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PubMed2005

Effectiveness of a transmucosal lidocaine delivery system for local anaesthesia during scaling and root planing.

OBJECTIVE: This study compared the efficacy of transmucosal anaesthetic patches containing lidocaine (46.1 mg/2 cm(2)) to placebo for local anaesthesia during quadrant scaling and root planing using periodontal clinical indices and patient perception of pain. MATERIAL AND METHODS: Forty healthy adults with moderate periodontal disease and moderate subgingival calculus were scaled at weekly intervals, two quadrants randomized to treatment patches and two quadrants randomized to placebo patches. Bleeding, probing depths and attachment levels were evaluated prior to treatment and 1 month after quadrant scaling was completed. Subjects completed 100 mm visual analogue pain scales 15 min. after patch placement and at the end of treatment, and were asked for verbal assessment of perceived pain. RESULTS: Subjects' verbal ratings demonstrated consistently greater pain relief with active patches than placebo (p<0.0001). Visual analogue scales demonstrated significantly greater pain relief with the treatment patches after 15 min. (p=0.0003) and at the end of treatment (p=0.0149). Efficacy of periodontal therapy was equivalent for treatment and control groups. No adverse events were observed; localized minimal gingival irritation was noted in three subjects. CONCLUSION: Transmucosal lidocaine patches provided sufficient anaesthesia for therapeutic quadrant scaling and root planing procedures.

Administration, Cutaneous↗
PubMed2001

Periodontal treatment with an Er: YAG laser compared to scaling and root planing. A controlled clinical study.

BACKGROUND: The aim of the present study was to compare the effectiveness of an Er:YAG laser to that of scaling and root planing for non-surgical periodontal treatment. METHODS: Twenty patients with moderate to advanced periodontal destruction were treated under local anesthesia and the quadrants were randomly allocated in a split-mouth design to either Er:YAG laser using an energy level of 160 mJ/pulse and 10 Hz or scaling and root planing (SRP) using hand instruments. Clinical assessments of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were made prior to and at 3 and 6 months after treatment. Subgingival plaque samples were taken at each appointment and analyzed using darkfield microscopy for the presence of cocci, non-motile rods, motile rods, and spirochetes. Differences in clinical parameters and prevalence of bacterial species were analyzed using the paired t-test. RESULTS: The PI remained nearly unchanged while a significant reduction of the GI occurred in both groups after 6 months (P < or =0.001, P< or =0.001, respectively). The mean value of BOP decreased in the laser group from 56% at baseline to 13% after 6 months (P < or =0.001) and in the SRP group from 52% at baseline to 23% after 6 months (P < or =0.001). The mean value of the PD decreased in the laser group from 4.9+/-0.7 mm at baseline to 2.9+/-0.6 mm after 6 months (P< or =0.001) and in the SRP group from 5.0+/-0.6 mm at baseline to 3.4+/-0.7 mm after 6 months (P < or =0.001). The mean value of the CAL decreased in the laser group from 6.3+/-1.1 mm at baseline to 4.4+/-1.0 mm after 6 months (P < or =0.001) and in the SRP group from 6.5+/-1.0 mm at baseline to 5.5+/-1.0 after 6 months (P < or =0.001). The reduction of the BOP score and the CAL improvement was significantly higher in the laser group than in the SRP group (P < or =0.05, P < or =0.001, respectively). Both groups showed a significant increase of cocci and non-motile rods and a decrease in the amount of motile rods and spirochetes. CONCLUSIONS: An Er:YAG laser may represent a suitable alternative for non-surgical periodontal treatment.

Adult↗
PubMed1998

Adjunctive use of a subgingival controlled-release chlorhexidine chip reduces probing depth and improves attachment level compared with scaling and root planing alone.

