Ultrasonic Instruments Research Articles

Endoscopic treatment with concomitant ultrasound monitoring of obstructive septum in Robert's uterus following pregnancy

Background: To further understand Robert’s uterus and sum up the experience of diagnosis and treatment for Robert’s uterus. A 17-year-old woman came to our hospital for dysmenorrhea in 18 April 2012. She had had severe dysmenorrhea [VAS (visual analogue scales): 6 marks] since her menarche occurring in December 2010. Gynecological examination: patent vagina and a smooth cervix. Type-B ultrasonic instrument indicated two uterine cavities. The right uterine cavity contained a liquid anechoic area. There was no continuous echo between the right uterine inferior segment and cervical canal, and there was only a cervical echo. For further diagnosis and treatment, the patient underwent hysteroscopy combined with laparoscopy. The patient was diagnosed with Robert’s uterus and received removal of the uterine septum. Five years later, the patient smoothly gave a full-term baby boy. Conclusion: Gynaecologists must pay close attention to the primary dysmenorrhea occurring in juvenile females in order to find uterine malformation early as much as possible.

Air Polishing and CHX Effects in Addition to Subgingival Ultrasonic Instrumentation on Clinical Periodontal Parameters: A Randomised Clinical Trial

Objectives: This study was performed to investigate the efficacy of using glycine powder air-polishing (GPAP) or antiseptics (CHX) adjunctively to scaling and root planing (SRP) in the treatment of periodontitis.
 Methods: In this trial, ninety patients (between 28-80 years old) who had at least three teeth with 3 to 7- mm periodontal pockets, were ıncluded from the Department of Periodontology. The patients were divided into three groups randomly. In the control group ultrasonic instrumentation was performed with distilled water and hand instrumentation, in the CHX group ultrasonic instrumentation was performed with CHX and hand instrumentation, in the GPAP group in addition to SRP with ultrasonic performed with distilled water and hand instrumentation, GPAP was performed for 10 seconds per periodontal pocket using a Perio-Flow device. All treatments were performed in one session. 
 Resuls: The scores of plaque index(PI),gingival index (GI), probing depth (PD), bleeding on probing (BOP) and clinical attachement level (CAL) were decreased in all groups after 1 month and the results were statistically significant in intergoup comparisions. PI and CAL scores were statistically significant in intragroup comparisions in GPAP group. Altough GI, PD and BOP scores were lower in the GPAP group than CHX and control group, the differences after 1 month were not statistically significant. 
 Conclusion: Within the limits of this study, it was seen that SRP was effective alone in the treatment of periodontitis. However, using a CHX with ultrasonic devices has little beneficial effects on periodontal parameters when compared with control and GPAP groups. GPAP groups was found more effectively in PI and CAL scores.

Efficacy of ultrasonic mechanical instrumentation with and without chlorhexidine in treatment of chronic periodontitis

Aim: The aim of the present study was to evaluate the effects of ultrasonic mechanical instrumentation (UMI) along with the professional use of chlorhexidine (CHX) compared with UMI alone during periodontal supportive therapy in patients with chronic periodontitis. Material and Methods: A total of twenty patients were included in the study and were divided into test and control group. The test group (ten patients) was treated with a single session of UMI along with subgingival irrigation under cavitation with CHX 0.02%. A 0.2% CHX solution was used for professional tongue brushing and mouth rinsing. The control group (ten patients) received a similar single session of UMI along with subgingival irrigation and professional tongue brushing and mouth rinsing with a control formulation. Clinical and microbiological parameters were assessed pre-treatment at 3 and 6 weeks post­treatment. Results: Results showed that there was a significant reduction of supragingival plaque and gingival inflammation as well as a significant reduction of subgingival bacterial pathogens in both test and control groups. The additional use of CHX did not result in any additional clinical and microbiological benefit with respect to UMI alone. Conclusion: CHX formulations in conjunction with UMI seems to produce no additional benefits over UMI alone during supportive therapy in chronic periodontitis patients. Keywords: Chlorhexidine, Chronic Periodontitis, Piezoelectric Ultrasonic, Subgingival Microbiota.

