PAIN AND DISCOMFORT LEVELS IN PATIENTS DURING ROOT SURFACE DEBRIDEMENT WITH SONIC METAL OR PLASTIC INSERTS

THE STUDY WAS DESIGNED TO EVALUATE whether root surface debridement wi th a sonic scaler plastic insert would cause less pain and discomfort to patients than an ordinary, probe-shaped metal sonic insert. One qua drant in each of 23 patients was debrided with each insert. Blood pres sure, mean arterial pressure, and heart rate were monitored before, du ring, and immediately after each treatment. Pain was also evaluated on a visual analogue scale (VAS) after each treatment, as well as 2 week s later following pain-provoking stimuli. Blood pressure, mean arteria l pressure, and heart rate did not reveal any differences between quad rants treated with plastic or metal inserts. Heart rate had a weak, po sitive association with treatment time. The VAS gave a higher pain sco re for the plastic (30.8) than for the metal insert (24.4), but this d ifference was not statistically significant (P = 0.055). Following pai n-provoking stimuli at the 2-week follow-up visit, quadrants debrided with the metal insert (31.3) scored significantly lower (less pain) (P <0.01) on the VAS than quadrants treated with the plastic insert (30. 7). It is concluded that the sonic metal insert caused less pain and d iscomfort to the patients due to its superior accessibility and water spray cooling. The significant difference between metal and plastic ti p debrided quadrants at the follow-up visit was probably caused by the smearing effect of the metal insert with partial closure of the denti n tubule orifices.