The present studies evaluated the efficacy of a controlled-release biodegradable chlorhexidine (CHX) (2.5 mg) chip when used as an adjunct to scaling and root planing on reducing probing depth (PD) and improving clinical attachment level (CAL) in adult periodontitis. Two double-blind, randomized, placebo-controlled multi-center clinical trials (5 centers each) were conducted; pooled data are reported from all 10 centers (447 patients). At baseline, following 1 hour of scaling and root planing (SRP) in patients free of supragingival calculus, the chip was placed in target sites with PD 5 to 8 mm which bled on probing. Chip placement was repeated at 3 and/or 6 months if PD remained > or = 5 mm. Study sites in active chip subjects received either CHX chip plus SRP or SRP alone (to maintain study blind). Sites in placebo chip subjects received either placebo chip plus SRP or SRP alone. Examinations were performed at baseline; 7 days; 6 weeks; and 3, 6, and 9 months. At 9 months significant reductions from baseline favoring the chlorhexidine chip compared with both control treatments were observed with respect to PD (chlorhexidine chip plus SRP, 0.95 +/- 0.05 mm; SRP alone, 0.65 +/- 0.05 mm, P < 0.001; placebo chip plus SRP, 0.69 +/- 0.05 mm, P < 0.001) and CAL (chlorhexidine chip plus SRP, 0.75 +/- 0.06 mm; SRP alone, 0.58 +/- 0.06 mm, P < 0.05; placebo chip plus SRP, 0.55 +/- 0.06 mm, P < 0.05). The proportion of patients who evidenced a PD reduction from baseline of 2 mm or more at 9 months was significantly greater in the chlorhexidine chip group (19%) compared with SRP controls (8%) (P < 0.05). Adverse effects were minor and transient toothache, including pain, tenderness, aching, throbbing, soreness, discomfort, or sensitivity was the only adverse effect that was higher in the chlorhexidine group as compared to placebo (P = 0.042). These data demonstrate that the adjunctive use of the chlorhexidine chip results in a significant reduction of PD when compared with both SRP alone or the adjunctive use of a placebo chip. These multi-center randomized control trials suggest that the chlorhexidine chip is a safe and effective adjunctive chemotherapy for the treatment of adult periodontitis.

Adult↗
PubMed1994

DNA probe analyses of the survival of selected periodontal pathogens following scaling, root planing, and intra-pocket irrigation.

This clinical study evaluated the survival rates of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in periodontal pockets following scaling and root planing and intra-pocket irrigation with antimicrobial agents in patients with moderate and severe periodontitis. The number of target organisms was determined utilizing DNA probes. Adult periodontitis patients were selected on the basis that the subgingival flora contained at least one of the target organisms. Forty-eight (48) inflamed pockets > or = 5 mm in depth with probing attachment loss and containing at least one of the target species were then selected in 7 adult patients who harbored these bacteria. Following baseline clinical and bacterial examination, all patients received thorough scaling and root planing. In addition, 1 or 2 teeth in each patient which harbored the target flora at baseline were randomly assigned to each of the following 4 treatment modalities: 1) control group, no irrigation; 2) saline group, irrigation with 2 cc of physiologic saline; 3) tetracycline group, irrigation with 2 cc of aqueous tetracycline hydrochloride, 50 mg/ml (5%); and 4) chlorhexidine group, irrigation with 2 cc 0.12% chlorhexidine. All selected sites (5 to 8 per patient) were nonadjacent teeth. Clinical parameters and microbial analysis were recorded again at one week, and one month post-irrigation. The survival rate of the target microorganisms was determined and the effect of irrigation with antimicrobial agents on this microflora was compared with the control groups (1 and 2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Effect of stannous fluoride and tetracycline on repair after delayed replantation of root-planed teeth in dogs.

Mandibular incisors were extracted and allowed to dry in air for 45 min. They were then root-planed extensively, leaving a cervical collar and the apical region uninstrumented, to prevent direct contact between root surface and alveolar bone after replantation while, at the same time, enabling precise and stable reseating of the tooth. Control teeth were replanted either without further treatment or after treatment with citric acid for 3 min. Experimental teeth were treated before replantation with 1% SnF2 for 5 min, 1% tetracycline HCl for 5 min, or 1% SnF2 followed by 1% tetracycline. Histometric analysis of healing in the root-planed areas showed minimal amounts of inflammatory resorption and ankylosis after 21 days in experimental teeth as compared with the control teeth. A persisting inflammatory reaction in the periodontal ligament without root resorption was, however, frequently seen. The observations confirm that the frequency of adverse healing reactions after delayed replantation of teeth from which nonvital soft tissue remnants have been removed can be reduced by demineralizing the root surface and preventing mechanical trauma to the root surface in the postoperative period. Root surface treatment with SnF2 followed by tetracycline resulted in complete absence of inflammatory resorption and ankylosis in this short-term experiment.

Animals↗
PubMed2000

Topical metronidazole application as an adjunct to scaling and root planing.

