Comparison of periodontal pocket penetration by conventional and microultrasonic inserts

Recently, 'microultrasonic' instruments have been developed with the aim of improving root-surface debridement. Whilst their reduced tip diameter and modified shape suggests that they may penetrate the periodontal pocket more easily than conventional inserts, there have been few studies investigating their efficacy. The aim of this investigation was therefore to compare the periodontal pocket penetration of a conventional ultrasonic insert (P10 insert - Dentsply) with microultrasonic inserts (Slimline FSI left and right - Dentsply). Efficacy of penetration was assessed by a modification of instrument limit. This modification permitted measurement of the linear % removal of the apical plaque border by image analysis. Debridement was carried out on randomly allocated surfaces of 30 teeth which had been treatment planned for extraction due to periodontitis. One surface on each tooth acted as an untreated control. The results of this study showed that both types of insert were able to reach and debride the apical plaque border, and at all pocket depths assessed. However no significant differences were found between the Slimline insert and the P10 tip. Trends between instruments were observed which suggest that the Slimline insert might more easily penetrate to and debride the apical plaque border in deep pockets, whereas the P10 insert might be more effective in disrupting the apical plaque border in shallow pockets. Future investigations using a larger sample size will be needed to confirm these observations.