Ultrasonic Dental Scaler Research Articles

Effect of herbal mouthrinsein dental ultrasonic scalers among Indians.

The use of herbal mouthrinse is gaining momentum in recent years. Therefore, it is of interest to evaluate the effect of 2 herbal mouthrinse (curcumin, cinnamon) in comparison with2 conventional mouthrinse (povidone iodine, chlorhexidine) when used as coolant in dental ultrasonic scalers. Hence, 200 participants were included in this study. Analysis of gingival index, periodontal index at baseline and one month follow up was completed. The inhibitory effects of both conventional and herbal mouth rinse in gingival health are similar. However, cinnamon and curcumin owing to its minimal adverse effects and low cost is useful as an alternative to chlorhexidine for reducing bacterial load in dental aerosols produced due to ultrasonic scalers.

Numerical investigation of cavitation in periodontal Pockets: Insights for enhancing cleaning efficiency

Ultrasonic dental scalers are indispensable instruments for efficient dental cleaning through the generation of cavitation. To gain valuable insights and enhance the cavitation cleaning effects, a numerical investigation is conducted using the finite element method via ABAQUS. Numerical results are compared with the experimental cavitation image for a scaler undergoes vibrations near a wall. We then analyse how the amplitude, frequency, and cross-sectional shape of the scaler affect cavitation generation. Numerical results indicate that cavitation is more pronounced for a scaler oscillating near a nearly rigid boundary than a soft boundary. It increases with the vibration amplitude because of higher ultrasonic energy transferring to the liquid and generating stronger pressure waves. The resonant frequency of the scaler coincides with the maximum cavitation and scaler tip amplitude. Reducing the dimension of the cross-section of the scaler in its oscillation direction increases both the scaler tip amplitude and the cavitation generated. This finding offers a potential design approach for enhancing the scaler cavitation and its cleaning effects. These insights provide practical guidance for optimising dental scaler settings, which can improve oral hygiene and prevent complications related to dental implants.

Hand instrumentation provides improved tissue response over ultrasonic scaler and substantiates safe dental practice: An in vivo study in rats.

The aim of this study was to evaluate the effectiveness of hand debridement (HD) versus ultrasonic dental scaler (UDS) for the treatment of experimental periodontitis (EP) in rats. Thirty 3-month-old male rats were used. EP was induced around the mandibular first molars (right and left). Seven days after induction, the treatments with either HD (n = 30) or UDS (n = 30) were randomly performed in each molar. Euthanasia were performed at 7, 15, and 30 days after treatment. Histometric (percentage of bone in the furcation [PBF]), histopathological, and immunohistochemical (for detection of tartrate-resistant acid phosphatase [TRAP] and osteocalcin [OCN]). Parametric data (PBF and TRAP) was analyzed by One-way ANOVA followed by Tukey's post-test. OCN was analyzed by Kruskal-Wallis followed by Student-Newman-Keuls post-test. The level of significance was 5%. Group HD presented higher PBF and lower TRAP-immunolabeling at 30 days as compared with UDS in the same period (p≤0.05). Group HD presented higher OCN immunolabeling at 30 days as compared with 7 and 15 days (p≤0.05). Persistent and exacerbated inflammatory process was observed in some specimens from group UDS at 30 days, as well as the bone trabeculae presented irregular contour, surrounded by many active osteoclasts. Nonsurgical periodontal therapy with HD resulted in higher PBF and lower expression of TRAP as compared with UDS. Also, HD increased the expression of OCN over time.

Cavitation in a periodontal pocket by an ultrasonic dental scaler: A numerical investigation

