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At least 19 recordsLinked to original sources

PubMed1990

[Friction sound as an objective sign of completion of root planing].

Root planing is one of the most important procedures in periodontal treatment. However, there are no objective clinical signs to indicate completion of this procedure. The purpose of this study was to examine the friction sound produced by curettes and root surfaces during root planing and to test the possibility of utilizing the sound changes as an objective parameter for evaluating completion of the procedure. The study consisted of a clinical and laboratory experiment. Seven periodontally diseased teeth were utilized in the clinical trial. During scaling and root planing with the Gracey curette, the friction sound was clinically analyzed with a sound spectrograph. The root surface, in situ, was observed by scanning electron microscopy (SEM) with the replica technique. Twenty-one periodontally diseased teeth were used in the laboratory study. Root planed surfaces were classified as pre-root planed and post-root planed according to their friction sounds during root planing. Each surface was examined by the following methods: 1) measuring root surface roughness 2) SEM observations 3) determination of number of adherent cells by the cultured fibroblast technique. As a result, post-root planed surfaces were well root planed as evaluated by SEM observations and the profilometer. Similarly, adherent cell counts were increased on post-root planed surfaces. These results indicated the possible usefulness of friction sound analysis to judge the completion of root planing.

Cell Adhesion↗

PubMed1985

Scanning electron microscope evaluation of wear of dental curettes during standardized root planing.

Root planing relies upon the quality of instrument cutting edges. This study evaluated the sharpness and wear of some dental curettes available in the market following standardized root planing procedures. Nine working edges of nine Gracey No. 1/2 DE curettes, three each from three different manufacturers, were used as controls. These unused factory-sharpened edges were examined by scanning electron microscope (SEM). Eighteen edges of nine curettes of the same brands were likewise examined after root planing procedures. Root planing was carried out on extracted one-rooted teeth mounted in natural positions in manikin jaws. Working areas measuring 3 X 5 mm were marked on root surfaces previously exposed by periodontitis. Root planing procedures included 15 vertical strokes done by either Side 1 or Side 2 of each instrument in relation to a single working area of a tooth, and the same procedure repeated 3 times using the opposite side of the curette. All working edges were examined at points 1 and 2 mm from the tip under 500 times magnification. Edge deformation increased significantly from the control group to the "15-stroke" group and from the "15-stroke" group to the "45-stroke" group. Factory-sharpened curettes (control) were sharp, with functional wire edges present on 55% of the specimens. After 15 strokes, nonfunctional wire edges and narrow edge deformations with bevels measuring less than 15 mu were present. After 45 strokes eight cutting edges (88.9%) showed bevels wider than 15 mu. The difference between the three brands was not significant in any group (i.e., controls, 15 strokes, 45 strokes). Further study is indicated to evaluate the relationships between bevel dimensions and root planing effectiveness.

Curettage↗

PubMed1997

Tetracycline fibers plus scaling and root planing versus scaling and root planing alone: similar results after 5 years.

This paper presents 5-year data pertaining to a subgroup of patients from a previous investigation who were treated with scaling and root planing plus tetracycline fibers. The parent study demonstrated that 6 months after therapy, scaling and root planing plus tetracycline fiber therapy was significantly better at reducing probing depth and gaining clinical attachment than scaling and root planing alone. However, the long-term data presented here show a regression from the original gains in clinical attachment levels in the fiber group. Ultimately, the use of fibers provided no significant advantage with regards to probing depth reduction or clinical attachment gain. Within the power of this study, which would have required 1.78 mm of change in clinical attachment to show a difference, there was no significant difference between the treatments at 5 years. This study underscores the need for additional long-term evaluation of this mode of therapy.

Analysis of Variance↗

PubMed1995

Effect of ND:YAG laser irradiation and root planing on the root surface: structural and thermal effects.