AIM: This study was carried out to investigate the effect of 2 applications of a metronidazole 25% dental gel as adjunctive therapy to subgingival scaling with root planing. METHOD: 59 of the original collective of 64 patients with adult periodontitis were observed for a 9-month period. This randomised single-blind study was carried out in split-mouth design. Each patient had to have at least 2 pockets with a probing depth of > or =5 mm in each quadrant. The clinical parameters, pocket probing depth (PPD), attachment level (AL) and bleeding on probing (BOP), were recorded at all teeth on days 0, 91, 175 and 259; in addition, subgingival plaque samples taken from 45 patients were analysed by means of dark-field microscopy. Therapy comprised subgingival scaling and root planing (SRP) of all quadrants and additional application of metronidazole 25%, dental gel in 2 randomly selected quadrants (SRP+Metro). Treatment was confined to teeth with a baseline PPD of > or =5 mm. Average PPD and AL and the incidence of BOP were computed for all pockets with a baseline PPD of > or =5 mm, and the 2 methods compared. The main efficacy variable for evaluation of the 2 treatments was the difference in PPD on day 259. RESULTS: Comparison of the 2 treatments revealed a statistically significant improvement in the clinical parameters for both treatment methods over the study period. Between baseline and day 259, significant differences in PPD (SRP+Metro: from 6.00 to 4.63 mm, SRP: from 6.02 to 4.83 mm) and BOP (SRP+Metro: from 67 to 31%, SRP: from 64 to 36%) were observed between the 2 treatment groups. Evaluation according to different patient groups demonstrated significant advantages of the combined therapy in previously-untreated patients, especially in female probands. Dark-field microscopy revealed a shift in the bacterial flora towards "healthy conditions". CONCLUSIONS: The results show that only minor advantages are to be gained from the application of a metronidazole 25% dental gel as adjunctive therapy to subgingival scaling. The distinctly better results of combined therapy in previously-untreated patients calls for more thorough investigation.

Administration, Topical↗
PubMed2004

Effect of a 3% potassium oxalate topical application on dentinal hypersensitivity after subgingival scaling and root planing.

BACKGROUND: The present study aimed to verify the effect of a single application of 3% potassium oxalate gel compared to a placebo gel immediately after subgingival scaling and root planing (SRP) on dentinal hypersensitivity (DH). METHODS: Fifteen patients undergoing periodontal treatment volunteered for this randomized controlled clinical trial. They presented with periodontitis on homologous contralateral canines and premolars, with complaints of dentinal hypersensitivity before periodontal therapy. Immediately after SRP under local anesthesia, the test and placebo agents were randomly applied on the cemento-enamel junction. Evaluation of DH reduction after treatment was self-reported, with assessment made by the patient's indication of how painful each treated. tooth was on a visual analog scale (VAS) at baseline, and 7, 14, and 21 days post-treatment. The results were analyzed by DH percent reduction for each observational moment in relation to baseline, for test and control teeth separately. Mean percent reductions for each group were compared by paired sample t test, with an alpha level of 0.05. RESULTS: On day 7, percent reduction for the test and control groups was 29.4% and 13.4%, respectively. On day 14 it was 64.6% and 20.5%, and on day 21 it was 81% and 34.7%, respectively. Significant differences between treatments were observed at 14 and 21 days. CONCLUSION: It may be concluded that subgingival scaling and root planing followed by a single application of a 3% potassium oxalate gel resulted in a significantly higher reduction of dentinal hypersensitivity at 14 and 21 days, when compared to the placebo.

Administration, Topical↗
PubMedDate not supplied

[Comparison of some subgingival microflora from juvenile periodontitis before and after scaling and root planing].

Actinobacillus actinomycetemcomitans and Capnocytophaga are subgingival bacteria that have correlation with juvenile periodontitis. Studies were carried out in a group of 20 patients with juvenile periodontitis before, after treatment by scaling, root planing, oral hygiene instruction and 20 patients with healthy gingiva as a control group. Gingival index, plaque index, pocket depth were measured. Subgingival bacteria were counted on selective media and compared by phase contrast microscopy. Before treatment all measurements in the patients and the control group were significantly different (P less than 0.05). In the patients before and after treatment all clinical measurements were significantly different (P less than 0.05) but the amount of A.actinomycetemcomitans and Capnocytophaga were not significantly different (P greater than 0.05). These results indicate that treatment of juvenile periodontitis by scaling, root planing and oral hygiene instruction improve the clinical measurements but are not effective in reducing proportions of subgingival bacteria.