Rancang Bangun Sistem Multipoint Transmitter – Receiver untuk Inspeksi Bawah Air Berbasis Ultrasonik Frekuensi Rendah

Non-destructive testing and evaluation are testing techniques that test and evaluate the properties of a material, component, or system without causing any damage caused by the testing and evaluation process. Ultrasonic sensors are devices with minimal risk in their use and are quite often used in non-destructive testing and evaluation processes. Low frequency ultrasonic (<200kHz) has been used in the testing and evaluation process in several scientific fields. Improving the test capability of low-frequency ultrasonic measurement instruments while remaining efficient and affordable is the core of this research. Increasing test capability and efficiency by adding five test points to a low-frequency ultrasonic measurement instrument for underwater inspections have been carried out by engineering a trigger signal generator that transmits 35kHz signals at 50V voltage proven to improve the quality of the echo signal received when compared to using trigger signal sourced directly from the wave generator device, the use of a pre-amplifier module on the receiver side of the echo signal is proven to be able to increase the voltage level of the echo signal and improve the reading value of the received echo signal, as well as the signal coupling mechanism built in this study, proved to be adequate to increase efficiency multipoint testing using one ultrasonicbased testing instrument.

Evaluation of the effect of using ultrasonic instruments to improve the shoulder of the preparations

OBJECTIVE To provide the basis for the clinical development of ultrasonic shoulder preparation by comparing the roughness and three-dimensional topography of shoulder surface between ultrasonic instruments and conventional rotary instruments, to make preliminary suggestions for clinical use of ultrasonic instruments. METHODS (1) Four areas of buccal and palatal surfaces of six extracted human premolars were prepared with different grit size of rotary instruments. Polyether was used to take impression of the shoulder area, 3-D topography measurement laser microscope (3-D TMLM) was used to scan the impressions and compare the shoulder surface roughness of the four areas. (2) Six extracted human premolars were prepared, mesial half of the shoulder was finished with traditional rotary instruments and distal half with ultrasonic instruments. Polyether was used to take impression of the shoulder area, 3-D TMLM was used to scan the impressions and compare the shoulder surface roughness and 3-D topography, and the shoulder surface morphology was observed by surgical microscope (×25 magnification). (3) Twenty extracted human maxillary symmetrical homonymous anterior teeth were poured into die stone using artificial gingiva, ultrasonic instruments group and rotary instruments group were divided randomly. After preparing the teeth and taking the shoulder impression with polyether in dental simulate on the training system, the surface roughness of the shoulder impression in mesial, middle and distal areas was scanned and compared. The data were analyzed using SPSS 25.0 software package. RESULTS (1) There was no significant difference in Ra and Rz values between the abutment shoulder and impression shoulder in different areas. (2) The surface roughness of the shoulder impression prepared by ultrasonic instruments [Ra:(6.59±2.33) μm, Rz:(34.69±7.29) μm] was significantly smaller than that of the rotary instruments [Ra:(21.79±4.89) μm, Rz:(91.69±14.82) μm] (P < 0.05). The morphology of the shoulder prepared by ultrasonic instruments was clear and continuous under microscope observation. (3) The surface roughness of each area of the shoulder prepared by ultrasonic instruments was significantly lower than that of the rotary instruments (P < 0.001); there was no significant difference of the surface roughness (Ra) in each area of the shoulder impression after ultrasonic instrument preparation, while the shoulder impression roughness in the mesial and distal areas was significantly higher than that in the middle area (P < 0.001) after rotary instrument preparation. CONCLUSION Compared with the rotary instruments, the ultrasonic instruments can obtain a smoother shoulder surface, especially can significantly improve the shoulder preparation effect near the proximal surface.

Evaluation of undergraduate Endodontic teaching in dental schools within Spain.

