J Cadosch | PubMed Health

PubMed2003

Root surface debridement and endotoxin removal.

OBJECTIVE: This study assessed associations between the number of standardized scaling strokes and the reduction of endotoxin on the root surface. BACKGROUND: Therapy of periodontally involved teeth attempts removal of accretions by scaling and root planing. The amount of mechanical therapy required to free the root surface from etiologic factors remains unknown. METHODS: Twenty-four extracted human caries-free single rooted teeth with at least 5 mm attachment loss were used. A region of interest (ROI) which contained subgingival calculus was defined on the root surface of each tooth. Standardized force instrumentation was applied using a force-measuring curet. Fifty working strokes were applied to every ROI. Forces applied were recorded. The force recordings were converted from Millivolts into Newtons (N). After every unit of 5 strokes, presence of calculus was evaluated and scaling debris was collected. Endotoxin concentration was determined in the debris samples. RESULTS: The endotoxin values for strokes 1-5 were statistically significantly greater than the values from all other stroke intervals. Complete calculus removal occurred after a mean of 9.3 strokes. The endotoxin concentration reached a minimal level with concentrations of 0.03-0.306 EU/ml after calculus removal was complete. CONCLUSION: These findings suggest that completion of calculus removal coincides with endotoxin levels associated with clinically healthy teeth.

Chromogenic Compounds↗

PubMed1991

In vivo scaling and root planing forces.

The purpose of the present study was to assess the scaling and root planing forces exerted in vivo. Ten dentists and 10 dental hygienists scaled and root planed one aspect of an incisor in an adult patient with untreated advanced periodontitis. During scaling and root planing forces were recorded using a piezo-electric receiver, an electronic transducer, and an analogous writer. The forces were recorded in mA and converted into Newtons (N). The results showed that the mean scaling force applied by dentists was 5.70 N and ranged between 1.01 to 10.35 N. The corresponding values for dental hygienists were a mean of 5.38 N, and a range of 1.52 to 15.73 N. The root planing forces in dentists reached a mean of 4.62 N, and ranged between 0.86 to 8.88 N. For hygienists, these values were 4.58 N with a range of 1.56 to 10.59 N. Negative forces impacting on the periodontal soft tissues were also recorded. They were not present in all therapists, but consistently at work within specific therapists. During scaling these forces reached a mean of -0.40 N in dentists and -0.47 N in dental hygienists. During root planing, these forces were mean -0.59 N in dentists, and -0.81 N in hygienists. There were no statistically significant differences between scaling forces and root planing forces, nor between forces used by dentists and hygienists (P greater than 0.05). However, there were significant differences between the force levels of the individual therapists for all positive forces (P = 0.0001), and for negative forces during root planing (P = 0.0001). The technology and information provided by this investigation may enable studies evaluating clinical effectiveness of scaling and root planing doses.

Adult↗