A comparison of root surface instrumentation using manual, ultrasonic and rotary instruments: An in vitro study using scanning electron microscopy.

Background: The commonly accepted idea concerning root planing is that excessive removal of cementum is not necessary for removal of endotoxins. The ideal instrument should enable the removal of all extraneous substances from the root surfaces, without causing any iatrogenic effects. Aim: To compare the remaining calculus, loss of tooth substance, and roughness of root surface after root planing with Gracey curette, ultrasonic instrument (Slimline® insert FSI-SLI-10S), and DesmoClean® rotary bur. Materials and Methods: The efficiency of calculus removal, the amount of lost tooth substance, and root surface roughness resulting from the use of hand curette, ultrasonic instrument, and rotary bur on 36 extracted mandibular incisors were examined by SEM. We used three indices to measure the changes: Remaining calculus index (RCI), Loss of tooth substance index (LTSI), and Roughness loss of tooth substance index (RLTSI). Twelve samples were treated with each instrument. The time required for instrumentation was also noted. Statistical Analysis: Kruskal-Wallis ANOVA was used for multiple group comparisons and the Mann-Whitney test for group-wise comparisons. Analysis was carried out with SPSS® software (version 13). Results and Conclusion: The RCI and LTSI showed nonsignificant differences between the three groups. RLTSI showed a significant difference between Slimline™ and hand curette as well as Slimline™ and Desmo-Clean™. Slimline™ showed the least mean scores for RCI, LTSI, and RLTSI. Thus, even though the difference was not statistically significant, Slimline™ insert was shown to be better than the other methods as assessed by the indices scores and the instrumentation time.

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.

Comparação de parâmetros periodontais após utilização de contenção ortodôntica com fio trançado e contenção modificada / Comparison of periodontal parameters after the use of orthodontic multi-stranded wire retainers and modified retainers

OBJECTIVE: The objective of the present study was to compare two types of fixed orthodontic retainers (a multi-stranded wire retainer and a modified retainer) in relation to established periodontal parameters. The multi-stranded wire retainer is commonly used, and the modified retainer has bends to enable free access of dental floss to interproximal areas. METHODS: For this crossover study, 12 volunteers were selected and used the following retainers for six months: (A) a multi-stranded wire retainer and (B) a modified retainer. Both retainers were fixed to all anterior lower teeth.After this experimental period, the following evaluations were made: Dental Plaque Index, Gingival Index, Dental Calculus Index and Retainer Wire Calculus Index. The volunteers also responded to a questionnaire about the use, comfort and hygiene of the retainers. RESULTS: It was observed that the plaque index and the gingival index were higher on the lingual surface (p<0.05) for the modified retainer. Furthermore, the calculus index was statistically higher (p<0.05) for the lingual and proximal surfaces when using the modified retainer. The retainer wire calculus index values were also significantly higher (p<0.05) for the modified retainer. In the questionnaire, 58 percent of the volunteers considered the modified retainer to be less comfortable and 54 percent of them preferred the multi-stranded wire retainer. CONCLUSION: From the results obtained, it could be concluded that the multi-stranded wire retainer showed better results than the modified retainer according to the periodontal parameters evaluated, as well as providing greater comfort and being the retainer preferred by the volunteers.

OBJETIVO: o presente estudo teve como objetivo comparar dois tipos de contenções ortodônticas fixas, em relação a parâmetros periodontais estabelecidos. A contenção com fio trançado é a mais comumente utilizada e a contenção modificada apresenta dobras que têm a finalidade de permitir o livre acesso do fio dental às áreas interproximais.MÉTODOS: para esse estudo cruzado, foram selecionados 12 voluntários que utilizaram, por 6 meses, A) Contenção com fio trançado e B) Contenção modificada — sendo essas fixadas em todos os dentes do segmento anterior. Após esse período experimental, foram feitas as seguintes avaliações: Índice de Placa Dentária, Índice Gengival, Índice de Cálculo Dentário e Índice de Cálculo ao longo do fio de contenção. Os voluntários também responderam a um questionário com relação à utilização, conforto e higienização das contenções.RESULTADOS: foi observado que o índice de placa e o índice gengival foram maiores nas faces linguais (p<0,05) para a contenção modificada. Além disso, o índice de cálculo foi estatisticamente maior (p<0,05) considerando-se as faces linguais e proximais na utilização da contenção modificada. O índice de cálculo ao longo do fio também apresentou valores significativamente maiores (p<0,05) na contenção modificada. Em relação ao questionário, 58% dos voluntários consideraram que a contenção modificada é mais desconfortável; e 54% deles preferiram a contenção com fio trançado.CONCLUSÃO: a partir dos resultados obtidos, pode-se concluir que a contenção com fio trançado apresentou melhores resultados do que a contenção modificada, de acordo com os parâmetros periodontais avaliados, além de apresentar maior conforto e preferência na sua utilização.

