CLINICAL-EVALUATION OF THE SPEED AND EFFECTIVENESS OF SUBGINGIVAL CALCULUS REMOVAL ON SINGLE-ROOTED TEETH WITH DIAMOND-COATED ULTRASONIC TIPS

SEVERAL STUDIES HAVE FOUND incomplete calculus removal during periodon tal treatment with traditional hand curets, sonic, and ultrasonic inst ruments. This study evaluated the speed and effectiveness of subgingiv al calculus removal with new diamond coated ultrasonic tips on single- rooted teeth. Single session subgingival scaling and root planing was performed on 80 teeth with 5 to 12 mm probing depths in 15 patients. E ach patient provided groups of 4 teeth that were randomly treated with either hand curets (HAND); standard smooth ultrasonic tip (US); or fi ne grit (FINDIAM) or medium grit (MEDDIAM) diamond-coated ultrasonic t ips. The time taken to reach the therapeutic endpoint of a clean, smoo th root surface in a defined region on each tooth with each instrument by the 3 therapists with differing experience levels was recorded. Th e teeth were then atraumatically extracted, stored in a surfactant, ph otographed at 10x, and the percent of calculus present in the area of the pocket or on a comparable control surface calculated by histometri c point counting. ANOVA and paired t tests showed that mean percent re maining calculus on treated versus control surfaces was HAND 4.6 +/- 5 .3 versus 57.5 +/- 28.2, US 4.7 +/- 6.4 versus 54.4 +/- 25.9, FINDIAM 4.3 +/- 5.2 versus 37.5 +/- 22.1, and MEDDIAM 3.4 +/- 4.2 versus 50.7 +/- 20.1, respectively (all P < 0.01). The mean time in seconds to rea ch the clinical endpoint ranged from HAND 289 +/- 193, US 194 +/- 67, FINDIAM 167 +/- 71, to MEDDIAM 147 +/- 92. All powered instruments wer e significantly faster than HAND (P < 0.05), but did not differ from e ach other. On a 0 = ''smooth'' to 3 = ''rough'' scale, most often HAND resulted in ''smooth'' surfaces (10/20), the powered tips of all type s ''slight'' surface roughness (10/20 each), and US the most ''moderat e'' roughness (7/20). There were no differences in percent calculus re maining, surface roughness, or time spent among the 3 treating clinici ans despite their varying experience levels. The results of this study showed that percent calculus remaining was <5% with all the instrumen ts given time ad libitum on a given root surface. Root roughness was g enerally slightly greater with all 3 powered tips. All of the powered instruments took significantly less time than the HAND. Both DIAM tips took less time than US. Diamond-coated ultrasonic tips appeared to be much more efficient than HAND or US in removing calculus in moderate- deep probing depths on single-rooted teeth in vivo.