants on the independent waterway disinfection of a periodontal ultrasonic scaler / 口腔疾病防治

Objective @#To compare the disinfection effect of 3% (v/v) hydrogen peroxide and 500 mg/L chlorine-containing disinfectants in the independent waterway of a periodontal ultrasonic scaler to provide a reference for clinical waterway disinfection management in stomatology departments.@*Methods @#The 18 ultrasonic scalers were randomly divided into 3 groups of 6 units: the control group, experimental group 1 (3% hydrogen peroxide disinfectant group), and experimental group 2 (500 mg/L chlorine-containing disinfectant group). The replaceable parts of the independent waterway pipes of the 3 groups of ultrasonic scalers were replaced, and the water supply was supplied with sterile distilled water (DW). In the control group, special treatment was not applied to the nonreplaceable pipe part. In experimental group 1, the 3% hydrogen peroxide was used to disinfect nonreplaceable pipelines. In experimental group 2, the nonreplaceable part was disinfected with the 500 mg/L chlorine-containing disinfectant. The water sample was taken from the outlet of the scaler working part in the three groups for monitoring before disinfection, immediately after disinfection and 10 consecutive days after disinfection. Bacteria in the water samples were cultured for the colony counts. Then, the bacterial culture data were compared between groups. The qualified criterion of the water sample was that the number of bacterial colonies was less than or equal to 100 CFU/mL. After disinfection, a bacterial species mass spectrometry identification analysis was carried out when the number of bacterial colonies in each group exceeded the standard for the first time. Biofilms from the inner wall of the tube in the three groups were observed under an electron microscope on the 10th day after disinfection.@*Results @#There were no significant differences between the three groups before disinfection (F = 2.549, P = 0.111). The number of bacterial colonies in the spout of 6 scalers in the control group all exceeded the standard, and three kinds of bacteria were cultured: Sphingomonas melonis, Herbaspirillum huttiense, and Ralstonia pickettii. Compared with those in the control group, the number of bacterial colonies in experimental group 1 decreased significantly for 1-2 days after disinfection (P<0.05) and reached the standard. On the 3rd day after disinfection, the number of bacterial colonies of group 1 increased rapidly and exceeded the standard, and three kinds of bacteria were cultured: Sphingomonas, Herbaspirillum huttiense, and Ralstonia pickettii. For experimental group 2, the number of bacterial colonies decreased significantly compared to the control group on Days 1 to 6 after disinfection, but the number of bacterial colonies increased slightly from the 7th day after disinfection and exceeded the standard. Two kinds of bacteria were cultured: Herbaspirillum huttiense and Ralstonia pickettii. The average number of bacterial colonies 10-day after disinfection in experimental group 2 was lower than that in experimental group 1(P<0.001). Under an electron microscope, the biofilm thickness of the two experimental groups was significantly lower than that of the control group. @* Conclusion @# There is water pollution in the independent waterway of a periodontal ultrasound scaler. Three percent hydrogen peroxide and 500 mg/L chlorine disinfectant both have effective disinfection effects on the outlet water of scalers, and the effect of 500 mg/L chlorine disinfectant is better than that of 3% hydrogen peroxide. The use of 3% hydrogen peroxide to disinfect periodontal ultrasound scaler-independent waterways is recommended for disinfection every other day, and disinfection once a week is recommended for the use of 500 mg/L chlorine disinfectant.

Letter to the Editor - Response to: The effect of dental scaling noise during intravenous sedation on acoustic respiration rate

No abstract available.

The effect of dental scaling noise during intravenous sedation on acoustic respiration rate (RRa™)

