Efficacy of An Ultrasonic Scaler with A Periodontal Probe-type Tip in Deep Periodontal Pockets

¹ Department of Periodontology and Endodontology, School of Dentistry, Hokkaido University, Kita 13, Nishi 7, Kitaku, Sapporo 060, Japan

Abundant evidence has been advanced to support the idea that destructive periodontal disease is closely associated with subgingival plaque and calculus. A probe-type tip has been newly designed for the ultrasonic scaler to be used for easy debridement in deep pockets without local anesthesia or gingival elevation. The purpose of this study was to examine, by in vitro and in vivo experiments, the potential of this device for clinical application. The efficiency of ultrasonic debridement on calculus removal by a probe-type tip was examined on extracted teeth. All of 170 calculus spots were easily removed by the device. Accessibility of the root surfaces to the tip in deep periodontal pockets was examined on 46 root surfaces within deep pockets. The Accessibility Quotient of the instrument was 0.94 ± 0.10. The efficiency of ultrasonic debridement of subgingival plaque and calculus in deep pockets was also examined in 86 non-instrumented root surfaces. The mean operating time was 115.0 ± 60.9 sec/surface. None of the patients complained of pain, even though anesthesia was not used. The mean percentage of residual deposits in microscopic pocket areas was 4.6 ± 7.4% in 58 experimental surfaces, although it was 95.8 ± 8.3% in 28 control surfaces. Finally, the efficacy of debridement on clinical parameters was examined in 72 deep pockets (4 mm) of 12 patients. Sulcus fluid and number of bleeding-on-probing sites decreased markedly one week after the debridement without anesthesia, and remained unchanged up to four weeks. A significant decrease of probing pocket depth and gain of probing attachment level were also found in instrumented sites. We concluded that the application of this device for subgingival debridement in deep pockets seems to be efficacious for non-surgical therapy.