Periodontal pockets are spaces or holes surrounded by teeth under the gum line. These pockets can become filled with infection-causing bacteria resulting in tissue, bone, and tooth loss. Cavitation produced by the oscillating tip of dental ultrasonic scalers plays a significant role in routine periodontal therapy to clean these areas. Numerical studies were conducted for a scaler vibrating in a periodontal pocket which was simplified to a hole, using ABAQUS based on the finite element method. The simulations consider the three-dimensional, nonlinear, and transient interaction between the vibration and deformation of the scaler tip, the water flow around the scaler and the cavitation formation. The numerical model was validated by comparing results with experimental data for a scaler vibrating in an unbounded liquid, the displacement at the free end of the scaler and the cavitation pattern near the scaler tip displaying excellent agreement. A parametric study for a scaler vibrating in a hole has been carried out in terms of the volume of the hole, the taper ratio (the radius ratio between the circular opening and bottom of the hole), and the immersion depth of the scaler tip in the hole. The amount of cavitation generated is evaluated by the cavitation density (or the void fraction) which is the ratio of the volume of the cavitation occupied in the hole to the total volume of the hole. Numerical results indicate that the cavitation density in the hole increases with the decreasing hole volume and the increasing taper ratio. It is inferred that cleaning effects could be increased if some modifications to the scaler design could be made to increase the blocking effect of the hole during the cleaning process. Cavitation is observed in the hole even if the scaler is placed above the hole and increases with the immersion depth.

The Effect of Dental Ultrasonic Scaler on Dental Restorations

The ultrasonic scalers are today becoming the most chosen form of dental polishing and cleaning. With the various researchers and lab tests done on them, it is steered clear of any side effects or invasive methodologies that might harm the patient in any manner. It works both on the soft and hard oral tissues have become the most widely used cleaning instruments among dental practitioners. Ultrasonic scalers use its vibrating power to eradicate different forms of dental plague and foreign components from the teeth. Through various on-field experiments and lab tests, it was made sure that these ultrasonic scalers work much better than any other primitive method for the same task. And that’s the major reason why it is so much in demand, ultrasonic scaling has become widely used for professional tooth cleaning. The aim of the systematic review is to assess the role of ultrasonic scaling on dental restoration. A computerized literature search was performed in following database including: Pubmed, the Cochrane Library, Google Scholar and Scopus databases from 1st January 2000 till January 2022. Studies determining the impact of ultrasonic scaling on dental restorations including randomized controlled trials, prospective and retrospective studies, and cross-sectional studies were included. After an initial search a total of 570 articles were identified. Then, 44 studies which were full-text articles were critically reviewed by independently for eligibility. Finally, 10 studies which met all the inclusion criteria were included in the review. The findings showed that out of all of the elements used, we can observe that the glass ionomers have had the chances of greater impacts. Further studies should assess the method of polishing for the removal of discolorations from ceramic restorations after ultrasonic scaling procedures and the possible side effects of polishing.

Imaging and Quantification of the Area of Fast-Moving Microbubbles Using a High-Speed Camera and Image Analysis.

An experimental and image analysis technique is presented for imaging cavitation bubbles and calculating their area. The high-speed imaging experimental technique and image analysis protocol presented here can also be applied for imaging microscopic bubbles in other fields of research; therefore, it has a wide range of applications. We apply this to image cavitation around dental ultrasonic scalers. It is important to image cavitation to characterize it and to understand how it can be exploited for various applications. Cavitation occurring around dental ultrasonic scalers can be used as a novel method of dental plaque removal, which would be more effective and cause less damage than current periodontal therapy techniques. We present a method for imaging the cavitation bubble clouds occurring around dental ultrasonic scaler tips using a high-speed camera and a zoom lens. We also calculate the area of cavitation using machine learning image analysis. Open source software is used for image analysis. The image analysis presented is easy to replicate, does not require programming experience, and can be modified easily to suit the application of the user.

Improved biofilm removal using cavitation from a dental ultrasonic scaler vibrating in carbonated water

The use of cavitation for improving biofilm cleaning is of great interest. There is no system at present that removes the biofilm from medical implants effectively and specifically from dental implants. Cavitation generated by a vibrating dental ultrasonic scaler tip can clean biomaterials such as dental implants. However, the cleaning process must be significantly accelerated for clinical applications. In this study we investigated whether the cavitation could be increased, by operating the scaler in carbonated water with different CO2 concentrations. The cavitation around an ultrasonic scaler tip was recorded with high speed imaging. Image analysis was used to calculate the area of cavitation. Bacterial biofilm was grown on surfaces and its removal was imaged with a high speed camera using the ultrasonic scaler in still and carbonated water. Cavitation increases significantly with increasing carbonation. Cavitation also started earlier around the tips when they were in carbonated water compared to non-carbonated water. Significantly more biofilm was removed when the scaler was operated in carbonated water. Our results suggest that using carbonated water could significantly increase and accelerate cavitation around ultrasonic scalers in a clinical situation and thus improve biofilm removal from dental implants and other biomaterials.