Effects of ND:YAG laser irradiation on untreated and root planed tooth roots were investigated to determine whether a cleaning effect and/or removal of smear layer could be achieved without concomitant microstructural or thermal damage. Sixty (60) healthy extracted teeth were either untreated, irradiated only, root planed only, or irradiated and root planed. Intra-pulpal and surface temperatures were monitored during irradiation, then SEM was performed. Smear layer elimination was achieved without inducing hard tissue microstructural damage at 5W, using pulse durations and intervals of 0.1 s, a fluence of 0.77 J/cm2, and a total energy density of approximately 700 J/cm2. However, these results were not consistent in all samples. At these parameters, intra-pulpal temperature increases of 9 to 22 degrees C and surface temperature increases of 18 to 36 degrees C were recorded. Thus, despite their effectiveness for smear layer removal, these parameters may not be appropriate for clinical use as an adjunct to conventional periodontal therapy.

Body Temperature↗

PubMed2006

Clinical outcomes of quadrant root planing versus full-mouth root planing.

OBJECTIVES: To determine the clinical effects of full mouth compared with quadrant wise scaling and root planing. METHOD: Twenty patients with chronic periodontitis (> or = 2 teeth per quadrant with probing pocket depths (PPD) > or = 5 mm and bleeding on probing (BOP) were randomized into a test group treated in two sessions with subgingival scaling and root planing within 24 h (full-mouth root planing (FMRP)) and a control group treated quadrant by quadrant in four sessions in intervals of 1 week (quadrant root planing (QRP)). PPD, relative attachment level (RAL) and BOP were recorded at baseline, 3 and 6 months. RESULTS: Analysing first quadrant data, in moderately deep pockets (5 mm < or = PPD < 7 mm) there was no evidence for a difference (FMRP-QRP) between both groups for PPD reduction (mean: -0.128 mm; CI: [-0.949, 0.693]; p=0.747), RAL gain (mean: 0.118 mm; CI: [-0.763, 1.000]; p=0.781), and BOP reduction (mean: -20.1%; CI: [-44.3, 4.2]; p=0.099). Likewise, no significant differences between treatments were found for initially deep pockets (PPD > or = 7 mm), neither for first quadrant nor for whole mouth data. CONCLUSION: The results of the present study demonstrated equally favourable clinical results following both treatment modalities.

Adult↗

PubMed2004

Quadrant root planing versus same-day full-mouth root planing.

OBJECTIVES: The aim of this study was to determine whether same-day full-mouth scaling and root planing (FM-SRP) and quadrant scaling and root planing (Q-SRP) resulted in variations in the systemic humoral immune response dynamics (antibody titres and avidity) during active treatment and 3 and 6 months post-therapy. MATERIALS AND METHODS: Forty patients with chronic periodontitis were recruited into this study. Subjects were randomised into two groups and received either scaling and root planing quadrant by quadrant at 2-weekly intervals (Q-SRP group) or same-day full-mouth scaling and root planing (FM-SRP group). Clinical measurements and serum samples were obtained at baseline and approximately 6 weeks after the last clinical intervention (R1) and 6 months after the initiation of therapy (R2). Furthermore, serum samples were obtained from each patient undergoing therapy (Q-SRP and FM-SRP) at 3 bi-weekly instances so as to determine the short-term effects of each session of scaling and root planing on the dynamics of the humoral immune response. Serum antibody titre was assayed by enzyme-linked immunosorbent assay (ELISA) and antibody avidity was measured by thiocyanate dissociation against five putative periodontal pathogens: Porphyromonas gingivalis; Actinobacillus actinomycetemcomitans; Prevotella intermedia; Treponema denticola and Bacteroides forsythus. RESULTS: Both therapies resulted in similar antibody titre reductions against the majority of the organisms tested and although there was a distinct trend for antibody avidity to increase following therapy, this was not found to be statistically significant, reflecting marked inter-individual variation. In addition, no evidence emerged from this study to support increased antibody titres following the active phases of both treatment approaches due to an inoculation effect. Nevertheless, significant short-term increases in antibody avidity to most test bacteria were noted for both treatment strategies. CONCLUSION: Both therapies were associated with a reduction in antibody titres and an increase in the binding ability or avidity of antibodies, but there was a marked inter-subject variability and statistical significance was reached for only some of the test bacteria. No significant differences in the humoral antibody dynamics were found between the two treatment approaches.

Adult↗

PubMed2004

Quadrant root planing versus same-day full-mouth root planing. I. Clinical findings.