To evaluate the current situation of undergraduate endodontic teaching in Spanish dental schools. An online version, translated into Spanish, of a survey conducted in the UK (Int Endod J 52, 2019, 1077) was sent via email to the undergraduate endodontic programme leads in all 23 Spanish dental schools. The response rate was 96%. In 95% of dental schools, endodontics is taught in the fourth year. Students treat simple root canal treatment cases in 100% of schools and only in 40% treat moderate cases. In 65% of schools, students are supervised by full-time professors who are specialists in Endodontics, significantly more frequently in private dental schools (P=0.002). Spanish dental schools use both rotary and reciprocating instrumentation systems during endodontic training, with consistency on methods of working length determination, use of silicate-based endodontic cements, irrigating solutions, inter-visit medicaments and canal filling techniques. No type of magnification is used in 90% of dental schools, and only 25% use ultrasonic instruments. Private dental schools have a significantly better staff: student ratio during clinical practice (P=0.041), spend significantly more hours in clinical training (P=0.04) and have significantly greater number of clinical areas specifically dedicated to Endodontics (P=0.010). Undergraduate endodontic teaching in Spanish dental schools follows the key recommendations of the ESE Undergraduate Curriculum Guidelines (Int Endod J 46, 2013, 1105), being, in most respects, comparable to that carried out in the UK (Int Endod J 52, 2019, 1077). The use of magnification and ultrasonic instruments needs to be increased. Private schools reported better results than public schools in some of the variables that were analysed.

Efficacy of a Nickel-Titanium Ultrasonic Instrument for Biofilm Removal in a Simulated Complex Root Canal.

This study evaluated the effectiveness of NiTi ultrasonic tips for Enterococcus faecalis (E. faecalis) biofilm removal in simulated complex root canals. Sixty root canal models consisting of a 30-degree curved main canal and two lateral canals were constructed from polydimethylsiloxane and incubated with E. faecalis. Irrigants in root canals were activated using a manual syringe (SI), a stainless steel (SS) instrument, a nickel-titanium (Ni-Ti) ultrasonic instrument, or a sonic instrument (EA). Instruments of SI, SS, and NiTi-9 groups were placed 9 mm from the apex, whereas those in NiTi-2 and EA groups were placed 2 mm from the apex. The efficacy of each method was determined as the ratio of fluorescence concentration before and after activation. In the apical curved canal, the highest efficacy was found in the NiTi-2 group (99.40%), followed by SI (84.25%), EA (80.38%), SS (76.93%), and NiTi-9 (67.29%) groups. In lateral canals 1 and 2, the efficacy was the highest in the NiTi-2 group and the lowest in the SI group. The NiTi ultrasonic instrument could effectively remove biofilms in the curved canal and lateral canals. This instrument should be introduced close to the working length. An up-and-down motion of the activation instrument is recommended.

Contamination of surgical mask during aerosol-producing dental treatments

ObjectivesSurgical masks are usually contaminated during dental treatment. So far it has not been investigated whether a surgical mask itself can be a source of microbial transmission. The aim of this study was therefore to investigate the microbiological contamination of surgical masks during dental treatment and the transfer of microorganisms from the mask to the hands.Materials and methodsFive dental treatment modalities were studied: carious cavity preparation (P-caries, n = 10), tooth substance preparation (P-tooth, n = 10), trepanation and root canal treatment (P-endo, n = 10), supragingival ultrasonic application (US-supra, n = 10), and subgingival periodontal ultrasonic instrumentation (US-sub, n = 10). Bacterial contamination of mask and gloves worn during treatment was tested by imprinting on agar plates. Additionally, before masks were tested, their outer surface was touched with a new sterile glove. This glove was also imprinted on agar. Bacteria were identified by MALDI TOF mass spectrometry. Colony-forming units (CFU) were scored: score 0: 0 CFU, score 1: < 102 CFU, score 2: > 102 CFU, score 3: dense microbial growth.ResultsAll masks and all gloves used during treatment displayed bacterial contamination (sample scores 0/1/2/3: masks 0/46/3/1 and gloves 0/31/10/9). After touching the masks with new sterile gloves, microorganisms were recovered with the following contamination scores: P-caries: 4/6/0/0, P-tooth: 2/8/0/0: P-endo: 7/3/0/0, US-supra: 0/9/1/0, US-sub: 2/8/0/0. No statistically significant differences were detected between the treatment modalities. Streptococci spp. and Staphylococci spp. representing the oral and cutaneous flora dominated.ConclusionsSurgical masks are contaminated after aerosol-producing dental treatment procedures. Used masks have a potential to be a source of bacterial contamination of the hands.Clinical relevanceDental staff should avoid touching the outer surface of masks with their hands to prevent transmission of pathogens. It is recommendable to change the mask after each treated patient followed by hand disinfection.

