Ultrasonic Scaling

It is the use of ultrasonic devices that dramatically improves the practice of supragingival scaling and periodontal debridement. Although ultrasonic technology has been around for decades, improvements in recent years have allowed its use to become mainstream. Ultrasonic technology in general, whether magnetostrictive (long inserts with metal rods that flex) or piezo-electric (small tips that screw onto the handpiece), and sonic scalers to a lesser degree, offer several advantages over hand scaling:

• Decreased treatment time, especially with heavy deposits, leaving more time for patient education or procedures such as placement of chemotherapeutic agents (ie, Arestin [OraPharma], Atridox [Collagenex Pharmaceuticals], or PerioChip [Dexcel Pharma]).
• More efficient removal of dental plaque and calculi with ultrasonic instrumentation.
• Ultrasonic tip spray promotes elimination of dental  plaque.
• Ultrasonic instruments rid the radicular surfaces of bacterial endotoxins while preserving the cementum.
• Less tissue trauma due to no sharp cutting edges.
• Water provides continuous tissue lavage, thereby reducing the need for rinsing during scaling, since the water flow allows for high visibility throughout the procedure; this lavage also increases tissue comfort for the patient during and after the procedure.
• Antiseptic solution can be substituted for the water to provide simultaneous irrigation/disinfection of the region being treated.
• Excellent for stain removal that may otherwise be tedious to scale by hand.
• Gritty, pumice-based polish may no longer be necessary or indicated following scaling with ultrasonic; due to the efficient stain removal during scaling, a milder, minimally invasive paste or polish can be used, preserving the glaze on composite and porcelain restorations; less abrasive polish enhances patient acceptance and lowers post-scaling sensitivity