OBJECTIVES: The aim of this study was to test the hypothesis that same-day full-mouth scaling and root planing (FM-SRP) resulted in greater clinical improvement compared to quadrant scaling and root planing (Q-SRP) in chronic periodontitis patients over a period of 6 months. MATERIAL AND METHODS: Forty patients were recruited into this study. Subjects were randomised into two groups. The FM-SRP group received full-mouth scaling and root planing completed within the same day, while the Q-SRP group received quadrant root planing at 2-weekly intervals over four consecutive sessions. Whole-mouth clinical measurements were recorded with a manual periodontal probe at baseline (BAS) and at reassessment 1 (R1) (approximately 6 weeks after the completion of therapy), and at reassessment 2 (R2) (6 months after the initiation of therapy). Selected site analyses were performed on the deepest site in each quadrant before and after therapy (R1 and R2) and clinical indices were recorded with an electronic pressure sensitive probe. In addition, during the active phase of treatment clinical data were collected at 2-weekly intervals from the remaining untreated quadrants in the Q-SRP group only. RESULTS: Both therapies resulted in significant improvements in all clinical indices both at R1 and R2. A continuous clinical improvement was seen for both treatment groups during the experimental period, which reached peak levels at 6 months (DeltaPD=1.8 mm, DeltaCAL=1.1 mm, p<0.001; PD: pocket depth; CAL: clinical attachment level). The selected-site analysis revealed no significant differences in any clinical index between the two treatment groups at R2 (DeltaPD=2.8 mm, DeltaRAL=1.1 mm; RAL: relative attachment level). At the selected sites, the analysis of the deep pockets (>7 mm) showed a significantly greater gain in RAL for the FM-SRP group compared to the Q-SRP group at R2 (p<0.05). The results of this analysis however, should be interpreted with care due to the small number of deep pockets. Data from the Q-SRP group provided an insight into how treated and untreated quadrants responded during the initiation of plaque control measures. There were significant reductions in PD, suppuration (SUP), modified gingival index (MGI) and plaque index (PI) in the remaining untreated quadrants in the Q-SRP group during the initial phase of treatment (p<0.05), while minimum changes in RALs and bleeding on probing (BOP) occurred. Nevertheless, the improvement in PD was clearly inferior to that seen after scaling and root planing. CONCLUSION: Following both therapeutic modalities, there were marked clinical improvements at both R1 and R2 (6 months) from baseline. The current study, in contrast to previous findings, failed to show that FM-SRP is a more efficacious periodontal treatment modality compared to Q-SRP. However, both modalities are efficacious and the clinician should select the treatment modality based on practical considerations related to patient preference and clinical workload.

Adult↗

PubMed2004

Quadrant root planing versus same-day full-mouth root planing. II. Microbiological findings.

OBJECTIVES: The aim of this study was to test the hypothesis that over a period of 6 months, same-day full-mouth scaling and root planing (FM-SRP) resulted in greater reductions in the detection frequency of five putative periodontal pathogens compared with quadrant scaling and root planing (Q-SRP) in chronic periodontitis patients. MATERIALS AND METHODS: Forty patients were recruited into this study. Subjects were randomised into two groups. The FM-SRP group received full-mouth scaling and root planing completed within the same day, while the Q-SRP group received quadrant root planing at 2-weekly intervals over four consecutive sessions. Selected-site analyses were performed on the deepest site in each quadrant before and after therapy, at approximately 3 and 6 months from baseline (R1 and R2) and clinical indices were recorded with an electronic pressure-sensitive probe. In addition, subgingival plaque samples were collected from these sites at baseline (BAS), at reassessment 1 (R1), approximately 6 weeks after the completion of therapy and at reassessment 2 (R2), 6 months from baseline. Polymerase chain reaction (PCR) was used to determine the presence of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Treponema denticola and Bacteroides forsythus in plaque. RESULTS: Both therapies resulted in significant improvements in all clinical indices both at R1 and R2. A marked reduction in the presence of all candidate periodontal pathogens was noted after both treatment modalities, reaching statistical significance for the majority of the test organisms. These improvements were maintained over a period of 6 months. When the two treatment groups were compared, a significantly higher percentage of Q-SRP patients was positive for P. intermedia at R1 compared with FM-SRP patients (p<0.05). In addition, a greater reduction in the patient prevalence for T. denticola was found for the FM-SRP group than the Q-SRP group at R1 and R2 from baseline (p<0.005), but the significance of this is questionable given the skewed detection frequency of this organism at baseline between the two treatments (p<0.01). CONCLUSION: This study failed to confirm that same-day FM-SRP resulted in greater microbiological improvements compared with Q-SRP at 2-weekly intervals over a 6-month period, as determined by PCR.