COVID-19 Pandemic in ASEAN Region and Implication in Dentistry

The coronavirus disease (COVID-19) has spread globally and has influenced every aspect of life worldwide. In the ASEAN region, at present, many nations are still locked the academic organizations, shopping malls, events, and activities, and banks and airports are shut down to prevent the spread of the COVID-19 infection. COVID-19 has affected dental practice, and, in many countries, dentists are affected by COVID-19, leading to deaths. The dental treatments should be done with high standards of care and infection control by following proper recommendations. Personal protective equipment, patient screening, hand hygiene practices, mouth rinsing, disposable instruments, and use of rubber dam, reducing ultrasonic instruments use, treating suspected or confirmed COVID-19 patients in separate rooms, and disinfection of the inanimate surfaces helps in protecting clinicians and patients.

The use of non‐surgical interventions in patients with peri‐implantitis; a systematic review and meta‐analysis

AbstractObjectivesTo systematically assess the efficacy of different non‐surgical treatment methods to manage peri‐implantitis reported to date in the literature, together with its correlation with time following therapy.Materials and MethodsA systematic literature review was undertaken to identify randomised control trials of the non‐surgical management of peri‐implantitis published up to November 2019. The search was limited to English language human studies containing follow‐up periods of ≥3 months and for sample size of 10 or more patients. A meta‐analysis was implemented for the following clinical parameters: Peri‐implant pocket depth (PPD), bleeding on probing (BOP), clinical attachment level (CAL), radiographic bone loss (RBL) and mucosal recession (MR).ResultsTwelve articles met the inclusion criteria. Two principal treatment modalities were identified; mechanical debridement and laser therapy, with two adjunctive therapies antimicrobial and antiseptic agents. Non‐surgical interventions (ultrasonic scalers, Er:YAG laser and powdered air‐abrasive devices) showed significant clinical improvement in the short term (&lt;3 months). Clinical benefit was demonstrated with the adjunctive use of antimicrobial agents in the short term but diminished with time. Antiseptic agents alone have no significant effect. Non‐surgical therapies applied in these studies failed to arrest mucosal recession, peri‐implant bone loss or reduce the counts of viable pathogens in the long term.ConclusionThe evidence demonstrate that the clinical parameters of peri‐implantitis, i.e. BOP, PPD and CAL may all be improved by simple mechanical debridement, using either ultrasonic instrumentation or Er:YAG laser therapy; adjunctive antimicrobial and antiseptic therapy. Further randomised control trials in this area are, however, required.

AEROSOL AND DENTISTRY IN COVID ERA

Aerosol and splatter play a significant role in transmission of infection in a dental set up, which is of great concern for the dentist and the patient. Major source of aerosol in a dental set up is from ultrasonic scalers and rotary instrument which are of primary importance for performing regular dental procedures. Since the aerosolized particles behave in a ballistic manner and can stay suspended in air for a long period of time, the probability of surface contamination and transmission of infection through contact of these contaminated surfaces within dental clinic is extremely high. Presently our anxiety due to possible aerosol contamination has increased multiple folds due to the COVID-19 pandemic crisis. Hence knowing the properties and composition of the aerosol, would give an insight into reducing the microbial load in the aerosol being generated during the regular dental procedures. KEYWORDS: COVID, Aerosol procedure, Airborne infection

The Use of Ultrasonic Instrumentats in the Dental Practice

The ultrasonic instrumentation in dentistry has been used since the middle of the last century. Improved visualization, ease of operation and precise cutting ability have allowed ultrasonic instruments to be widely used in dentistry. The study considers the possibilities of using ultrasound instruments in various fields of dentistry.&#x0D; Advantages of ultrasonic instruments include conservative preparation of the cavity, less painful caries removal procedure and minimal noise generation. All these improvements are presented in clinical cases. In addition, the gentle effect on soft tissues is a characteristic feature of ultrasonic devices when applied to operative or orthopedic dentistry during the preparation of the cavity.&#x0D; Although some issues, such as high-frequency noise, interference to cardiac pacemakers, and low cutting efficiency compared to conventional high-speed or low-speed air-turbine tools, still need to be considered, the results of previous research show that ultrasound tools have an extremely high potential to become a convenient and effective tool for various dental procedures deserve future development.

