The Effectiveness of the Titan‐S Sonic Sealer Versus Curettes in the Removal of Subgingival Calculus

Abstract
This study evaluated clinically the effectiveness of hand versus sonic subgingival scaling and root planing in the removal of calculus by visually examining the root surface at the time of periodontal flap surgery. Consideration was given to the method of instrumentation, probing depth, number of roots, and type of tooth surface. Eleven patients with modreate to advanced periodontal disease were evaluated. Four subjects were scaled and root planed with the Titan-S only, four with curettes only, and three with the Titan-S + curettes. At reevaluation 3 to 6 weeks after scaling and root planing, the decision to perform periodontal flap surgery was made based upon probing depth, bleeding upon probing, previous access to the root surface, furcation involvement, and the patient''s level of oral hygiene. A full thickness mucoperiosteal flap was elevated to gain access to the root surface and measure the distance from the cementoenamel junction to the residual calculus. A total of 690 surfaces were evaluated surgically. The percentage of surfaces with residual calculus for each method of instrumentation was: Titan-S only (31.9%), curettes only (26.8%), and Titan-S + curettes (16.9%). Overall, 15.7% of the surfaces probing 0 to 3 mm, 29.3% of the surfaces probing 4 to 5 mm, and 44.4% of the surfaces probing 6 to 12 mm had residual calculus. It was concluded that: (1) the combination of the Titan-S + curettes was more effective than either method used alone; (2) there was no consistent difference between the Titan-S and curettes; (3) as the probing depth increased, the percentage of surfaces with residual calculus increased; and (4) subgingival calculus removal was more difficult for multiple-root teeth and for proximal surfaces.
Funding Information
  • Medical University of South Carolina

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