Evaluation of Remaining Cementum Thickness Following the Use of Hand and Ultrasonic Curettes of Periodontally Diseased Root Surface - An in-vitro Study

Authors

  • Sandeep Kour PG Student, Himachal Institute of Dental Science, Paonta Sahib, Himachal Pradesh, India.
  • Rajan Gupta Head of Department & Professor, Himachal Institute of Dental Science, Paonta Sahib, Himachal Pradesh, India.
  • Parveen Dahiya Professor, Himachal Institute of Dental Science, Paonta Sahib, Himachal Pradesh, India.
  • Mukesh Kumar Professor, Himachal Institute of Dental Science, Paonta Sahib, Himachal Pradesh, India.
  • Lolakshi Kachroo Senior Lecturer, Himachal Institute of Dental Science, Paonta Sahib, Himachal Pradesh, India.

Keywords:

Cementum Loss, Curettage, Hand Curette, Stereomicroscopic Analysis, Ultrasonic Curette

Abstract

Background: Scaling and root planing are the most predictable treatment outcomes for periodontal disease. However root planing with hand curettes removes excess of cementum as compared to ultrasonic curettes. Hence the purpose of this study was to evaluate the effectiveness of remaining cementum thickness following the use of ultrasonic and hand curettes.

Aim: To evaluate the remaining cemental thickness following the use of hand and ultrasonic curettes on periodontally diseased root surface using a stereomicroscope.

Materials and Methods: Thirty single rooted teeth were extracted due to advanced periodontitis and were randomly divided into two groups: Group 1 (SRP with hand curettes) and Group 2 (SRP with ultrasonic curettes). The proximal surfaces of the teeth (mesial and distal) were subjected to root planning. one surface served as a test site where instrumentation was done and no instrumentation was done on the other surface (control site). Following instrumentation, midroot region of instrumented specimen was cross-sectioned and prepared for stereomicroscopic study. The data gathered from stereomicroscopic study was subjected to statistical analysis by Mann Whitney test.

Results: The results of our study showed that in both the groups, the mean cemental thickness in scaled group was significantly lower than unscaled group. Clinically, teeth treated with the ultrasonic scaler showed less tooth substance removal than hand curettes but the difference between the two groups were statistically non-significant.

Conclusion: Both the therapies i.e. SRP with hand curettes and ultrasonic curettes seemed to be effective in the removal of diseased cementum.

References

1. Aspriello SD, Piemonstese M, Sauro S. Ultramorphology of root surface subsequent to hand ultrasonic
simultaneous instrumentation during non-surgical periodontal treatments. An in vitro study. J Appl Oral
Sci 2011; 19(1): 74-81.
2. Adriaens PA, DeBoever JA, Loesche WJ. Bacterial invasion in root cementum and radicular dentin of
periodontally diseased teeth in humans: a reservoir of periodontopathic bacteria. J Periodontol 1988; 59:
222-230.
3. Rabbani GM, Ash MM, Caffesse RG. The effectiveness of subgingival and root planning in calculus removal.
J Periodontol 1981; 52(3): 119-123.
4. Nishida M, Katamsi D, Ucheda A. Hypersensitivity of the exposed root surfaces after surgical periodontal
treatment. J Osaka Univ Dent Soc 1976; 16: 73-77.
5. Proye M, Caton J, Polson A. Initial healing of periodontal ligament pockets after a single episode of root planning monitored by controlled probing forces. J Periodontol 1982; 53(5): 296-301.
6. Balu P, Ramalingam S, Raja M. Cementoenamel junction in health and disease. A light microscopic Study. Int J
Oral Maxillofac Pathol 2011; 2(4): 20-23.
7. Moskow BS, Bressman E. Cemental response to ultrasonic and hand instrumentations. J Am Dent Assoc
1972; 68: 698-703.
8. Robinson PJ. Possible roles of diseased cementum in periodontitis. J Prev Dent 1975; 2: 3-5.
9. Casarin RCV, Ribeiro FV, Sallum AW. Evaluation of root surface defect produced by hand curettes and
ultrasonic tips with different power settings. Braz Dent J 2009; 20(1): 58-63.
10. Kawashima H, Sato S, Kishida M. Comparison of root surface instrumentation using two piezoelectric
ultrasonic scalers and a hand scaler in vivo. J Periodontol Res 2007; 42: 90-95.
11. Polson AM. The root surface and regeneration: present therapeutic limitations and future biologic potentials.
J Clin Periodontol 1986; 13: 995-999.
12. Selvig G, Bergenholtz G, Lindhe J. Effect of experimentally induced marginal periodontitis and periodontal scaling on the dental pulp. J Clin Periodontol 1970; 5: 59-73.
13. Coldiron E, Walsh TF, Laird WR et al. Effects of cavitational activity on the root surface of teeth during
ultrasonic scaling. J Clin Periodontol 1990; 17: 306-312.
14. Ritz L, Hefti AF, Rateitschak KH. An in vitro investigation on the loss of tooth substance in scaling with various
instrumentations. J Clin Periodontol 1991; 18: 643-647.
15. Pratebha B, Sudhakar R, Raja M. Cemento-Dentinal junction in health and disease: a light microscopic
study. Int J Oral Maxillofac Pathol 2011; 2(4): 20-40.
16. Levespere JE, Yukuna RA, Rice DA et al. Root surface removal with diamond- coated ultrasonic instruments:
an in vitro and SEM study. J Periodontol 1996; 67: 1281-1287.
17. Khosravi M. External root resorption: its implication in dental traumatology pedodontics, periodontics,
orthodontics and endodontics. Int Endod J 2004; 18: 109-118.
18. Furseth R, Johensen E. A microradiographic comparison of sound and carious human dental cementum. Arch
Oral Biol 1998; 13: 1197-206.
19. Moreno CS, Moliner, Alememy AS. In vitro evaluation of root surface microtopography following the use of
two polishing systems by confocal microscopy (CFM) and (SEM). an in vitro study. OHDM 2013; 12(4): 608-15.
20. Jones WA, O’Leary TJ. The effectiveness of in vivo root planning in removing bacterial endotoxins from the
roots of periodontally involved teeth. J Periodontol 1978; 49(7): 337-42.
21. O’Leary TJ, Kafrawy AH. Total cementum removal: arealistic objective. J Periodontol 1983; 54: 221-6.
22. Singh VM, Salunga RC, Huang VJ. Analysis of the effect of various decalcification agents on the quantity and
quality of nucleic acid (DNA and RNA) recovered from bone biopsies. Ann Diagn Pathol 2013; 17(4): 322-6.
23. Bozbay E, Dominici F, Gokbuget AY et al. Preservation of root cementum: a comparative evaluation of powerdriven versus hand instruments. Int J of Dent Hyg 2018; 16(2):202-209.
24. Dahiya P, Kamal R, Gupta R et al. Comparative evaluation of hand and power-driven instruments on root surface characteristics: A scanning electron microscopic study. Contemp Clin Dent 2011; 2(2): 79-83.
25. Leal JI, Flores DB, Brevo M. Effect of root planning on surface topography an in vitro randomized experimental trial. J Periodontol 2014; 5: 268-73.
26. Khosravi M, Bahrami ZS, Atabaki MSJ, et al. Comparative effectiveness of hand and ultrasonic instrumentations in root surface planning in vitro. J Periodontol 2004; 31: 160-5.

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Published

2020-07-29