PLACENTAL HEMODYNAMIC ASSESSMENT IN WOMEN WITH SEVERE PREECLAMPSIA IN SECOND- AND THIRD-TRIMESTER PREGNANCY BY 3D POWER QUANTITATIVE DOPPLER ULTRASOUND

Objective: The present study analyzed the fetal–placental hemodynamic parameters in women with severe preeclampsia in second- and third-trimester pregnancy with a view to developing effective predictive indicators for preeclampsia and providing support for the prenatal clinical treatment of preeclampsia. Materials and Methods: From January 2015 to January 2019, 160 pregnant women diagnosed with severe preeclampsia at Xiangyang First People’s Hospital were recruited as the study group. The diagnostic criteria for preeclampsia were in accordance with the guidelines of the International Society for the Study of Hypertension in Pregnancy (ISSHP). A sample of 160 healthy pregnant women with normal blood pressure were selected as the control group. The GE Voluson E8 and E10 four-dimensional (4D) ultrasonic diagnostic instruments and the three-dimensional (3D) power Doppler in angio-quantitative mode were used to measure the hemodynamic parameters of the placenta, left uterine artery (LUA), right uterine artery (RUA), middle cerebral artery (MCA), umbilical artery (UA), and ductus venosus (DV) in the two groups. The above parameters were analyzed statistically using SPSS 22.0. Results: The systolic/diastolic velocity ratio (S/D), pulsatility index (PI), and resistance index (RI) of the MCA in the study group were lower than those of normal subjects of the same gestational age (P &lt; 0.05). These parameters in the UA were higher in the study group than those in normal subjects (P &lt; 0.05). The ratios between the peak ventricular systolic velocity and the peak atrial systolic velocity (S/A), pulsatility index for the vein (PIV), pre-load index (PLI), and peak velocity index for the vein (PVIV) in the DV were significantly different between the study and normal groups (P &lt; 0.05). The placental vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were lower in the study group than those in normal subjects of the same gestational age (P &lt; 0.05). There were good correlations between VI, VFI and RUA, PI, with correlation coefficients of −0.697 and −0.702, respectively. FI was the indicator that had the highest diagnostic efficacy for severe preeclampsia. The predictive sensitivity of the FI with a cut-off value of 34.92 was 96.3%, and the corresponding specificity was 86.9%. Conclusions: Placental FI had the highest predictive efficacy for severe preeclampsia and provides a reliable quantitative indicator and data support for preeclampsia management. 3D power quantitative Doppler ultrasound provides a novel avenue for the study of severe preeclampsia.

Design and development of ultrasonic bipolar square-wave pulser for non-destructive testing of concrete structures.

This paper provides design and development details of the generation of bipolar High Voltage (HV) square wave pulses for the excitation of low frequency ultrasonic transducers. Such a circuit is required for the purpose of ultrasonic inspection of components, particularly where high energy is required to insonify the attenuative medium, such as concrete. A HV (±350 V) square wave pulse has been generated by an ultrafast complementary Metal Oxide Semiconductor Field-Effect Transistor (MOSFET) pair, which is driven by high speed MOSFET drivers. The generated bipolar square wave pulse has been utilized to energize a 108 kHz ultrasonic transducer to operate in the pulse-echo mode for the evaluation of a concrete test block. The receiver amplifier filters the received low-amplitude echo signals, which are reflected back from a discontinuity, and amplifies further for signal to noise ratio enhancement. The pulser board designed has been tested and evaluated for its functionality to measure ultrasonic velocity in the highly attenuative concrete medium up to a depth of 1 m. The measured value of acoustic velocity was compared with the value obtained from the commercially available ultrasonic pulse velocity instrument, and the values obtained are within ±5%.

