Ultrasonic dental instruments is an effective means to eliminate biofilm in the oral cavity. The position of ultrasonic instruments in oral health armamentarium was consolidated through the additional ergonomic benefit of the operator. However, the idea that ultrasonic scaling has an additional sterilization effect is controversial because there is no evidence that there is a study of this problem in living organisms. In January 2012 in oral hygiene, a. Damien Walmsley, BDS, MSc, PhD, Shared his about ultrasonic instrument cavitation bubble formation (pulse) and sound wave microflow (fluid flow produced by the ultrasonic vibration) point of view. In this interview, Dr Flemmig shares his views on this polarizing topic.
Can you produce an ultrasonic scaler that can kill bacteria in a periodontal bag?
There are two components to this problem. First, there is evidence to support some ultrasound insertion/tip (UITs) cavitation in vitro. 1. The occurrence of cavitation depends on the configuration, power setting and time of the Inuit. The flat UITs, which are not suitable for the qingchuang under the gingiva, have been shown to produce the maximum cavitation. A circular UITs needs to be run in a high-power environment, or within a few minutes of a moderate setting, to produce detectable levels of cavitation. So far, there has been no assessment of whether there will be cavitation around the delicate UITs, which are usually used for expansion under the gingiva. Although these studies provide evidence, in some cases cavitation may occur in vitro, but it has not yet shown the cavitation of periodontal bags under gingiva.
The second part of the problem involves the antibacterial effect of ultrasonic instruments. In vitro studies have shown controversial results in the study of possible periodontal pathogens that were killed by ultrasonic scalders. In an experiment, the effect of sterilization of the constant temperature was studied. The authors concluded that the observed bacterial dissolution was due to accidental temperature increases. 3. When the temperature remains in physiological level, the ultrasonic wave and the phonetic symbol, did not cause a lot of bacteria aggregation actinomycetes, porphyrin bacteria, campylobacter, streptococcus or stomach. In this experiment, bacteria were found to be killed only after using an ultrasound cell interferometer (an experimental instrument used to break down bacterial cell membranes). The results show that killing bacteria requires much more energy than an ultrasound. In another in vitro study, the ultrasonic scalars had a larger contraction in the plaques than the Ultrasonic Scaler. 5. However, there is no difference in the microbial composition in the periodontal pocket after the use of ultrasound or acoustic frequency scaler to scale. Therefore, there is no evidence that ultrasonic scalding can kill bacteria in periodontal pockets.
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