Graetz Christian, Schwendicke Falk, Plaumann Anna, Rauschenbach Sebastian, Springer Claudia, Kahl Maren, Sälzer Sonja, Dörfer Christof E
Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany,
Clin Oral Investig. 2015 Jun;19(5):987-95. doi: 10.1007/s00784-014-1319-x. Epub 2014 Sep 19.
There is uncertainty regarding the benefits and risks of hand versus powered root surface instrumentation. Moreover, the influence of operators' experience on treatment results is unclear. We compared newly developed sonic, ultrasonic and hand instruments, hypothesizing that powered devices allow to remove more simulated plaque in less time than hand instruments, with significant influence of operators' experience.
Sonic scaler (AIR), ultrasonic scaler (TIG) device and double Gracey curettes (GRA) were utilized by seven experienced operators (EOs) and four less experienced operators (LOs) in periodontitis manikin heads. The time required for treatment, the proportion of residual-simulated plaque and the weight loss caused by scaling as a proxy for root surface destruction were measured.
Using different instruments led to significantly different proportions of removed simulated plaque regardless of operators' experience (AIR, 80.2 ± 21.3 %, TIG, 69.9 ± 22.5 %, GRA, 73.1 ± 20.0 %) (p < 0.001). Treatment times did not significantly differ between EO and LO (p > 0.05). Weight loss was increased when using hand instead of powered instruments (p < 0.001), with significantly higher weight loss induced by LO than EO (p = 0.004).
Within the present study, EO did not remove more simulated plaque in less time but induced less root surface destruction. Using a sonic device was most beneficial for plaque removal.
Successful root surface debridement requires both time and training regardless of the used instrument. Hand instruments might cause more damage to root surfaces, especially in the hands of less experienced operators.
手动与动力根面器械操作的益处和风险尚不确定。此外，操作者经验对治疗结果的影响也不明确。我们比较了新开发的声波、超声波和手动器械，假设动力器械比手动器械能在更短时间内去除更多模拟菌斑，且操作者经验有显著影响。
7名经验丰富的操作者（EOs）和4名经验较少的操作者（LOs）在牙周炎人体模型头部使用声波洁治器（AIR）、超声波洁治器（TIG）和双Gracey刮治器（GRA）。测量治疗所需时间、残余模拟菌斑比例以及作为根面破坏指标的洁治导致的重量损失。
无论操作者经验如何，使用不同器械导致去除模拟菌斑的比例有显著差异（AIR，80.2±21.3%；TIG，69.9±22.5%；GRA，73.1±20.0%）（p<0.001）。EO和LO的治疗时间无显著差异（p>0.05）。使用手动器械而非动力器械时重量损失增加（p<0.001），LO导致的重量损失显著高于EO（p=0.004）。
在本研究中，EO并未在更短时间内去除更多模拟菌斑，但导致的根面破坏较少。使用声波器械对菌斑去除最有益。
无论使用何种器械，成功的根面清创都需要时间和培训。手动器械可能对根面造成更多损伤，尤其是在经验较少的操作者手中。
