The effectiveness of different root debridement modalities in open flap surgery

Abstract. It is unclear what degree of roughness or smoothness result from use of hand instruments alone in comparison to the use of hand instruments in combination with other aids and how it may effect the grade of cleanliness. The aim of this study was to determine in vivo whether the combination of hand instruments with other aids can increase the effectiveness of root debridement. 11 patients with holpless 4 mandibular incisors were involved in this study. After elevating a lingual and buccal mucoperiosteal flap, the 4 incisors were randomly treated with either: (1) no treatment (control); (2) 5-niin scaling (method 1); (3) 4-min scaling and 1-min instrumentation with a perio-diamond bur (15 μm) (method 2); (4) 3-min scaling, 1-min instrumentation with a perio-diamond bur (15 μm) and 1 min with an air abrasive system (method 3). The cleanliness of the surface was determined using the method of Eschler and -Rapley. The degree of roughness (Ra and Rt) were measured with a laser beam (computer supported optical surface sensor system). In addition, an SEM analysis was performed. With regard to the remaining calculus (surface cleanliness), method 3 yielded significantly better results than the other 2 methods. The roughness analyses also exhibited that method 3 is superior to methods 1 and 2. The qualitative results of the SEM investigations demonstrated the most homogenous and smooth surfaces with method 3. Root debridement in vivo was most significant using a combination of different treatment modalities (i. e., curettes, perio-diamond bur and air abrasive system).