BACKGROUND: Respiration monitoring is necessary during sedation for dental treatment. Recently, acoustic respiration rate (RRa™), an acoustics-based respiration monitoring method, has been used in addition to auscultation or capnography. The accuracy of this method may be compromised in an environment with excessive noise. This study evaluated whether noise from the ultrasonic scaler affects the performance of RRa in respiratory rate measurement. METHODS: We analyzed data from 49 volunteers who underwent scaling under intravenous sedation. Clinical tests were divided into preparation, sedation, and scaling periods; respiratory rate was measured at 2-s intervals for 3 min in each period. Missing values ratios of the RRa during each period were measuerd; correlation analysis and Bland-Altman analysis were performed on respiratory rates measured by RRa and capnogram. RESULTS: Respective missing values ratio from RRa were 5.62%, 8.03%, and 23.95% in the preparation, sedation, and scaling periods, indicating an increased missing values ratio in the scaling period (P < 0.001). Correlation coefficients of the respiratory rate, measured with two different methods, were 0.692, 0.677, and 0.562 in each respective period. Mean capnography-RRa biases in Bland-Altman analyses were −0.03, −0.27, and −0.61 in each respective period (P < 0.001); limits of agreement were −4.84–4.45, −4.89–4.15, and −6.18–4.95 (P < 0.001). CONCLUSIONS: The probability of missing respiratory rate values was higher during scaling when RRa was used for measurement. Therefore, the use of RRa alone for respiration monitoring during ultrasonic scaling may not be safe.

Influence of Scaler Tip Design on Intensity of Pain and Discomfort During Scaling

@#To evaluate patient’s subjective preferences to scaling with narrow probe-shaped EMS Perio Slim PS tips compared to conventional tip based on pain perception using the Visual Analogue Scale (VAS). Ten patients were treated using a piezoelectric ultrasonic device (EMS) and two different scaler tips representing a conventional scaler tip and a Perio Slim PS scaler tip in a split-mouth design. Pain was evaluated after 2 minutes scaling using Visual Analogue Scale (VAS). Data obtained was analysed by SPSS version 19.0 using Wilcoxon test. Pain assessment after treatment confirmed by the Visual Analogue Scale (VAS) showed that the Perio Slim PS scaler tip (maximum pain score: 4, minimum: 2) caused less pain than the conventional scaler tip (maximum: 8, minimum: 3) (p-value = 0.007). Using Perio Slim PS scaler tip caused less pain and discomfort during scaling treatment when compared with conventional scaler tip. Acrylic resin is commonly used to fabricate removable prostheses due to its adequate physical, mechanical properties and cost effectiveness. There has been continuous development of the materials to improve their properties and to widen its application in different clinical setting. To study the history development of the acrylic resin and elaborate on the properties of different types and the processing methods of acrylic resins used to fabricate denture base which are commercially available in the market. This would help the dental clinician in choosing the best material of choice. The authors have summarized the history, development and classification of different type of acrylic resins used in fabricating denture and processing methods based on all the published research available on this topic using published materials available in the Dental Library, University of Malaya and the database (Science Direct, PubMed). Every type of acrylic denture base material has its pros and cons. Therefore, careful selection of material and the processing method is crucial to ensure the best outcome for prosthodontic treatment. Hence, upholding the patients’ best interest and improving their quality of life.

Aerosol, a health hazard during ultrasonic scaling: A clinico‑microbiological study.

Context: Ultrasonic scaling is a routinely used treatment to remove plaque and calculus from tooth surfaces. These scalers use water as a coolant which is splattered during the vibration of the tip. The splatter when mixed with saliva and plaque of the patients causes the aerosol highly infectious and acts as a major risk factor for transmission of the disease. In spite of necessary protection, sometimes, the operator might get infected because of the infectious nature of the splatter. Aim: To evaluate the aerosol contamination produced during ultrasonic scaling by the help of microbiological analysis. Materials and Methods: This clinico‑microbiological study consisted of twenty patients. Two agar plates were used for each patient; the first was kept at the center of the operatory room 20 min before the treatment while the second agar plate was kept 40 cm away from the patient’s chest during the treatment. Both the agar plates were sent for microbiological analysis. Statistical Analysis: The statistical analysis was done with the help of STATA 11.0 (StataCorp. 2013. Stata Statistical Software, Release 13. College Station, TX: StataCorp LP, 4905 Lakeway Drive College Station, Texas, USA). Statistical software was used for data analysis and the P < 0.001 was considered to be statistically significant. Results: The results for bacterial count were highly significant when compared before and during the treatment. The Gram staining showed the presence of Staphylococcus and Streptococcus species in high numbers. Conclusions: The aerosols and splatters produced during dental procedures have the potential to spread infection to dental personnel. Therefore, proper precautions should be taken to minimize the risk of infection to the operator.

Adverse events associated with ultrasonic scalers: A manufacturer and user facility device experience database analysis.

