Scaling and root planing efficacy in multirooted teeth

Area of Science:

• Periodontology
• Dental instrumentation

Background:

• Root surface access and operator experience are critical factors in effective scaling and root planing.
• Multirooted teeth, particularly molars with furcations, present unique challenges for calculus removal.

Purpose of the Study:

• To investigate the impact of operator experience and surgical access on the thoroughness of instrumentation in multirooted teeth.
• To evaluate the efficacy of scaling and root planing with and without flap access in removing calculus from root surfaces and furcations.

Main Methods:

• Fifty extracted molars were randomly assigned to four operators with differing experience levels.
• Instrumentation was performed with or without surgical (flap) access for scaling and root planing.
• Teeth were subsequently extracted and blindly assessed for residual calculus, including examination of furcation areas after sectioning.

Main Results:

• Both flap access and higher operator experience significantly increased the frequency of calculus-free root surfaces compared to non-surgical approaches.
• Experienced operators achieved better calculus removal than less experienced operators under both open and closed procedures.
• Even with an open approach, experienced operators achieved calculus-free furcation surfaces only 68% of the time.

Conclusions:

• Surgical access and operator experience are crucial for enhancing calculus removal from multirooted teeth.
• Conventional instrumentation techniques may have limitations in achieving complete calculus removal from complex furcation areas.
• Further research into advanced techniques may be necessary for optimal furcation debridement.