Comparison of Various Root Planing Instruments: Hand and Ultrasonic—Standard Smooth and Diamond Coated: An in vivo Study

Abstract

ABSTRACT Aim and objective This study was conducted to evaluate and compare the effectiveness of various root planing instruments, namely the curette, standard smooth ultrasonic tip and diamond coated ultrasonic tip under conditions of nonsurgical root debridement. Materials and methods A total of 20 incisors from 14 patients, with a pocket depth of 5 to 10 mm, indicated for extraction were selected for the study. Teeth selected were randomly assigned to one of the two groups, experimental group A and experimental group B. The proximal surfaces of teeth in experimental group A was instrumented with either Gracey curette or standard smooth ultrasonic tip and in experimental group B with either Gracey curette or diamond coated ultrasonic tip, randomly. Teeth were extracted without injuring the experimental area. The surface area under treatment was photographed at 10X and the percentage of residual calculus was evaluated. Teeth were processed for viewing under scanning electron microscope. Photomicrographs were graded for degree of cleanliness, Remaining Calculus Index (RCI) and Roughness and Loss of Tooth Substance Index (RLTSI) by an independent examiner. Results Percentage of residual calculus as evaluated using stereomicroscope did not show any statistical significance within the groups and among all the three instruments. Scanning electron microscopic assessment for the degree of cleanliness showed better cleanliness for curette compared to standard smooth ultrasonic tip. Remaining calculus was significantly higher for standard smooth ultrasonic tip compared to curette. Diamond coated ultrasonic tip showed greater roughness and loss of tooth substance. Conclusion Within the limits of this in vivo study, diamond coated ultrasonic tip removed a greater amount of root surface and created a rougher surface compared to the curette and standard smooth ultrasonic tip. The amount of root surface removed with diamond coated ultrasonic inserts suggests that they should be used with caution.