Background: The present study was conducted to determine the frequency and type of adverse events (AEs) associated with ultrasonic scaler reported to the Food and Drug Administration manufacturer and user facility device experience (MAUDE) database. Materials and Methods: The authors reviewed the ultrasonic scaler units (USU) related AEs reported to MAUDE from October 1, 1995, to September 31, 2015. Analyses of details collected are presented. Results: MAUDE received a total of 667 unique USU‑related AE reports. Of 667 cases, MAUDE classified 628 instances (94.2%) as malfunction 27 (4%) as injurious, 10 (1.5%) as others, and 2 (0.3%) claiming the use of USU as cause of death. Of the 667 cases, 511 (76.6%) were used for endodontic application, and 147 (22%) as scaler applications. In 512 (76.8%) instances, there was separation of the tips, posing danger to patients or users, and 112 (16.8%) instances of overheating, 12 (1.8%) instances of breakage, and electrical issues in 8 (1.2%) instances. These AE resulted in 19 instances of thermal injury, 2 suspicious deaths, and hearing loss in 3 cases. In 4 cases, patient swallowed broken parts requiring additional medical care. Conclusions: Use of USU, a Class 2 device without exemption, carries a degree of risk to patient’s safety, if not properly used. As of today, MAUDE data is the only reliable source of AE until another database or such study is carried out. Certain AE that has been largely anecdotal, such as hearing loss has been reported in this study. The findings from study reiterate that more in‑depth analysis of AE of USU is needed. Until then operator needs to take all precautions to avoid AE when using USU.

The effect of copper alloy scaler tip on the surface roughness of dental implant and restorative materials / 대한치과보철학회지

PURPOSE: This study is designed to investigate the various impacts of different types of scaler tips such as cooper alloy base tip and the others on the surface roughness of teeth and implant by the method which is currently in clinical use. MATERIALS AND METHODS: Four different types of disc shaped porcelain, titanium, zirconia, and Type III gold alloy dental materials sized 15 mm diameter, 1.5 mm thickness were used for the experiment. Plastic hand curette (Group PS), cooper alloy new tip (Group IS), and stainless steel tip (Group SS) were used as testing appliances. A total of 64 specimens were used for this study; Four specimens for each material and appliance group. Surface roughness was formed with 15 degree angle in ultrasonic scaler tip and with 45 degree angle in hand curette of instrument tip and the specimen surface with 5 mm long, one horizontal-reciprocating motion per second for 30 seconds by 40 g force. To survey the surface roughness of each specimen, a field emission scanning electron microscope, an atomic force microscope, and a surface profiler were used. (Ra, microm). RESULTS: According to SEM, most increased surface roughness was observed in SS group while IS groups had minimal roughness change. Measurement by atomic force microscope presented that the surface roughness of SS group was significantly greater than those of PS, IS and control groups in the type III gold alloy group (P<.05). IS group showed lesser surface roughness changes compared to SS group in porcelain and gold alloy group (P<.05). According to surface profiler, surface roughness of SS group showed greater than those of PS, IS and control groups and IS group showed lesser than those of SS group in all specimen groups. Type III gold alloy group had large changes on surface roughness than those of porcelain, titanium, zirconia (P<.05). CONCLUSION: The result of this study showed that newly developed copper alloy scaler tip can cause minimal roughness impacts on the surface of implant and dental materials; therefore this may be a useful alternative for prophylaxis of implant and restored teeth.

The effect of working parameters on removal of casting gold alloy using a piezoelectric ultrasonic scaler with scaler tip in vitro / 대한치주과학회지

PURPOSE: Ultrasonic scalers have been widely used for removing biofilm which is considered as major etiologic factor of periodontal disease. The purpose of this study was to evaluate the effect of working parameters of piezoeletric ultrasonic scaler with scaler tip (No. 1 tip) on casting gold alloy removal. METHODS:Type III dental casting gold alloy (Firmilay(R) , Jelenko Inc, CA, USA) was used as substitute for tooth substance. Piezoeletric ultrasonic scaler and No.1 scaler tip (P-Max(R) , Satelec, France) were selected. The selected working parameters were mode (P mode, S mode), power setting (2, 4, 8) and lateral force (0.5 N, 1.0 N, 2.0 N). The effect of working parameters was evaluated in terms of ablation depth, ablation width and ablation area. RESULTS: Mode influenced ablation depth and ablation area. Power also influenced ablation depth and ablation area. Especially, Power 2 and power 8 showed statistically significant difference. Lateral force had influence on ablation width, and 0.5 N resulted significant increase compared with 1.0 N and 2.0 N. Ablation depth was influenced by mode, power and lateral force and defect width was influenced by lateral force. Ablation area was influenced by mode and power. CONCLUSIONS: It can be concluded that the use of piezoelectric ultrasonic scaler with No. 1 scaler tip in S mode and high power may result in significant loss of tooth substance.

