Ultrasonic Scaling

 

Department of Periodoncs Periodoncs Seminar topic: ULTRASONIC SCALING

Guided by: Dr. Roshan Lal Dr. Yashpal Dr. Amita Dr. Preetinder Singh Dr. Nitin Soni Dr. Sumit Kaushal Dr. Sarita Dr. Alka

Submitted By:  Yogesh Mehra

6099 B.D.S. Intern

 

ULTRASON UL TRASONIC IC SCALING SCALING Introducon: What is periodontal disease? •

Periodontal disease is the infecon of supporng structure of Periodontal teeth.

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Most important cause of adult tooth loss

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Begins with plaque which if not removed may hardens to form

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calculus This increases no. of harmful bacteria and resulng in deepening spaces b/w teeth and gums c/a pockets. pockets.

 

What is an ultrasonic scaler? To ght with periodontal disease we need to reduce plaque, calculus & no. of bacteria in the pockets of mouth. It consists of wand with scaling p that produces ultrasonic vibraons in combinaon with water ow that removes the calculus. Its an important tool in prevenon and t/t of periodontal diseases. Benets of ultrasonic scaling: 1) Inc Incre rease asess e ec cien iency cy of calcu calculus lus re remo mova vall 2) Le Less ss ne need ed of han and d sc scal alin ing g 3) Mo More re comf comfort ortabl able e ac acces cesss tto o rroo oott surf surface acess

 

Sonic: in 1960’s, eg. Denosonic Scaler,Titan S,Kavo Sonic ex •

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Air-driven scalers Sonic scaler ps are large in diameter and universal in design. Operated by compressed air. air.

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6000 Hz to 9000 Hz frequency Plaque and calculus removed removed by tapping moon

Ultrasonic scalers: Consists of wand with a scaling p that produces quick small ultrasonic vibraons. Types of Ultrasonic scalers: 1) Magnetostricve 2) Piezoelectric

 

Magnetostricve ultrsonic scalers: •

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In 1950’s Eg. Dentsply De ntsply,, Cavitron,Odontosson Driven by either a metal sck Consisng of Ni-Fe alloy strips or ferrite insert inserted into hand piece A live coil in hand piece generates air alternang electromagnec eld that l/t expansion and contracon of ferro-magnec material The resulng vibraons are conducted to the scaler p in ellipcal or orbital paern. 25 KHz to 30 KHz

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Less technique sensive

 

Piezoelectric Ultrasonic scalers: •

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Eg. Amdent, EMS Piezon Master, Master, Satallec Suprasson New generaon of USS light in weight, compact modern design,quick, eecve, eortless, more hygienic.

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The vibraons arethe generated changes in dimension of quartz crystals resulngbymode of oscillaon is strictly linear. •

This uses pulsing voltage applied to ceramic crystals.

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32 KHz – 35 KHz

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More technique sensive

 

Principles of Ultrasonic scaling: Are CAVITATION an ACOUSTIC STREAMING Cavitaon:

Cavitaon is dened as the growth of subsequent violent collapse of a Cavitaon small gas lled pre-exisng inhomogenity inhomogenity in the bulk uid. This moon results in development of shock wave, increased temperature and pressure & free radical formaon in the uid .

Acousc streaming:

def as generaon of me independent steady unidireconal circulaon of uid in the vicinity of a small vibrang object. This ow of liquid has small velocity of order of few cenmeters/sec, but because of small dimensions involved there is formaon of hydrodynamic stresses at the scaler p.  

 

WORKING: •

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Keep the scaling p parallel to tooth surface. Scaling p should not kept more than 15 degree angle to avoid avoid etching or grooving of the tooth surface. Centre the spray on the middle 1/3rd of tooth & use a constant circular moon Working p should come in contact with calculus to fracture and remove it.

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The scaling p vibrates in ellipcal, ellipcal, curved linear or gure “8”

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Not to be used > 10 sec on any single tooth

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Never to press harder than one ounce of pressure Use light, vercal, horizontal , or oblique overlapping strokes.

 

Paent Pa ent posion and nger rests: •

For upper arch the paent is seated in supine

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posion with the chin slightly lied For mandible the back rest should be at 45 degree to oor

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For lingual aspect of mandibular man dibular anterior teeth lower the paent’s chin Light pen or modied pen grasp is used, and extra oral nger rest should be used for maxillary teeth and extraoral or intraoral nger rest for mandibular teeth.

 

Role of coolant: •

Keep ssues in physiologic temperature range

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Flow rate 14 ml/min to 23 ml/min .

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Water contributes to three physiological eects: Acousc streaming, streaming, Acousc turbulence and cavitaon.

Instrument Power seng : High power – produce aerosol and splaer formaon might reduce the volume of cooling agent that is delivered in to the periodontal pocket. use

lowest eecve power seng

 

DRAWBACKS OF ULTRASONIC SCALING : 1.

Thermal Thermal e eects ects on den denta tall p pulp ulp - p perf erform orming ing USS wit withou houtt iirrig rriga aon on leads to increase in temperature complete damage of pulp ssues .

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Thermal Thermal e eects ects on p perio eriodon donum um – ver very y li lile le e eect ect is o obser bserved ved on surrounding tooth supporng ssues

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Vibra Vibraon on h haz azar ards ds tto o paen paentt – da damag mage e eryt erythro hrocyt cytes, es, lleuk eukoc ocyte ytess & platelets , blood platelets are sensive to sheer she er stresses & such forces forc es are produced by occurrence of acousc micro streaming around an ultrasonically oscillang p.

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AER AEROSO OSOLL : a aero erosol sol & spla splaer er fo forma rmaon on duri during ng u ultr ltraso asonic nic sca scaler ler contact with uids whether the uid is saliva , blood & water . The energy transmied to uid is enough to produce the aerosol suspension of the ne liquid parcle . Fine aerosol mist may remain air borne for extended period of me, contaminang the dental operatory

 

5. Auditory : potenal hazard to auditory system of both operator & paent For paent damage can occur through the transmission of ultrasound through tooth contact through the inner ear via the bones of the skull . May l/t nnitus , may cause permanent damage to inner ear 6.Cardiac pacemaker pacemakers s : it of is well known that magnec, electrical electromagnec elds sucient strength can interfer interfere e withor the acon of pacemaker pacemakerss . The handpiece of ultrasonic scaler produces an electromagnec eld

 

INDICATIONS: •

Adjunct to manual scaling but not a substute

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In following

Calculus and stain remov removal al Disrupt microbial colonies Gingival Cureage Overhangs and excess cement removal aer cementaon cementa on of orthodonc appliances

 

CONTRAINDICATIONS: •

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Paent with unknown communicable disease Immune compromised paent Cardiac Pacemaker Laser eye surgery Demineralized areas Children Paent Pae nt with swallowing/gagging problem History of chronic pulmonary disease Exposed dennal surfaces Respiratory diseases Titanium implants Porcelain crowns

 

PRECAUTIONS: •

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 avoid direct contact contact of cleaning jet with so ssues Avoid prolonged use of this system on cementum and denn . Not use more than 10 sec on any single tooth Never press harder than 1 ounce of pressure Use consistent water spray Use mask, gloves and protecve eye wear and use high speed evacua evacuaon on to minimize inhalaon of contaminated aerosols.

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Direct the paent to rinse for 1 min with 0.12% chlorhexidine.

 

COMMON OPERATORS ERRORS: •

Excessive Excessiv e pressure during scaling

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Failure to use lowest eecve power seng

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Failure to use adequate water ow

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Failure to ush water lines before and aer each use •

Failure to keep p in constant moon

 

Reference: Carranza Lindhe

Thank You