Aggregatibacter actinomycetemcomitans↗
PubMed2002

Enhancing the value of scaling and root-planing: Arestin clinical trial results.

Locally delivered antibiotics are used to treat periodontitis and these agents are found to be effective in improving the treatment result. Microencapsulated minocycline hydrochloride (Arestin) has been tested and reported to provide significantly greater probing depth reduction in conjunction with scaling and root-planing than scaling and root-planing alone. Thus, it was suggested that the use of locally delivered antimicrobial agents should be incorporated as part of an optimal non-surgical therapeutic regimen. This paper evaluates the efficacy of the minocycline microspheres in patients with moderate to severe periodontitis in a model, which is a randomised, evaluator-blinded study with an open-label; four arm parallel design. The patients were selected based upon 'active' disease, as determined by at least two teeth having one site each with pocket depth (PD) > or = 6 mm and with prostaglandin E2 (PGE2) levels > 66.2 ng/ml in gingival crevicular fluid. The trial was of 6 months duration and used a formulation of minocycline microspheres containing 1 mg minocycline. Responses of groups receiving SRP followed by one dose per pocket of the minocycline microspheres (SRP + MPTS) were compared to SRP alone, MPTS alone or no treatment. There were substantially greater reductions in PD and gains in clinical attachment level (CAL) at each post-treatment time point in the SRP + MPTS group compared to the other treatment groups. PD reduction and gain in CAL at month 3 in the SRP + MPTS group vs. SRP alone was statistically significant. These data further support the adjunctive use of minocycline in a slow release vehicle for the treatment of periodontitis with SRP.

Analysis of Variance↗
PubMed1982

Scaling and root planing in shallow pockets.

The present study was undertaken to enable histological assessment of attachment level alterations following repeated scaling and root planing in periodontal sites with "normal" sulcus/pocket depth. Two monkeys (Macaca cynomolgus) were used. During a period of 6 months, scaling was carried out once every 2 weeks at the buccal surfaces of premolars and molars on the right side of the jaws. The contralateral teeth served as untreated controls. Six months after the completion of treatment (1 year after the start of the experiment), the animals were sacrificed and histological sections of all test and control teeth were produced. In these sections the distances between the cemento-enamel junction (CEJ) and the apical extent of the junctional epithelium (JE) and between the JE and the alveolar bone crest (BC) were measured. The results revealed that repeated scaling and planing resulted in an average loss of connective tissue attachment amounting to 0.39 mm and in a corresponding recession of the alveolar bone crest. The findings are discussed in relation to recent observations from clinical trials demonstrating loss of clinical attachment following repeated scaling and root planing in sites with shallow gingival pockets.

Animals↗
PubMed1997

Clinical and microbiological features of subjects with adult periodontitis who responded poorly to scaling and root planing.

In a previous report, it was shown that scaling and root planing (SRP) decreased mean pocket depth and attachment level in subjects with adult periodontitis, as well as the levels and prevalence of Bacteroides forsythus, Porphyromonas gingivalis and Treponema denticola. However, a subset of subjects in that study exhibited mean loss of attachment following SRP. The purpose of the present investigation was to seek clinical and microbiological differences between subjects who responded well or poorly to SRP. 57 subjects with adult periodontitis were treated by full-mouth SRP under local anaesthetic. Clinical assessments of plaque, redness, suppuration, BOP, pocket depth and attachment level were made at 6 sites per tooth prior to and 3 months post-SRP. Attachment level measurements were repeated at each visit and differences in means between visits used to assess change. 18 subjects showed mean attachment loss 3 months post-SRP (poor response group), while 39 showed mean attachment level gain (good response group). The prevalence and levels of 40 subgingival taxa in subgingival plaque samples from the mesiobuccal site of each tooth (maximum 28 sites) in each subject prior to and 3 months post-SRP were assessed using checker-board DNA-DNA hybridization. The prevalence of each species was computed for each subject and averaged across subjects in the 2 treatment-response groups at each visit. Differences between groups were sought using the Mann-Whitney test. There were no statistically significant differences between the 2 response groups in any clinical parameter prior to therapy. Subjects in the good response group showed more attachment level gain at sites with baseline pocket depths of < 4 mm, 4-6 and > 6 mm than poor response subjects. Of 40 species evaluated, A. naeslundii genospecies 2 (A. viscosus), T. denticola, C. gracilis and C. rectus were significantly higher and more prevalent pre-therapy in the good response subjects. Mean attachment level change post SRP could be predicted using multiple linear regression with A. naeslundii genospecies 2 (A. viscosus) and T. denticola as the predictor variables (r2 = 0.373, p < 0.00001). Sites that gained > or = 2 mm of attachment post therapy showed a significant decrease in the counts of P. gingivalis (7.5 +/- 3.5 to 0.2 +/- 0.2 x 10(5)), T. denticola (8.2 +/- 3.5 to 1.8 +/- 1.1 x 10(5)) and B. forsythus (11.1 +/- 5.7 to 0.3 +/- 0.2 x 10(5)). The data of the present investigation indicate that SRP is most effective in subjects and sites with high levels of the subgingival species that this therapy affects.