The effect of standoff distance and surface roughness on biofilm disruption using cavitation.

Effective biofilm removal from surfaces in the mouth is a clinical challenge. Cavitation bubbles generated around a dental ultrasonic scaler are being investigated as a method to remove biofilms effectively. It is not known how parameters such as surface roughness and instrument distance from biofilm affect the removal. We grew Strepotococcus sanguinis biofilms on coverslips and titanium discs with varying surface roughness (between 0.02–3.15 μm). Experimental studies were carried out for the biofilm removal using high speed imaging and image analysis to calculate the area of biofilm removed at varying ultrasonic scaler standoff distances from the biofilm. We found that surface roughness up to 2 μm does not adversely affect biofilm removal but a surface roughness of 3 μm caused less biofilm removal. The standoff distance also has different effects depending on the surface roughness but overall a distance of 1 mm is just as effective as a distance of 0.5 mm. The results show significant biofilm removal due to an ultrasonic scaler tip operating for only 2s versus 15-60s in previous studies. The technique developed for high speed imaging and image analysis of biofilm removal can be used to investigate physical biofilm disruption from biomaterial surfaces in other fields.

High speed imaging of biofilm removal from a dental implant model using ultrasonic cavitation

ObjectivesCurrent instruments cannot clean in between dental implant threads and effectively remove biofilm from the rough implant surface without damaging it. Cavitation bubbles have the potential to disrupt biofilms. The aim of this study was to see how biofilms can be disrupted using non-contact cavitation from an ultrasonic scaler, imaged inside a restricted implant pocket model using high speed imaging. MethodsStreptococcus sanguinis biofilm was grown for 7 days on dental implants. The implants were placed inside a custom made restricted pocket model and immersed inside a water tank. An ultrasonic scaler tip was placed 0.5mm away from the implant surface and operated at medium power or high power for 2s. The biofilm removal process was imaged using a high speed camera operating at 500 fps. Image analysis was used to calculate the amount of biofilm removed from the high speed images. Scanning electron microscopy was done to visualize the implant surface after cleaning. ResultsCavitation was able to remove biofilm from dental implants. More biofilm was removed at high power. Scanning electron microscopy showed that the implant surface was clean at the points where the cavitation was most intense. High speed imaging showed biofilm removal underneath implant threads, in areas next to the ultrasonic scaler tip. SignificanceA high speed imaging protocol has been developed to visualize and quantify biofilm removal from dental implants in vitro. Cavitation bubbles from dental ultrasonic scalers are able to successfully disrupt biofilm in between implant threads.

How does ultrasonic cavitation remove dental bacterial biofilm?

Bacterial biofilm accumulation is problematic in many areas, leading to biofouling in the marine environment and the food industry, and infections in healthcare. Physical disruption of biofilms has become an important area of research. In dentistry, biofilm removal is essential to maintain health. The aim of this study is to observe biofilm disruption due to cavitation generated by a dental ultrasonic scaler (P5XS, Acteon) using a high speed camera and determine how this is achieved. Streptococcus sanguinis biofilm was grown on Thermanox™ coverslips (Nunc, USA) for 4days. After fixing and staining with crystal violet, biofilm removal was imaged using a high speed camera (AX200, Photron). An ultrasonic scaler tip (tip 10P) was held 2mm away from the biofilm and operated for 2s. Bubble oscillations were observed from high speed image sequences and image analysis was used to track bubble motion and calculate changes in bubble radius and velocity on the surface. The results demonstrate that most of the biofilm disruption occurs through cavitation bubbles contacting the surface within 2s, whether individually or in cavitation clouds. Cleaning occurs through shape oscillating microbubbles on the surface as well as through fluid flow.

