Kocher T, Rühling A, Herweg M, Plagman H C
Sektion Parodontologie in der Klinik für Zahnerhaltungskunde und Parodontologie im Zentrum für Zahn-, Mund- und Kieferheilkunde, Kiel, Germany.
J Clin Periodontol. 1996 Jul;23(7):662-9. doi: 10.1111/j.1600-051x.1996.tb00591.x.
The purpose of this study was to determine the suitability of different scaling instruments for surgical removal of hard and soft bacterial deposits and for the removal of soft accretions only for maintenance treatment within furcations. 12 upper and 12 lower plastic replicated molars, with through-and-through furcations, were instrumented 3 x with 4 different types of instruments: (1) hand instruments; (2) a conventional sonic scaler insert; (3) a set of 3 modified sonic scaler inserts with budded tips and different angulated shafts; (4) a set of 3 sonic scaler inserts with a plastic-coating and different angulated shafts. The plastic replicas were fixed in a dummy head without any replicated soft tissues. In the furcation area, an easily removable surface coating material was applied to the teeth to represent the "plaque" and a second, more stubborn lacquer layer representing "calculus/cementum". Following instrumentation, the following parameters were recorded to assess efficacy; time required for instrumentation, loss of weight, depth of substance removal at the furcation entrance, % of furcation area instrumented, whereby removal of these 2 layers was judged separately. Only minor differences were observed between hand instruments, conventional and budded sonic scaler inserts as to loss of weight, depth of substance loss and area instrumented. The plastic-coated sonic scaler inserts were just as effective in surface layer removal representing "plaque" as the 3 other instruments, but resulted in less loss of weight and less depth of substance removal. In conclusion, the more aggressive hand instruments, the conventional and budded sonic scaler insert, are preferably used for the surgical phase to increased ease of entry into the furcation dome. An effective debridement of the furcation roof seems only possible with an odontoplastic, for which a furcation is fitted to the instrument by means of an intensive instrumentation, thus leading to weight loss and pronounced substance removal. The plastic-coated sonic scaler inserts seems to be a reasonable choice for maintenance treatment within furcation, since this treatment phase is usually restricted to removal of soft bacterial deposits.
本研究的目的是确定不同的洁治器械对于手术清除软硬菌斑沉积物以及仅用于根分叉维护治疗时清除软垢的适用性。12颗上颌和12颗下颌塑料复制磨牙，具有贯通性根分叉，分别使用4种不同类型的器械进行3次操作：（1）手动器械；（2）传统超声洁治头；（3）一组3个带有芽状尖端和不同角度杆的改良超声洁治头；（4）一组3个带有塑料涂层和不同角度杆的超声洁治头。塑料复制品固定在无任何软组织复制的模拟头中。在根分叉区域，在牙齿上涂抹一种易于去除的表面涂层材料以代表“菌斑”，并涂抹第二层更顽固的漆层以代表“牙结石/牙骨质”。操作完成后，记录以下参数以评估疗效：操作所需时间、重量损失、根分叉入口处物质去除深度、根分叉区域被操作的百分比，其中这两层的去除分别进行判断。在重量损失、物质损失深度和操作区域方面，手动器械、传统超声洁治头和带芽状的超声洁治头之间仅观察到微小差异。带塑料涂层的超声洁治头在去除代表“菌斑”的表层方面与其他3种器械一样有效，但重量损失和物质去除深度较小。总之，更具攻击性的手动器械、传统超声洁治头和带芽状的超声洁治头，在手术阶段更适合使用，以增加进入根分叉穹顶的便利性。似乎只有使用牙用塑料器械并通过密集操作使器械适配根分叉，才能有效清创根分叉顶部，从而导致重量损失和明显的物质去除。带塑料涂层的超声洁治头似乎是根分叉维护治疗的合理选择，因为这个治疗阶段通常仅限于清除软菌斑沉积物。
