Root surface smoothness or roughness following open debridement. An in vivo study.

Consensus has not been reached on the desired characteristics of the root surface following cleaning. It is also not clear what degree of roughness or smoothness results from use of different instruments. In the present human clinical study, various instruments for root surface cleaning were evaluated. 18 teeth destined for extraction for periodontal reasons were utilized. After reflection of soft tissue flaps, the 72 root surface aspects of the 18 teeth were uniformally treated with one of the following instruments: Gracey curette (GC), piezo ultrasonic scaler (PUS), Perioplaner curette (PPC), sonic scaler (SS), 75 microns diamond (75 D) and 15 microns diamond (15.D). The degree of roughness of each surface was measured after extraction. A planimetry apparatus was used to establish the average surface roughness (Ra) and the mean depth of the roughness profile (Rz). It was demonstrated that hand- and machine-driven curettes as well as very fine rotating diamonds created the smoothest root surfaces, while "vibrating" instruments such as sonic and ultrasonic scalers, as well as coarse diamonds, tended to roughen the root surface. Whether the root surface should be rough or smooth in order to enhance tissue healing remains an open question.