Comparison of Root Surface Wear and Roughness Resulted from Different Ultrasonic Scalers and Polishing Devices Applied on Human Teeth: An In-Vitro Study.

The aim of the present study was to compare the root surface wear and roughness, resulted from the professional dental hygiene instruments, including ultrasonic dental scalers, rubber prophy cups, and nylon bristle brushes, on the extracted human mandibular incisor teeth. Teeth (n = 80) were randomly assigned into eight groups according to the applied scaler type (Ma = Magnetostrictive, Pi = Piezoelectric), degree of power (M = Medium, F = Full), and angulation (0° and 45°). In the second stage, the specimens (n = 40) were further divided into two groups according to the applied polishing device (nylon bristle brush or rubber prophy cup). Laser scanner and contact profilometer devices were used for the surface analysis. Both ultrasonic instruments tested in our study produced rougher surfaces when full power was used at a 0° angle (p < 0.01). The highest wear (0.82 ± 0.07 mm3) and roughness values (0.30 ± 0.01 µm) were detected in the PiF0 group. Polishing performed with a rubber prophy cup resulted in almost twice the wear as well as a smoother surface when compared to polishing performed with a nylon bristle brush (p < 0.001). Variations in the application parameters of ultrasonic scalers and the type of polishing instrument might lead to significantly different root-surface characteristics.

Numerical investigation of cavitation generated by an ultrasonic dental scaler tip vibrating in a compressible liquid.

Bacterial biofilm accumulation around dental implants is a significant problem leading to peri-implant diseases and implant failure. Cavitation occurring in the cooling water around ultrasonic scaler tips can be used as a novel solution to remove debris without any surface damage. However, current clinically available instruments provide insufficient cavitation around the activated tip surface. To solve this problem a critical understanding of the vibro-acoustic behaviour of the scaler tip and the associated cavitation dynamics is necessary. In this research, we carried out a numerical study for an ultrasound dental scaler with a curved shape tip vibrating in water, using ABAQUS based on the finite element method. We simulated the three-dimensional, nonlinear and transient interaction between the vibration and deformation of the scaler tip, the water flow around the scaler and the cavitation formation and dynamics. The numerical model was well validated with the experiments and there was excellent agreement for displacement at the free end of the scaler. A systematic parametric study has been carried out for the cavitation volume around the scaler tip in terms of the frequency, amplitude and power of the tip vibration. The numerical results indicate that the amount of cavitation around the scaler tip increases with the frequency and amplitude of the vibration. However, if the frequency is far from the natural frequency, the cavitation volume around the free end decreases due to reduced free end vibration amplitude.

On the use of ultrasonic dental scaler tips as cleaning technique of microfiltration ceramic membranes

The use of ultrasonic dental scaler (UDS) tips has been investigated for cleaning ceramic membranes fouled when filtering cactus juice. Thin and long tips having a larger coverage exhibited the best performance for removing the cake layer deposited on the membrane surface. Such tips cleaned an area equivalent to almost one third of total area of the membrane surface. However, the cleaned area could be increased notoriously if the membrane were placed in rotatory disc holder. The resistance-in series model and atomic force microscopy (AFM) technique helped to reveal the effect of the UDS tips as cleaning process of ceramic membranes. The reversible resistances estimated for UDS tips were 58% and 17% lower than the ones obtained by chemical cleaning at transmembrane pressures of 0.3 bar and 0.5 bar, respectively. This was corroborated by microscope images, which showed the detachment of cake layer of the membrane surface. Results of this work showed that UDS tips are an innovative option as cleaning strategy for filtration membranes.

The Effect of Ultrasound, Oxygen and Sunlight on the Stability of (-)-Epigallocatechin Gallate.

