PERIO 4 - Ultrasonic and polishing

• What is this?

  Ultrasonic scaler (Piezon)

  
• What is this?

  prophylactic polishing

  
• What are the two mechanisms by which ultrasonic scalers work?

  Magneto-striction and piezo-electric
• Describe how magento striction ultrasonic scalers work

  • electrical energy is applied to the handpiece drive coil generating magnetic energy, which causes vibration. This vibration is at a speed of 25-30,000 cycles per second.
  • This scaler has an elliptical strokes which means all 4 surfaces can be utilised.
• Describe how the piezo-electric scalers work

  • Contain crystals that form mechanical energy which causes the tip to move side to side in a linear strokes
  • so only lateral surfaces are active
• What are the features common to both types of ultrasonic scalers?

  • High frequency vibrations
  • adjustable power
  • water lavage: cooling, cavitation, acoustic streaming
• What are the purposes of water lavage?

  • cooling: The water spray keeps the tip and handpiece from overheating, which could damage both the instrument and the patient's tissues.
  • Cavitation: Water droplets hitting the tip create minute bubbles that implode, releasing energy. This cavitation effect helps disrupt bacterial cell walls and enhances biofilm removal.
  • Acoustic Streaming: The forceful flow of the cavitating fluid extends the cleaning action beyond the area directly contacted by the tip. This streaming also helps remove debris and flush out the treatment site.
• What medical considerations need to be taken before using an utrasonic scaler?

  • Cardiac Pacemakers
  • Osseointegrated Implants
  • Dysphagia (difficulty swallowing)
  • Severe Respiratory Diseases like COPD may find aerosol irritating
  • Hearing Aids
  • Cochlear Implants
  • Brain Stimulators
• What dental considerations need to be taken before using the ultrasonic ?

  • Exposed Dentine in case of sensitivity
  • Demineralized Enamel (can worsen)
  • Implants (use specialised tips)
  • Restorative Margins
  • Crowns/Bridges
• What speed should the contra-angled hand piece for polishing?

  10,000rpm
• What is the correct polishing technique?

  • Use minimal pressure
  • begin at gingival margin and move towards occlusal surface
  • work from distal to mid to mesial surfaces