EFFECTIVENESS OF SUBGINGIVAL INSTRUMENTATION WITH POWER-DRIVEN INSTRUMENTS IN THE HANDS OF EXPERIENCED AND INEXPERIENCED OPERATORS - A STUDY ON MANNEQUINS

Power instrumentation of periodontally-diseased root surfaces is gaini ng in significance as an alternative to conventional curette methods. In an experimental study employing manikins with simulated bone loss, we investigated whether inexperienced and experienced operators were a ble to achieve greater therapeutic success with power-driven devices t han with hand instruments in subgingival scaling. 10 dentists experien ced in periodontal treatment and 10 inexperienced dentists instrumente d 7 teeth in the upper jaw, which had been covered with artificial dep osits. Hand instruments, the Perioplaner system, a sonic and an ultras onic scaler were used. The time required for treatment was measured an d the % of residual deposits was calculated by means of image-processi ng techniques. Weight loss was also determined for the teeth that were scaled with the hand instruments and the Perioplaner system. Experien ced operators left significantly less % of residual deposits on the te eth (18+/-7.6%) than the inexperienced (27+/-8.4%), regardless of the type of instrument selected. Both experienced and inexperienced operat ors left the smallest amounts of residual deposits with hand instrumen ts (13+/-9.8%/24+/-9.5%). Both treatment groups removed more hard toot h structure with hand instruments than with the Perioplaner system (53 +/-48mg versus 47+/-25.9 mg). Experienced operators needed somewhat mo re time for debridement than unexperienced. Use of the sonic/ultrasoni c device required somewhat less time than hand instrumentation. Inexpe rienced operators are, however, unable to improve their treatment resu lts by using the power-driven instruments included in the study.