Comparative evaluation of hand and power-driven instruments on root surface characteristics: An in vitro scanning electron microscopic study
Background: Scaling and root planning are an important component of periodontal therapy which aim at removal of soft and hard deposits from the exposed root surfaces. Various instruments available to clinicians for mechanical root preparations like sonic and ultrasonic scalars, hand curettes and scalars, and rotary instruments remove plaque and calculus with loss of tooth substance. Aim: This study aimed to evaluate and compare the efficiency and effectiveness of root planning instruments namely, Gracey curette, ultrasonic instrument and rotary bur on the root surface of periodontal involved mandibular anterior teeth by scanning electronic microscopic evaluation. Materials and Methods: A total of 50 single, rooted teeth were used in this study; five specimens were used as control (no instrumentation done) and the remaining 45 specimens were equally divided into three groups. Specimens from each group were then subjected to root planning by one of the following instruments: (1) a Gracey curette, (2) ultrasonic tip and (3) a Rotary bur. The efficiency of calculus removal, the amount of lost tooth substance, and root surface roughness resulting from the instrumentation were examined by SEM. Three indices namely remaining calculus index (RCI), Loss of tooth substance index (LTSI), and Roughness loss of tooth substance index (RLTSI) were used to measure the changes. The time required for instrumentation was also noted. Result: Comparison of RCI between the Groups was statistically non-significant with a p' value of 0.546. Comparison of LTSI, RLTSI and time spent between the Groups was statistically significant with a p' value of < 0.001. Conclusions: The Demo-Clean® bur used in this study accorded good results with minimal alteration in the morphology of the root surface. The Time required for instrumentation using ultrasonic instrument was significantly lower than other groups.