The Effect of a Piezoelectric Ultrasonic Scaler with Curette Tip on Casting Gold Removal in Vitro / 대한치주과학회지

Periodontal debridement is most important procedure in periodontal treatment, because periodontal disease is the biofilm infection. The use of ultrasonic instrument has many clinical advantages compared to classical hand instrument. The introduction of newly developed ultrasonic scaler tips made the use of ultrasonic scaler popular. However the study of tooth substance removal according to the working parameters of ultrasonic scaler with newly developed tips is not sufficient. The purpose of this study is to evaluate the effects of working parameters of piezoelectric ultrasonic scaler with curette tip on casting gold removal. The working parameters was standardized by the sledge device which controls lateral force(0.5 N, 1.0 N, 2.0 N) and power setting was adjusted 2, 4, 8 in P mode and S mode and instrumentation time was 5 seconds. The defect depth and width were measured with profile meter and defect surface was examined by SME. The depth of defect was significantly large in S mode(39.58 +/-19.35micrometer) compared to P mode(8.37 +/-6.98micrometer). There was significant decrease of depth of defect between 1.0N(32.87 +/-27.18micrometer) and 2.0N(14.86 +/-15.04micrometer). The area of defect was also significantly large in S mode(4482.42 +/-3551.71micrometer2) compared to P mode (922.06 +/-960.32 micrometer2). There was significant decrease of area of defect between 1.0N(3889.12 +/-3936.00micrometer) and 2.0N(974.66 +/-986.01micrometer). The change of mode did not effect on the width of the defect. The change of power setting did not effect on the depth, width, and area of defect. In spite of limitation of this study it could be concluded that the use of piezoelectric ultrasonic scaler with curette tip on S mode could make significant tooth substance loss.

The Effect of a Piezoelectric Ultrasonic Scaler with Curette Tip on Casting Gold Removal in Vitro / 대한치주과학회지

Periodontal debridement is most important procedure in periodontal treatment, because periodontal disease is the biofilm infection. The use of ultrasonic instrument has many clinical advantages compared to classical hand instrument. The introduction of newly developed ultrasonic scaler tips made the use of ultrasonic scaler popular. However the study of tooth substance removal according to the working parameters of ultrasonic scaler with newly developed tips is not sufficient. The purpose of this study is to evaluate the effects of working parameters of piezoelectric ultrasonic scaler with curette tip on casting gold removal. The working parameters was standardized by the sledge device which controls lateral force(0.5 N, 1.0 N, 2.0 N) and power setting was adjusted 2, 4, 8 in P mode and S mode and instrumentation time was 5 seconds. The defect depth and width were measured with profile meter and defect surface was examined by SME. The depth of defect was significantly large in S mode(39.58 +/-19.35micrometer) compared to P mode(8.37 +/-6.98micrometer). There was significant decrease of depth of defect between 1.0N(32.87 +/-27.18micrometer) and 2.0N(14.86 +/-15.04micrometer). The area of defect was also significantly large in S mode(4482.42 +/-3551.71micrometer2) compared to P mode (922.06 +/-960.32 micrometer2). There was significant decrease of area of defect between 1.0N(3889.12 +/-3936.00micrometer) and 2.0N(974.66 +/-986.01micrometer). The change of mode did not effect on the width of the defect. The change of power setting did not effect on the depth, width, and area of defect. In spite of limitation of this study it could be concluded that the use of piezoelectric ultrasonic scaler with curette tip on S mode could make significant tooth substance loss.