Actinomyces viscosus↗
PubMed2005

Efficacy of an intrapocket anesthetic for scaling and root planing procedures: a review of three multicenter studies.

In recent years, three multicenter studies have been conducted to evaluate the clinical efficacy of an active 5% dental gel to reduce pain when placed into periodontal pockets before initiating scaling and root planing procedures. In each of the clinical studies, the researchers found statistically significant differences between the pain scores of the active dental gel group and the placebo gel group that favored the active gel for the control of pain during periodontal scaling and root planing procedures. This article reviews each of the three studies and highlights some of the differences among them.

Administration, Topical↗
PubMed1987

Dentine hypersensitivity. The effects in vitro of acids and dietary substances on root-planed and burred dentine.

Evidence indicates that teeth exhibiting cervical dentine hypersensitivity have open dentinal tubules at the dentine surface. The identification of factors which render dentine exposed and tubules open is important both to the prevention and management of dentine hypersensitivity. In this study, recently extracted teeth were root planed or burred to expose the root dentine. Specimens were horizontally sectioned and then using the apical portion as control, the coronal portions placed in a variety of strong and weak acids and dietary fluids. Examination under the scanning electron microscope revealed a smear layer covering completely underlying tubules on the control root planed or burred portions. Test portions exposed to strong and weak acids showed loss of the smear layer and exposure of large numbers of tubules. Formic and tannic acids produced no changes. Some dietary fluids, in particular red and white wine, citrus fruit juices, apple juice and yogurt produced similar etching effects to the acids. The low pH carbonated drink, coca-cola, and a blackcurrent cordial produced no effects. The results of this study in vitro cannot necessarily be extrapolated to the clinical situation, but suggest that certain dietary factors could play a rôle in the aetiology of dentine hypersensitivity. Dietary advice to patients may prove important in the management of this often recurrent condition.

Acids↗
PubMed1995

Intrasulcular laser Doppler readings before and after root planing.

A reproducible and sensitive laser Doppler periodontal probe has recently been developed for intrasulcular measurement of gingival blood flow. The specific aims of this investigation were to determine the relation between intrasulcular laser Doppler readings (LDR) and traditional diagnostic criteria as well as to evaluate the response to root planning in terms of LDR and traditional criteria. LDR and clinical measurements (bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (CAL) were obtained from 2 healthy and 2 diseased sites in 30 systemically healthy adult volunteers with localized moderate to advanced periodontitis. All 30 subjects were re-examined 1 month following root planing while 10 subjects were re-examined at approximately 1 year after treatment. Subject-adjusted correlations between pretreatment LDR and PD as well as LDR and CAL were 0.74 and 0.71, respectively. 1 month following root planing, the diseased sites had undergone a significant reduction in LDR and PD with an accompanying gain in CAL. Prior to treatment, 95 of 120 sites (79%) agreed on an ordinal classification (high, low) for LDR and BOP. Mantel-Haenszel common odds ratios for agreement between LDR and BOP were 9.6 pre-treatment and 4.3 one month after treatment. A slight rebound of all measurements was noted in a group of 10 subjects followed for 1 year. It was concluded that the laser Doppler periodontal probe is an unbiased non-invasive method of monitoring the response to periodontal therapy.

Adult↗
PubMed1991

[The effect of a formaldehyde-tyrothricin combination placed in periodontal pockets in association with scaling and root planing].