Adult↗

PubMed1993

The clinical effectiveness of open versus closed scaling and root planing on multi-rooted teeth.

Scaling and root planing are the most common techniques utilized to achieve a biologically-acceptable root surface. Thorough root debridement is a demanding task, with residual deposits of plaque and calculus a not uncommon finding after instrumentation. This study evaluated the effectiveness of scaling and root planing via a closed versus an open flap approach. Sixty multi-rooted teeth were assigned to one of three groups: untreated controls, closed scaling/root planing, and open flap scaling/root planing. Following debridement, teeth were extracted, immersed in methylene blue, and examined for the percent surface area having stainable residual deposits. The mean percent stained surface area covered by residual plaque and calculus was 54.3% in the closed root planing group compared to 33.0% in the open flap root planing group. The untreated control teeth had 91.0% of the root surface covered with stainable deposits. Within-group comparisons showed no significant difference in the percent stained residual plaque and calculus in shallow areas of the pocket (< or = 3 mm apical to the gingival margin) compared to deeper areas (> 3 mm subgingival). Examination of furcation regions demonstrated heavy residual stainable deposits for both treatment methods, with no significant differences between techniques. There was no correlation between the time spent in root debridement and the percent residual deposit area. The results demonstrate that hand instrumentation alone is inadequate for thorough debridement of furcations and suggest that new approaches are needed to provide a root surface which is compatible with formation of new periodontal attachment. High frequency ultrasonic instruments, rotary burs, and chemical agents may assist in debridement of such surfaces.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Factors determining the outcome of scaling and root planing.

Scaling and root planing are the predominant and recognized forms of periodontal therapy. They have been known for centuries, and have been investigated with increasing intensity since the turn of the century. Scaling and root planing aim at therapeutic changes of the "hard tissue lesion" at the root surface, in order to render it biologically acceptable to cells capable of attaching to it. Two major components of these root surface alterations are calculus and cementum alterations. Numerous studies have shown that scaling and root planing effectively removes subgingival deposits, and that this removal is seldom complete in deeper pockets. Even though beneficial clinical effects of scaling and root planing have been shown, it is unlikely that the full potential of healing is utilized today due to technical shortcomings. Several studies have shown that the design and dimensions of curets as used today are not optimal. These instruments are for many situations too big, subject to rapid dulling, and produce a smear layer. Chemical agents have been used to remove this layer with limited success. The therapist is a virtually unknown factor in the system of delivering scaling and root planing. A recent study showed that scaling and root planing forces used by different therapists on similar root surfaces varied by factors greater than 10. In addition, higher forces were shown to remove significantly more root substance. Apparently there is a large subjective component included in the delivery of scaling and root planing therapy. Even though scaling and root planing have been shown to be effective therapeutic procedures, many aspects require more research.

Clinical Competence↗

PubMed2003

In vivo and in vitro effects of an Er:YAG laser, a GaAlAs diode laser, and scaling and root planing on periodontally diseased root surfaces: a comparative histologic study.

