The effectiveness of root debridement in open flap procedures by means of a comparison between hand instruments and...

The goal of the present in vivo study was to evaluate human roots by means of scanning electron microscopy (SEM), after treating the root surfaces either with conventional hand instruments or with newly developed diamond burs. Peculiar root anatomy often makes perfect instrumentation with hand instruments difficult or impossible. On 20 teeth destined for extraction because of severe periodontitis, the root surfaces were exposed by mucoperiosteal flap procedures. Ten roots were then planed using fine curettes, and 10 were instrumented using diamond burs. Following extraction, the root surfaces were stained and photographed. Stained areas were examined by SEM. On the 20 test teeth, 79 surfaces were evaluated. From these, 381 stained zones were checked by SEM for the presence of bacteria. A total of 216 stained areas from teeth treated by hand instruments was evaluated; 15 of these (6.9%) contained bacteria. Of roots treated by diamond burs, 165 stained areas were evaluated; 9 (5.5%) exhibited bacteria. Thus, both methods resulted in root surfaces that were essentially bacteria-free.