Análisis in vitro de la micro dureza del esmalte dental humano expuesto al peróxido carbamida y sometido a la acción del flureto / In vitro analysis of the micro hardness of human enamel exposed to carbamide peroxide under the action of flureto

Este estudio analizó la micro dureza del esmalte dental humano expuesto al agente blanqueador peróxido de carbamida a 16%, con posterior aplicación, o no, de fluoreto de sodio a 2%. La muestra fue constituida por 20 dientes humanos, terceros molares inclusos de los cuales fueron confeccionados 20 especímenes divididos en 2 grupos: Grupo A compuesto por 10 especímenes que fueron clareados, Grupo B compuesto por 10 especímenes clareados y sometidos a la aplicación de fluoreto. Fueron tomadas las medidas iniciales y finales de micro dureza para los dos grupos. Después del análisis estadístico, los resultados demostraron que, para el Grupo A, el agente blanqueador no presentó una reducción estadísticamente significativa (p < 0,05) en la micro dureza del esmalte dental, ya para el Grupo B, el uso de fluoreto de sodio a 2% restauró completamente la micro dureza del esmalte. Se concluye que la técnica de blanqueamiento vital mediato con peróxido de carbamida a 16% es un tratamiento recomendado, pues aunque altere la micro dureza del esmalte, esa pérdida es revertida probablemente debido al efecto tapón de la saliva y al uso de fluoretos pos blanqueamiento

This study analyzed the microhardness of the human dental enamel exposed the brighten agent 16% carbamide peroxide, with and without application of 2% sodium flouride. The sample was established by twenty human tooth, intact third molars from which have been obtained twenty fractions of enamel and were made the specimens, these have been divided in two groups : Group A - composed by 10 specimens which were only brighten, Group B - composed by ten specimens brighten and submitted on the application of flouride. After the initial results of microhardness of the dental enamel, were made the final measures of microhardness from the specimens from the Groups A and B. After statistical analysis, the results demonstrating that to the Group A, the brighten agent it didn´t present a reduction significant estatistical (p < 0,05) on microhardness of the dental enamel, about the group B the use of 2% sodium flouride revamped entirely the microhardness of the enamel. We concluded that the technique of mediate vital bleaching with 16% carbamide peroxide is a recommended treatment, because even it affects the microhardness of the enamel, this waste is probably reverted due the tampon effect from saliva and the use of flouride after bleaching

En el tratamiento periodontal, por qué siempre el raspaje / In periodontal treatment, why always scaling

Se hace referencia a la principal causa etiológica de las enfermedades gingivo-periodontales y de las alteraciones que provoca en los tejidos involucrados, especialmente en el área de la unión dentogingival. Se define el significado del raspaje y alisado radicular, su efecto sobre dientes y encías y los beneficios que se reflejan en la recuperación de las características histológicas y clínicas normales. Se dan a conocer los resultados positivos sobre los distintos parámetros periodontales, concluyendo que es el procedimiento clínico más importante del tratamiento en periodoncia.

Efficacy of Carisolv™ as an adjunctive therapy to scaling and root planing on subgingival calculus removal

The purpose of this study was to evaluate the effectiveness of subgingival application of Carisolv™ gel as an adjunctive therapy to scaling and root planing (SRP) on calculus removal compared to conventional instrumentation. Forty-five teeth requiring extraction due to severe periodontal disease were randomized to the following treatments: 1) SRP alone; 2) placebo gel + SRP; 3) Carisolv™ gel + SRP. Either test or placebo gel was applied subgingivally for 1 min and then the root were instrumented until a smooth and calculus-free surface was achieved. Instrumentation time and the number of strokes required were recorded. After extraction, the efficacy of root surface instrumentation was measured by percentage of remaining calculus. There was no statistically significant difference (p>0.05) between the treatment groups regarding either time required for instrumentation or the percentage of residual calculus. The subgingival application of Carisolv™ gel prior to SRP did not provide any additional benefit to root instrumentation compared to scaling and root planing alone.

O objetivo deste estudo foi avaliar a efetividade da aplicação subgengival do gel Carisolv™ em associação aos procedimentos de raspagem e alisamento radicular (RAR) na remoção do cálculo dental aderido à superfície radicular, quando comparado à terapia periodontal mecânica convencional. Foram utilizados 45 dentes indicados para a exodontia devido à doença periodontal avançada, os quais foram divididos em três grupos de tratamento: 1) RAR apenas; 2) placebo + RAR; 3) Carisolv™ + RAR. O tempo despendido e o número de movimentos realizados para a instrumentação das superfícies radiculares foram avaliados durante o tratamento. Em seguida, os dentes foram extraídos e avaliados quanto ao percentual de cálculo residual, por meio de um sistema computadorizado de análise de imagens. Não houve diferença estatisticamente significante (p>0,05) entre os grupos com relação ao tempo requerido para os diferentes tratamentos, assim como quanto ao percentual de cálculo residual. Os resultados indicaram que a aplicação do Carisolv™ não promoveu benefícios adicionais àqueles obtidos com a terapia mecânica convencional na remoção do cálculo subgengival.

