Morphological studies of changes in dental hard tissues following different methods of dental deposit removal

Aim: To study structural changes in hard tooth tissues after manual, ultrasonic, and sonic methods of removing dental deposits and identifying the most rational method for various supragingival deposits.

Materials and Methods: Eight patients with supragingival deposits were examined, and eight teeth planned for extraction due to orthodontic or surgical indications: three teeth with dental plaque, three with mineralized deposits, and two with smoker's plaque. Of the three patients with dental plaque, one underwent manual scaling, another ultrasonic scaling, and the third sonic scaling. Similarly, among the three patients with dental calculus, manual, ultrasonic, and sonic scaling were performed. In the two patients with smoker's plaque, ultrasonic and sonic scaling were applied. After tooth extraction, morphological studies were conducted.

Results: Manual scaling of dental plaque left residual deposits and damaged enamel surfaces. For dental calculus, minimal residual deposits and relatively intact enamel were observed. Ultrasonic scaling caused microscopic changes: destruction of enamel prisms, partial fragmentation of the reticular layer in teeth with plaque, partial destruction of superficial enamel layers, thickening of the reticular layer with PAS-positive vegetations in teeth with calculus. In teeth with smoker's plaque, enamel prism destruction, hyperplasia, and reticular layer fragmentation were observed. Sonic scaling caused more pronounced destructive changes.

Conclusions: Manual scaling is the most rational method for supragingival mineralized deposits, while the air-abrasive method is preferred for non-mineralized deposits and smoker's plaque. The destructive changes caused by ultrasonic scaling limit its clinical applicability. Sonic scaling is unsuitable for removing dental debris due to its aggressiveness.