BACKGROUND AND OBJECTIVES: The aim of the present histologic study was to compare the in vivo and in vitro effects of an erbium: yttrium, aluminum, and garnet (Er:YAG) laser (ERL), combined with a fluorescent calculus detection system, a diode laser (DL) and scaling and root planing (SRP) on periodontally diseased root surfaces. STUDY DESIGN/MATERIALS AND METHODS: Twenty-four single rooted teeth, considered for extraction due to severe periodontal destruction, were included in the study. Prior to extraction all mesial root surfaces were randomly assigned to the following treatment groups: (1) ERL combined with a calculus detection system with fluorescence induced by 655 nm InGaAsP DL radiation (160 mJ/pulse and 10 pulses/second under water irrigation) (ERL), or (2) GaAlAs DL (1.8 W, pulse/pause relation 1:10), or (3) SRP using hand instruments. Immediately after extraction, all distal root surfaces were treated with the same instruments under standardized conditions. For light microscopic investigation, a plastic embedding technique was used to cut the undecalcified roots into 30 microm thick crossections. The following parameters were recorded by on blind examiner: remaining debris, root surface morphology, and thermal side effects. RESULTS: Root surfaces instrumented with both, ERL in vivo and DL in vitro exhibited no detectable surface alterations. In contrast, ERL scaling in vitro and SRP in vivo/in vitro produced superficial microchanges in root cementum. However, irradiation with DL in vivo caused severe damages to the root surface (i.e., crater formation). There were no signs of thermal side effects in all laser treated groups. ERL provided subgingival calculus removal on a level equivalent to that provided by SRP. DL was unsuitable for calculus removal, since macroscopic inspection revealed the presence of large amounts of subgingival calculus. CONCLUSIONS: The present in vivo results showed that (i) ERL, combined with a fluorescent calculus detection system, provided a selective subgingival calculus removal on a level equivalent to that provided by SRP, and (ii) DL, using this power output, was unsuitable for calculus removal and altered the root surface in an undesirable manner.

Dental Calculus↗

PubMed2006

A comparative SEM study between hand instrument and Er:YAG laser scaling and root planing.

Scaling and root planing are one of the most commonly used procedures for the treatment of periodontal diseases. Removal of calculus using conventional hand instruments is incomplete and rather time-consuming. In search for more efficient and less difficult instrumentation, investigators have proposed lasers as alternatives or adjuncts for scaling and root planing. The aim of the present study was to compare the effectiveness of subgingival scaling and root planing with erbium: yttrium, aluminium, garnet (Er:YAG) laser and hand instrumentation in vitro. The mesial and distal surfaces of 15 periodontal loosed extracted teeth were treated randomly either by hand instrumentation or by Er:YAG laser irradiation. After choosing the "very long pulse mode" (pulse duration of about 700 micros), the output energy of 160 mJ with 920-microm beam diameter (RO7 Perio tip, Fidelis, Fotona, Slovenia) and frequency of 12 Hz were selected, both according to the best results of past studies. In addition, air water spray was used during the procedures. The morphology of the root surface was evaluated by three observers with a scanning electron microscopy in magnifications of 50x and 400x. The result of this setting showed that the rate of remained roughness on treated root surfaces in two groups of hand instruments and Er:YAG laser had a meaningful difference: The surface roughness in Er:YAG laser group was more than in hand instruments group. The present study could demonstrate the in vitro capability of the Er:YAG laser for scaling and root planing in periodontitis, although the effectiveness of this setting did not reach that achieved by hand instrumentation. It could be concluded that lower frequency and long pulse duration maybe more suitable for the micro-morphology of root surface after treatment. This theory is going to be tested with the same laser instrument in the next study.

Dental Calculus↗

PubMed2005

The need for pain control during scaling and root planing.

Scaling and root planing is a common procedure in clinical practice. Despite the frequency of the procedure, the control of pain associated with scaling and root planing has not been well studied. Recently, studies have pointed out a need for pain control during the procedure in a significant number of subjects-perhaps as many as 30% of patients. This need for pain control is similar to the need for instrumentation during maintenance therapy. The need also is similar whether hand instrumentation or ultrasonic equipment is used. The current most used form of pain control is local anesthesia injections. However, many patients object to the use of "the needle." Therefore, there is a need for a noninjectable form of pain control that is effective.

Administration, Topical↗

PubMed1980

Root planing and curettage.

Root planing and curettage are at least as satisfactory as other surgical techniques for the gain and maintenance of attachment in most periodontal pockets. Reduction of pocket depth and root exposure are less following subgingival curettage than after other modalities of surgery. It is not known if soft tissue curettage adds anything to the results of scaling and root planing. Curettage is demanding with regards to technical skill and time, and may be impractical in many instances compared to flap surgery.