Terapia periodontal de soporte / Supportive periodontal therapy

La terapia periodontal de soporte tiene como objetivo la manutención de la salud de los tejidos dentales y del periodonto. Ella representa una medida preventiva para individuos que no presentan historia de problemas periodontales y una continuación de la terapia para el paciente con enfermedad periodontal. De este modo, logra optimizar los resultados de la terapia y prevenir la recurrencia de la enfermedad. Diversos estudios han sido conducidos para individualizar y adaptar la TPS al perfil y a las necesidades de cada paciente. Las evidencias disponibles indican que la enfermedad periodontal puede ser tratada y que el éxito a largo plazo del tratamiento será logrado cuando exista un programa de manutención con visitas frecuentes al profesional. Este trabajo discute los objetivos, procedimientos e intervalos de retorno a la terapia periodontal de soporte

Evaluation of efficacy of Sofscale. A clinical and SEM study.

Efficacy of Sofscale in the case of removal of calculus from the root surface as claimed by manufacturers was evaluated in the present study. 32 patients suffering from chronic periodontitis, having calculus deposits in the lower incisors were selected for the study. A double blind study was conducted to evaluate the ease with which calculus could be removed. In the second part of study, a SEM study of the root surface subjected to root planing alone and root planing after application of Sofscale was done to see whether any remnants of calculus was left behind. In the double blind study conducted on 32 patients, it was found in 21 patients, calculus could be removed with greater ease and less time in experimental area compared to the control. 17 patients were able to correctly identify the product side as easier to Sofscale. Patients did not complain of increased sensitivity of teeth or discomfort following application of Sofscale. Under SEM the root surface after root planing showed the presence of smear layer whereas after Sofscale application root surface appeared devoid of smear layer. No other significant difference were noticed between the root surfaces.

Condiçöes periodontais e necessidades de tratamento em pacientes do Centro Municipal de Saúde "Raphael Sorbo", Araraquara, SP-1995 / The periodontal condictions and treatment needs in patients at the Municipal Health Center \"Raphael Sorbo\" in Araraquara, SP-1995

O objetivo desse estudo foi verificar as condiçöes periodontais e necessidades de tratamento de pacientes, com idades entre 20 e 54 anos, que demandaram os serviços odontológicos do Centro Municipal de Saúde "Raphael Sorbo" de Araraquara, SP, nos meses de julho e agosto de 1995. Os exames clínicos foram realizados por um único examinador, previamente treinado, usando o CPITN. Os resultados mostraram que, em todas as idades, as maiores porcentagens de indivíduos apresentaram cálculo dental como a condiçäo periodontal mais freqüente, sendo a raspagem/polimento dental e a instruçäo de higiene bucal as maiores necessidades de tratamento. Os tratamentos complexos se mostraram necessários em 9,5 por cento e 25 por cento dos indivíduos das faixas etárias de 35-44 e 45-54 anos, respectivamente

Efecto de un dentifrico que contenga pirofosfato soluble y fluoruro de sodio sobre los depositos de calculo dental / Effect of a dentrifice which contains soluble pyrophosphate and sodium fluoride in dental calculus deposits

El presente estudio demuestra que las sales de pirofosfatos solubles tienen un efecto real en la inhibicion de la formacion del calculo dental. Se describe una comparacion entre un grupo experimental y un control que fueron sometidos a remocion de calculos dentales. La asignacion de los sujetos a los dos grupos, en forma aleatoria, permitio conocer el impacto que una crema dental compuesta de pirofosfatos de sodio solubles ejercio sobre la formacion de calculo dental nuevo. Los objetivos terminales del estudio fueron en su orden los siguientes: medir la reduccion y control del calculo dental utilizando un dentifrico que obtenga pirofosfato tetrasodico y fluoruro de sodio; medir la reaccion del sangrado gingival; comparar los resultados obtenidos con un grupo control o testigo que utilizaria un dentifrico comun. El proposito de este estudio fue evaluar el poder inhibitorio que posee una crema dental a la cual se le adicionaron pirofosfatos sodicos y fluoruro de sodio, en la formacion de nuevos calculos dentales. Este estudio clinico se justifica por la importancia que tiene el control del calculo dental-placa bacteriana, elementos indisolublemente considerados patologicos a los tejidos gingivales. Por otra parte, se crearia con esta clase de productos un medio masivo para la prevencion del sarro o calculo que, apoyados en la profilaxis y detartraje darian mejores resultados a la salud oral. Con base en criterios que se describen en el estudio se selecciono un grupo de pacientes a quienes se les sometio a profilaxis y detartraje. Ademas se les instruyo..