Subgingival polishing with a teflon-coated sonic scaler insert in comparison to conventional instruments as assessed on extracted teeth -: (I) Residual deposits

Background: Recent studies have shown that endotoxins are located on the periodontally diseased root cementum and not within it. These studies led to the suggestion that the root surface could be treated less aggressively during periodontal therapy. Thus, we designed a teffon-tubed sonic scaler insert for subgingival polishing. It was our objective to assess to which extent this new instrument is capable of removing bacterial deposits in deep pockets in comparison with conventional scaling instruments. Method: We compared the extent to which plaque and calculus could be removed with a curette, a conventional sonic and ultrasonic scaler insert, a Per-io-tor insert, and a teflon-tubed sonic scaler insert. 84 teeth requiring extraction had been treated with one of these instruments. After extraction, the teeth were stained with Malachite green, and the following areas were assessed: area lacking plaque and calculus, calculus, and area only covered with plaque. For statistical comparison, nonparametric analyses were carried out. Results: Curettes and conventional ultrasonic and sonic-scaler inserts had more area lacking plaque and calculus (97.5%, 92.2%, 92.1%) than did the Per-io-tor (80.1%) or the teflon-coated sonic scaler insert (84.4%). A similar effectivity sequence was observed for residual soft deposits (curette: 1.9%, ultrasonic scaler: 6.1%, sonic scaler: 5.4%, teflon-coated sonic scaler: 5.1% and Per-io-tor: 9.5%). Conclusions: The Per-io-tor and the teflon-coated sonic scaler insert seem to be suitable for the removal of soft deposits on the root surface, but not for the removal of calculus.