Clinical outcomes following periodontal surgery and root surface decontamination by erythritol-based air polishing. A randomized, controlled, clinical pilot study

AimTo evaluate the outcomes following surgical periodontal treatment and root surface decontamination by means of air polishing using an erythritol powder or conventional mechanical root debridement.Material and methodsThirty systemically healthy patients (44.38 ± 8.2 years old, 11 smokers, 19 women) diagnosed with periodontitis stages III–IV were included. Each patient, with one single-rooted tooth, with one probing pocket depth (PD) ≥ 6 mm associated with horizontal bone loss, was treated by means of simplified papilla preservation flap (SPPF) and randomized to either test treatment (careful removal of the calculus with the tip of a blade, air polishing of the root surfaces with erythritol) or to the control group (scaling and root planing with hand curettes, ultrasonic instruments). PD, clinical attachment (CAL), bone sounding (BS), and radiographic bone level (BL) were evaluated at baseline and 12 months postsurgically.ResultsTwenty-seven patients completed the 12-month follow-up (test: n = 14, control: n = 13). In both groups, statistically significant improvements were obtained (p < 0.05, mean CAL gain/PD reduction: test, 2.50 ± 1.60 mm/3.00 ± 0.96 mm; control, 2.85 ± 1.21 mm/3.38 ± 1.12 mm). No statistically significant differences were observed between the groups for any of the investigated parameters (p < 0.05).ConclusionWithin their limits, the present results indicate that the use of air polishing with an erythritol powder during periodontal surgery may represent a valuable minimally invasive adjunct following calculus removal by means of hand and ultrasonic instruments or a valuable alternative to these, for root surfaces without calculus.Clinical relevanceThe use of air polishing with an erythritol powder during periodontal surgery appears to represent a valuable minimally invasive adjunct following calculus removal by means of hand and ultrasonic instruments or a valuable alternative to these, for root surfaces without calculus.

Immediate Oral Rehabilitation With Quad Zygomatic Implants: Ultrasonic Technique vs Conventional Drilling.

Inserting zygomatic implants is a challenging surgery and requires special care and great precision. Piezoelectric surgery offers several advantages: more precise bone cutting with improved intraoperative visibility and a low temperature increase. The aim of this case-control study was to evaluate whether ultrasonic instruments can be as effective as standard drilling instruments for zygomatic implant surgery in terms of clinical outcomes. Ninety-two patients with atrophic maxilla were included in the study. Implant sites were prepared with the ultrasonic technique (test group = 47 patients) or traditional drilling (control group = 45 patients). In total, 368 zygomatic implants were inserted (202 with the extrasinus technique, 77 with the sinus slot technique, and 89 with the Brånemark technique). Complete arch provisional prostheses were delivered 3 to 5 hours after the surgical operations. The mean follow-up after surgery was 24 months (range = 12-32 months). The primary outcome evaluations were based on implant survival rates and postoperative complications. Operative time and surgeon's stress were evaluated as secondary outcomes. Implant survival rate was 100% in the test and 98.89% in the control group. Postoperative complications were seen in 9 patients (4 in the test and 5 in the control group); the difference was not statistically significant. Operative time was longer in the test group; however, surgeons were more comfortable using ultrasonic instruments. Within the limitations of this preliminary study, the ultrasonic technique was a feasible alternative to traditional drilling for zygomatic implant surgery.

Reopening dentistry after COVID-19: Complete suppression of aerosolization in dental procedures by viscoelastic Medusa Gorgo.

The aerosol transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has impacted the delivery of health care and essentially stopped the provision of medical and dental therapies. Dentistry uses rotary, ultrasonic, and laser-based instruments that produce water-based aerosols in the daily, routine treatment of patients. Abundant aerosols are generated, which reach health care workers and other patients. Viruses, including SARS-CoV-2 virus and related coronavirus disease (COVID-19) pandemic, continued expansion throughout the USA and the world. The virus is spread by both droplet (visible drops) and aerosol (practically invisible drops) transmission. The generation of aerosols in dentistry-an unavoidable part of most dental treatments-creates a high-risk situation. The US Centers for Disease Control and The Occupational Safety and Health Administration consider dental procedures to be of "highest risk" in the potential spreading of SARS-CoV-2 and other respiratory viruses. There are several ways to reduce or eliminate the virus: (i) cease or postpone dentistry (public and personal health risk), (ii) screen patients immediately prior to dental treatment (by appropriate testing, if any), (iii) block/remove the virus containing aerosol by engineering controls together with stringent personal protective equipment use. The present work takes a novel, fourth approach. By altering the physical response of water to the rotary or ultrasonic forces that are used in dentistry, the generation of aerosol particles and the distance any aerosol may spread beyond the point of generation can be markedly suppressed or completely eliminated in comparison to water for both the ultrasonic scaler and dental handpiece.