The Effect of a Piezoelectric Ultrasonic Scaler with Curette Tip on Root Substitute Removal in Vitro / 대한치주과학회지

Based on current evidence in the literature, it is known that endotoxin is a weakly adherent surface phenomenon and that power-driven instruments can be used to accomplish definitive root detoxification and maximal wound healing without overinstrumentation of root and without extensive cementum removal. And one of the newly developed curette tips used with low power of piezoelectric ultrasonic scaler, is effective to remove calculus and not to remove the excessive cementum. The purpose of this study is therefore, to assess the influence of ultrasonic power and various working parameters on root substitute removal when instrumentation is performed with the curette tip on piezoelectric ultrasonic scaler. This study assessed defect depth, width and area resulting from instrumentation using a piezoelectric ultrasonic scaler with a curette type tip in vitro to acrylic resin block as a root substitute. The working parameters was standardized by the sledge device which controls lateral force(0.5 N, 1 N, 2 N) and instrumentation time(5 sec, 10 sec, 20 sec) and power setting was adjusted 0,2,4,8 in P mode. Power setting had the greatest influence on defect depth compared to lateral force and instrumentation time(standardized regression parameter estimates+/-standard error, 0.37+/-0.02, 0.19+/-0.02, 0.07+/-0.02). The effects on defect area also greatest for power setting(0.57+/-0.03) compared to lateral force and instrumentation time(0.33+/-0.03, 0.12+/-0.03). The effect of the power setting on the defect width(0.15+/-0.01) is not so great as defect depth or defect area compared to lateral force(0.12+/-0.01) and effect of instrumentation time is minimal(0.02+/-0.01). It could be concluded that the power setting has the greatest influence on the defect depth and area in curette type tip with low power of piezoelectric ultrasonic device. Many parameters can be adjusted in various situation in clinical use of piezoelectric ultrasonic scaler but the power setting is the first parameter to be adjusted.

The Effect of a Piezoelectric Ultrasonic Scaler with Curette Tip on Root Substitute Removal in Vitro / 대한치주과학회지

Based on current evidence in the literature, it is known that endotoxin is a weakly adherent surface phenomenon and that power-driven instruments can be used to accomplish definitive root detoxification and maximal wound healing without overinstrumentation of root and without extensive cementum removal. And one of the newly developed curette tips used with low power of piezoelectric ultrasonic scaler, is effective to remove calculus and not to remove the excessive cementum. The purpose of this study is therefore, to assess the influence of ultrasonic power and various working parameters on root substitute removal when instrumentation is performed with the curette tip on piezoelectric ultrasonic scaler. This study assessed defect depth, width and area resulting from instrumentation using a piezoelectric ultrasonic scaler with a curette type tip in vitro to acrylic resin block as a root substitute. The working parameters was standardized by the sledge device which controls lateral force(0.5 N, 1 N, 2 N) and instrumentation time(5 sec, 10 sec, 20 sec) and power setting was adjusted 0,2,4,8 in P mode. Power setting had the greatest influence on defect depth compared to lateral force and instrumentation time(standardized regression parameter estimates+/-standard error, 0.37+/-0.02, 0.19+/-0.02, 0.07+/-0.02). The effects on defect area also greatest for power setting(0.57+/-0.03) compared to lateral force and instrumentation time(0.33+/-0.03, 0.12+/-0.03). The effect of the power setting on the defect width(0.15+/-0.01) is not so great as defect depth or defect area compared to lateral force(0.12+/-0.01) and effect of instrumentation time is minimal(0.02+/-0.01). It could be concluded that the power setting has the greatest influence on the defect depth and area in curette type tip with low power of piezoelectric ultrasonic device. Many parameters can be adjusted in various situation in clinical use of piezoelectric ultrasonic scaler but the power setting is the first parameter to be adjusted.

Microbial Contaminations of Ultrasonic Scalers, High-Speed Handpieces and Water Syringe Lines / 대한치주과학회지

The purpose of this study was to evaluate various methods of decontamination of ultrasonic scalers, high-speed handpieces and air-water syringes in dental equipments. Eimination of possible sources of microbial infection in dental operatories should be of primary importance. Microbial contamination levels of high speed handpieces, air-water syringes and ultrasonic scalers of 11 dental units in Seoul National University Hospital were evaluated after flushing the lines, alcohol sponge rubbing, or soaking in 0.1% chlorhexidine for 1,3 and 5 minutes. The result suggests that flushing the lines or soaking the tips in 0.1% chlorhexidine before use of the water systems may reduce the microbial levels. Soaking in 0.1% chlorhexidine for 5 minutes was most effective in reducing bacterial contamination.