(−)-Epigallocatechin gallate (EGCG), is the main catechin found in green tea, and has several beneficial effects. This study investigated the stability of EGCG aqueous solution under different stored and ultrasonic conditions to determine whether it can be used with an ultrasonic dental scaler to treat periodontal infection. Four concentrations (0.05, 0.1, 0.15, 2 mg/mL) of EGCG aqueous solution were prepared and stored under four different conditions (A: Exposed to neither sunlight nor air, B: Exposed to sunlight, but not air, C: Not exposed to sunlight, but air, D: Exposed to sunlight and air) for two days. The degradation rate of EGCG was measured by high performance liquid chromatography (HPLC). On the other hand, an ultrasonic dental scaler was used to atomize the EGCG solution under four different conditions (a: Exposed to neither air nor sunlight, b: Not exposed to air, but sunlight, c: Not exposed to sunlight, but air, d: Exposed to air and sunlight), the degradation of EGCG was measured by HPLC. We found that the stability of EGCG was concentration-dependent in water at room temperature. Both sunlight and oxygen influenced the stability of EGCG, and oxygen had a more pronounced effect on stability of EGCG than sunlight. The most important conclusion was that the ultrasound may accelerate the degradation of EGCG due to the presence of oxygen and sunlight, but not because of the ultrasonic vibration. Thus, EGCG aqueous solution has the potential to be used through an ultrasonic dental scaler to treat periodontal infection in the future.

Imaging and analysis of individual cavitation microbubbles around dental ultrasonic scalers

Cavitation is a potentially effective and less damaging method of removing biofilm from biomaterial surfaces. The aim of this study is to characterise individual microbubbles around ultrasonic scaler tips using high speed imaging and image processing. This information will provide improved understanding on the disruption of dental biofilm and give insights into how the instruments can be optimised for ultrasonic cleaning. Individual cavitation microbubbles around ultrasonic scalers were analysed using high speed recordings up to a million frames per second with image processing of the bubble movement. The radius and rate of bubble growth together with the collapse was calculated by tracking multiple points on bubbles over time. The tracking method to determine bubble speed demonstrated good inter-rater reliability (intra class correlation coefficient: 0.993) and can therefore be a useful method to apply in future studies. The bubble speed increased over its oscillation cycle and a maximum of 27ms−1 was recorded during the collapse phase. The maximum bubble radii ranged from 40 to 80μm. Bubble growth was observed when the ultrasonic scaler tip receded from an area and similarly bubble collapse was observed when the tip moved towards an area, corresponding to locations of low pressure around the scaler tip. Previous work shows that this cavitation is involved in biofilm removal. Future experimental work can be based on these findings by using the protocols developed to experimentally analyse cavitation around various clinical instruments and comparing with theoretical calculations. This will help to determine the main cleaning mechanisms of cavitation and how clinical instruments such as ultrasonic scalers can be optimised.

Risk of electromagnetic interference induced by dental equipment on cardiac implantable electrical devices.

Patients with cardiac implantable electrical devices should take special precautions when exposed to electromagnetic fields. Proximity to equipment used in clinical dentistry may cause interference. This study evaluated in vitro the risks associated with different types/makes of cardiac devices and types of dental equipment. Six electronic dental tools were tested on three implantable cardioverter defibrillators and three pacemakers made by different manufacturers. Overall, the risk of interference with the pacemakers was 37% lower than with the implantable cardioverter defibrillators. Regarding the types/makes of cardiac devices analysed, that from Boston Scientific had a five-fold greater risk of interference than did that from Biotronik [prevalence ratio (PR) = 5.58]; there was no difference between that from Biotronik and that from Medtronic. Among the dental equipment, the electric pulp tester had the greatest risk of inducing interference and therefore this device was used as the benchmark. The electronic apex locator (PR = 0.29), Periotest M (PR = 0.47), and the ultrasonic dental scaler (PR = 0.59) were less likely to induce interference than the electric pulp tester. The risk was lowest with the electronic apex locator. Pacemakers presented a lower risk of light to moderate interference (PR = 0.63). However, the risk of severe electromagnetic interference was 3.5 times higher with pacemakers than with implantable cardioverter defibrillators (PR = 3.47).

High Speed Imaging of Cavitation around Dental Ultrasonic Scaler Tips.