A solution of formaldehyde and tyrothricin was placed in periodontal pockets of 14 patients. One maxillary quadrant was used as the experimental side, while the contralateral quadrant was employed as the control. A placebo solution was placed in the pockets of the control side. Both the experimental and control sides were treated on days -3, 0, +4, +7, +11 and +14. Scaling and root planing was accomplished on day 0. Plaque and gingival indices, and gingival fluid volume were recorded on all of the treatment days, as well as on day +28. Pocket depths were noted on days -3, 0, +14 and +28. Improvements were noted in all parameters measured on both the experimental and control sides, although statistical analyses revealed that plaque and gingival indices were slightly better in the experimental side. The author concludes that placing a Formaldehyde-Tyrothricin solution in periodontal pockets offers some therapeutic gain over scaling and root planing alone.

Adult↗
PubMed1990

[Ultrasonic root planing. An alternative method versus hand instruments? An in vitro comparison and SEM study].

This study showed no difference between the use of the "Piezon Master 400", using four different attachments as compared to the "Hu Friedy" Curettes as far the formation of grooves and scratch marks is concerned. Both root planing methods gave rise to a scalloped surface of the root cement. The ultrasonic root planing however showed a more discrete scalloped surface with very small tears and having a hammered appearance. Hand instrumentation showed much wider tears on the root surface structure.

Dental Scaling↗
PubMed1999

Effectiveness of a sanguinarine regimen after scaling and root planing.

BACKGROUND: A variety of chemical agents have been evaluated relative to their abilities to inhibit dental plaque and to improve gingival health. Chlorhexidine gluconate is the best known and most widely used member of these agents, but its long-term use is compromised by different side effects, especially extrinsic tooth and tongue staining. Another agent, sanguinarine, which is currently used in both a mouthrinse and toothpaste, leads in some cases only to a transient burning sensation and could be used on a long-term basis. The purpose of this 14-week controlled clinical trial was to assess the effectiveness of a toothpaste and oral rinse containing sanguinaria extract after scaling, root planing and a chlorhexidine regimen. METHODS: Sixty patients diagnosed as having adult periodontitis received initial periodontal therapy including scaling and root planing, followed by a 2-week oral care regimen which included rinsing with 0.2% chlorhexidine gluconate oral rinse. Upon completion of this 2-week initial therapy phase, patients were randomly assigned to either sanguinarine toothpaste and oral rinse or to control toothpaste and oral rinse without sanguinarine. Plaque (modified Quigley-Hein index) and gingivitis (gingival index) were measured prior to periodontal therapy, at the end of the chlorhexidine phase (2 weeks), and after 8 and 14 weeks. RESULTS: Sanguinarine-containing toothpaste and oral rinse significantly inhibited the redevelopment of gingivitis through the 12 weeks following the chlorhexidine phase compared to the control toothpaste and rinse. Patients in the test group had 26% fewer bleeding sites at 8 weeks, and 32% fewer at 14 weeks, than the control group. CONCLUSIONS: Our results support the combined use of chlorhexidine mouthrinse for a short term (2 weeks) followed by sanguinaria mouthrinse and toothpaste up to 3 months in order to optimize the effectiveness of chlorhexidine without side effects. Further studies on the long-term effect of this combination should be established.

Adult↗
PubMed1992

The effectiveness of scaling and root planing with curets designed for deep pockets.

This study evaluates the effectiveness of subgingival scaling and root planing with longer shank, thinner blade, rigid curets compared to the standard rigid Gracey curet. A total of 35 non-molar teeth from 7 patients provided 140 root surfaces for evaluation; 52 root surfaces were instrumented with the rigid longer shank curets; 52 with the standard rigid Gracey curets; and 36 provided untreated controls. A bilateral matched design was utilized where contralateral teeth in the same arch were instrumented. Instrumentation was standardized at 15 minutes per tooth. Both scaled and unscaled teeth were extracted immediately after the experimental procedures. They were viewed under a stereomicroscope with a 0.10 mm grid to assess the percent of surface covered by calculus and unaltered cementum. The curet efficiency was also evaluated. The results indicated a significant treatment effect compared to the controls in relation to the percentage of residual calculus and curet efficiency. However, there was no significant difference between the rigid longer shank and standard rigid Gracey curets. There was a difference noted when tooth surfaces were evaluated. Mesial tooth surfaces had the least remaining calculus and demonstrated the best curet efficiency.

Aged↗