An in vitro comparative study of a reciprocating scaler for root surface debridement

Objectives: A number of instruments are available for debriding periodontally involved root surfaces. The aim of this SEM study was to assess and compare the efficiency of the recently marketed EVA scaling system with that of ultrasonic (Cavitron-Dentsply) and hand instruments (Ash Dental Products). Methods: Forty-five periodontally involved extracted teeth were divided into three equal groups for instrumentation. The teeth were mounted onto typodonts, set in phantom heads and instrumented to tactile smoothness and visual cleanliness. Replica specimens of the debrided roots were prepared for the SEM and views were recorded on video film. The efficiency of instrumentation was assessed using the Remaining Calculus Index (RCI) and the Roughness and Loss of Tooth Substance Index (RLTSI). Five original specimens from each group were prepared for light microscopy to confirm histologically the appearances seen under the SEM. Results: Observations indicated that there were no statistically significant differences between the different instruments but the EVA system took significantly longer than either the ultrasonic (P < 0.0001) or hand instruments (P < 0.025) to achieve visual cleanliness. The results supported the view that no instrument removes all extraneous deposits and all were capable of cavity roughness and minor damage to root cementum. Only the hand and ultrasonic instruments left scratches after instrumentation, although the greater part of all the surfaces was surprisingly smooth and calculus free after root surface debridement. Conclusions: Recently marketed EVA inserts are comparable to ultrasonic and hand instruments for root planing, with respect to calculus removal and quality of the remaining root surface.