The systemic inflammatory response following hand instrumentation versus ultrasonic instrumentation-A randomized controlled trial.

This study sought to investigate whether the immediate systemic inflammatory response following full-mouth debridement differs following use of hand compared with ultrasonic instruments. Thirty-nine periodontitis patients were randomized to treatment with full-mouth debridement using either hand or ultrasonic instrumentation completed within 24hr. Serum and periodontal clinical parameters were collected at baseline, day 1, day 7 and day 90 post-treatment. Differences in systemic inflammatory markers were assessed using general linear models at each timepoint, corrected for age, gender, smoking status, body mass index and baseline levels of each marker. Across all patients, serum C-reactive protein increased at day 1, with no differences between hand and ultrasonic groups (p(adjusted)=.22). There was no difference between groups in interleukin-6 (p(adjusted)=.29) or tumour necrosis factor α (p(adjusted)=.53) at day 1. Inflammatory markers returned to baseline levels by day 7. Treatment resulted in equal and marked improvements in clinical parameters in both groups; however, total treatment time was on average shorter for ultrasonic instruments (p(adjusted)=.002). Ultrasonic instrumentation resulted in shorter treatment time with comparable clinical outcomes. Levels of serum C-reactive protein at day 1 were similar following debridement with hand or ultrasonic instruments.

The use of piezoelectric instrumentation and platlet rich fibrin matrix in septorhinoplasty: Report of two cases

Introduction. Rhinoplasty is one of the most commonly performed surgeries in the area of aesthetic surgery. Surgical instruments, which are used in traditional rhinoplasty, like saws, chisels and osteotomes are relatively imprecise and their usage can lead to uncontrolled fractures of the bone and consequently to inadequate final results. Piezoelectric-powered ultrasonic instruments (PEI) are currently the most innovative instrumentation available for minimally traumatic reshaping of the bony vault and lateral walls. There are many studies which have shown positive effects of platelet-rich fibrin (PRF) in postoperative course of rhinoplasty patients. Case report. We presented two innovative approaches in rhinoplasty combined PEI and PRF matrix through two case reports. In both patients, satisfying results were achieved by use of PEI technique. Also, usage of PRF membrane provided good healing and small postoperative edema. Conclusion. Based on our experience, the use of of PEI technique has many benefits. It is safe, practical and effective method and it demonstrates valuable and favourable results in osteotomies. Also, usage of PRF membrane helps patients in better healing and less postoperative edema.

Topographic aspects of airborne contamination caused by the use of dental handpieces in the operative environment

BackgroundThe use of dental handpieces produces aerosols containing microbial agents, bacteria, and viruses representing a high-risk situation for airborne cross infections. The aim of this study was to map and quantify the biological contamination of a dental operatory environment using a biological tracer. MethodsStreptococcus mutans suspension was infused into the mouth of a manikin, and an operator performed standardized dental procedures using an air turbine, a contra-angle handpiece, or an ultrasonic scaler. The presence of the tracer was measured at 90 sites on the dental unit and the surrounding surfaces of the operatory environment. ResultsAll tested instruments spread the tracer over the entire dental unit and the surrounding environment, including the walls and ceiling. The pattern and degree of contamination were related to the distance from the infection source. The maximum distance of tracer detection was 360 centimeters for air turbine, 300 cm for contra-angle handpiece, and 240 cm for ultrasonic scaler. No surface of the operative environment was free from the tracer after the use of the air turbine. ConclusionsAttention should be paid to minimize or avoid the use of rotary and ultrasonic instruments when concerns for the airborne spreading of pandemic disease agents are present. Practical ImplicationsThis study supports the recommendations of dental associations to avoid treatments generating aerosols, especially during pandemic periods. Guidelines for the management of dental procedures involving aerosols, as well as methods for the modification of aerosols aimed to inactivate the infective agent, are urgently needed.