Total cementum removal: a realistic objective?

The purpose of the study was to determine if total cementum removal from periodontally involved root surfaces was a clinically realistic objective. The experimental specimens were 36 periodontally involved teeth, extracted because of advanced periodontal disease. Eighteen teeth were from patients under age 36 while the other 18 were from patients over 36. All teeth had at least 6 mm of attachment loss on the proximal surface tested and showed no evidence of forceps damage. After removing all visible calculus, equal numbers of each tooth type in each age group were given 50 planing strokes with either a Jacquette scaler, a Gracey curet, or an Indiana University curet. Following the planing procedure the specimens were fixed, decalcified, and 7 microns thick sections prepared and stained with hematoxylin and eosin. Two teeth were excluded from the evaluation due to poor orientation. In none of the remaining 34 teeth was cementum totally removed over the entire proximal test surface. There was no apparent difference between the instruments in the amount of residual cementum found. Larger amounts of residual cementum were seen in more apical areas in both age groups.