Abstract
ABSTRACT Complete cementum removal is no longer a requisite. Many studies have demonstrated that hand and power-driven instruments are equally effective in reducing the probing depth, attaining attachment level gains and reducing inflammation by removal of plaque bacteria, calculus, and endotoxin. Power-driven instruments have many advantages over the manual scalers; however, further studies are needed to improve the performance of currently available instruments. These include the development of a more effective tip and ultrasonic generator unit. Long-term randomized controlled studies are also required to examine the efficacy of the newly designed scalers. These studies would help to provide treatment based on exact information regarding the instrument and technology. Every instrument comes with its own disadvantages and advantages but when proper protocol is followed the instrument can be put to its best use for the comfort of the patient and the operator. The use of Ultrasonic in periodontal surgery definitely has benefits but the choice to use hand instrument or ultrasonic instruments depends solely in the manual skill, expertise and preference of the clinician.
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