Dental Instruments↗

PubMed1978

The effectiveness of in vivo root planing in removing bacterial endotoxin from the roots of periodontally involved teeth.

In this study, scaling alone resulted in endotoxin values considerably greater than the values for healthy root surfaces. However, the root-planed Samples contained only about 1 ng more of endotoxin than did the healthy root surfaces. This small difference can be accounted for by the presence of small flecks of calculus left after root planing. Considering that out of a total sample size of 48 surfaces there was only 1 ng difference in the amount of endotoxin between planed teeth and uninvolved teeth, the basic conclusion must be that root planing, as performed in this study, was able to render diseased root surfaces approximately as free of detectable endotoxin as were uninvolved, healthy root surfaces of unerupted teeth.

Adult↗

PubMed1980

Postsurgical bone loss following root planing by ultrasonic and hard instruments.

The ultrasonic scaler is currently used to plane the roots in periodontal surgery. The purpose of this study was to provide experimental evidence in support of, or against, the use of the ultrasonic scaler for root planning in periodontal surgical procedures. A notch was made through the enamel of each canine of nine adult cats. Full thickness mucoperiosteal flaps were elevated on each canine. Using hand curettes, soft tissue tags were removed from each tooth. At the maxillary right canines and mandibular left canines the roots were planed using the ultrasonic scaler, while at the maxillary left canines and mandibular right canines the roots were planed using hand curettes. A caliper was used to measure the distance from the notch to the crest of the alveolar process at each tooth. The mucoperiosteal flaps were repositioned and secured with cyanoacrylate cement. Three months postoperatively all 36 sites were reoperated and the distance from the notch of each canine to the crest of its alveolar process was measured using the caliper. The same caliper was used for all sites and the same investigator made all the measurements. Analysis of the results showed that all canines lost alveolar bone as a result of the surgical procedure, however, there was no statistical significance between the amount of bone lost on the canines where root planing was carried out by the ultrasonic scaler and the canines where the roots were planed with hand curettes. These findings support the use of the ultrasonic scaler for the planing of roots following elevation of mucoperisteal flaps and confirm its value in the practice of periodontal surgical procedures.

Alveolar Process↗

PubMed1997

An in vitro study of various instruments for root planing.

Rotating instruments are becoming increasingly significant in the scaling and planing of the root surface. The objective of this in vitro study was to test various root-planing instruments on extracted teeth and then to compare the treated surfaces using scanning electron microscopy. Two manual instruments (scaler and curette) and five mechanically rotating instruments (Desmo-Clean; Perio-Set; Viking-Set; and 40-microns and 15-microns diamond finishers) were investigated. From a total of 42 teeth, six root surfaces were treated with each instrument. The results confirm the clear superiority of the manual instruments (especially the curette). The manual instruments permit good root planing with minimum ablation from the root surface and only a thin smear layer (a compound of grinding dust, dentinal fluid, and water). The best planing results by rotating instruments were achieved with the Desmo-Clean and the 15-microns diamond finisher, whose performance was almost equal to that of the manual instruments. The rotating instruments, however, were associated with higher ablation and a marked smear layer. Manual instruments remain the media of choice on easily accessible root surfaces; however, rotating instruments are of advantage in inaccessible areas (eg, furcations) because of their handling properties.

Bicuspid↗

PubMed1989

Endodontic effects of root planing in humans.

Although the deliberate removal of cementum by root planing remains part of periodontal therapy, its scientific basis is under challenge. A potentially harmful effect of root planing is the exposure of dentinal tubules to the oral environment; this study investigated the short-term endodontic effects of root planing in humans. Ten teeth with significant loss of periodontal attachment had one proximal surface root planed; the other proximal surface was not root planed. After 10-14 days, the teeth were extracted and processed for light microscopic and SEM examination. Hypersensitivity to thermal stimuli was reported by 4 subjects after root planing. Chronic pulpitis was found in 3 pulps adjacent to the area of root planing. Bacterial penetration of dentin was observed, although the depth of penetration was less than reported by others. The results indicated that previous perceptions of the beneficial role of root planing in periodontal therapy require reconsideration.

Dental Prophylaxis↗