2. Primary goal of periodontal treatment
Flap surgery vs. nonsurgical planing
Ultrasonic with mini-inserts vs. manual
curettes
3. Treatment
◦ 10 single-rooted teeth destined for extraction
◦ Two step treatment was performed
General ultrasonic supragingival scaling
Surface planing
By manual curette without time limit on distal surfaces
By ultrasonic inserts on mesial surfaces
4. SEM observations
◦ 2.5% glutaraldehyde in pH 7.2 buffer, 24 hours
◦ Rinsed 3 times in 0.1mol/L cacodylate buffer
◦ Dehydrated with ethanol and acetone
◦ Dried by CO2 and Balzers CPD 0.10
◦ Secondary electrons vs. backscattered electrons
5.
6.
7.
8.
9.
10. Comparing two instrumentation procedures
vs. comparing two periodontists
Moderate lateral pressure vs. high lateral
pressure
11. Goal: elimination of all plaque and calculus
Moderate lateral pressure is better
Not depend on the instrumentation itself, but
on how it performed, particularly on the
pressure
12. With strong lateral pressure
◦ More scratching
◦ Cementum removal
◦ Dentin exposure
13. Smoother surfaces in moderate lateral
pressure
Cracked or “dried-mud” appearance
Less smear layer with ultrasonic treatment
than with manual treatment
14. New ultrasonic generator and inserts are as
effective as nonsurgical manual curettes
Degree of lateral pressure is a vital factor
New mini-inserts are better in apical zones as
long as moderate lateral pressure is used