Cavitation occurs around dental ultrasonic scalers, which are used clinically for removing dental biofilm and calculus. However it is not known if this contributes to the cleaning process. Characterisation of the cavitation around ultrasonic scalers will assist in assessing its contribution and in developing new clinical devices for removing biofilm with cavitation. The aim is to use high speed camera imaging to quantify cavitation patterns around an ultrasonic scaler. A Satelec ultrasonic scaler operating at 29 kHz with three different shaped tips has been studied at medium and high operating power using high speed imaging at 15,000, 90,000 and 250,000 frames per second. The tip displacement has been recorded using scanning laser vibrometry. Cavitation occurs at the free end of the tip and increases with power while the area and width of the cavitation cloud varies for different shaped tips. The cavitation starts at the antinodes, with little or no cavitation at the node. High speed image sequences combined with scanning laser vibrometry show individual microbubbles imploding and bubble clouds lifting and moving away from the ultrasonic scaler tip, with larger tip displacement causing more cavitation.

The performance characteristics of a piezoelectric ultrasonic dental scaler

The objective of this work was to investigate the performance characteristics of a piezoelectric ultrasonic dental scaler using scanning laser vibrometry. The vibration characteristics of three standard piezoelectric tips were assessed with scanning laser vibrometry under various conditions: unconstrained, under a stream of flowing water, in a water tank, as well as subjected to loads to simulate clinical conditions. Subsequently, the tips were used to disrupt an in-vitro biofilm model of dental plaque, developed using a non-pathogenic Gram-negative species of Serratia (NCIMB40259).The laser vibrometry data showed that the oscillation pattern of the ultrasonic tip depends primarily on its shape and design, as well as on the generator power. Thin tips and high power settings induce the highest vibrations. Water irrigation of the tip and loads influence the tip performance by diminishing its vibration, while water volume increases it.Serratia biofilm was disrupted by the cavitation bubbles occurring around the scaler tip. The most effective biofilm removal occurred with the thinner tip.Understanding how the ultrasonic tip oscillates when in use and how it removes dental plaque is essential for gaining more knowledge regarding the cleaning mechanisms of the ultrasonic system. Cavitation may be used to remove plaque and calculus without a mechanical contact between the dental tip and the teeth. Better knowledge would enable dental specialists to understand and improve their techniques during routine cleaning of teeth. It will also lead to improving tip design and to the production of more effective instruments for clinical use.

Efficacy Comparison of On-Site Preparation of 5%Lidocaine Niosome Dispersion and Benzocaine/Tetracaine Gel

Pain reduction from palatal injection was comparatively investigated by using topical anesthetics, 5% lidocaine encapsulated niosomes (LN) and 18%benzocaine/2%tetraciane gel (BZ). The LN was prepared chair-sidedly by an ultrasonic dental scaler with physicochemical evaluation. A pin-prick test on the palatal mucosa of 10 healthy subjects determined the onset and the effective time of LN to be 45 s (±17.3) with the mean effective time of 130.5 s (±57.5). The pain intensity during an actual palatal injection (cuspid region) was compared after the topical application of LN and BZ in another 23 healthy subjects, using a split-mouth design. The median injection pain VAS after the application of BZ was 3.5 cm, significantly higher than that after the application of LN (median = 2.0 cm, (p&lt; 0.05). The present study confirmed the use of the ultrasonic dental scaler in enhancing the efficacy of lidocaine in pain reduction from palatal injection.

Do ultrasonic dental scalers interfere with implantable cardioverter defibrillators? An in vivo investigation

ObjectivesTo test the in vivo effects of an ultrasonic dental scaler on various implanted cardioverter defibrillator (ICD) models. Methods12 consecutive patients with ICDs had continuous both electrocardiogram monitoring and device interrogation to detect interferences during the use of an ultrasonic dental scaler. ResultsNo interferences were detected by any ICD. Evaluation of the electrocardiograms for each patient failed to show any abnormalities in pacing during testing. ConclusionThe results of this study suggest that the routinary clinic use of piezoelectric dental scalers do not interfere with the functioning of any of the tested ICDs. Clinical significanceUltrasonic dental scalers have been suspected of electromagnetic interference (EMI) with the normal functioning of ICDs and the use of this type of equipment for patients with these devices has been controversial. This is the first in vivo study to investigate EMI of ICD activity during the operation with ultrasonic dental scaler.