The Effect of Mechanical Instrumentation on Dental Hard Tissue In Vitro: A Systematic Review

Area of Science:

• Periodontology
• Biomaterials Science
• Dental Materials

Background:

• Dental hard tissues are susceptible to material loss and surface changes during periodontal therapy.
• Hand instruments, ultrasonic scalers, and air polishing devices are commonly used for dental cleaning.

Purpose of the Study:

• To analyze the effects of hand instruments, ultrasonic scalers, and air polishing devices on dental hard tissues.
• To focus on material loss and surface roughness caused by these dental instruments.

Main Methods:

• Systematic review of MEDLINE, EMBASE, and Cochrane Library databases.
• Inclusion of studies on human cementum and dentine with at least six human teeth specimens.
• Exclusion of studies using powders other than glycine or erythritol or examining combined treatments.

Main Results:

• Hand curettes generally caused higher substance loss compared to ultrasonic scalers.
• Root substance loss varied: ultrasonic scalers (0.28–14.73 μm/stroke), hand instruments (0.86–20.60 μm/stroke), and air polishing (0.12–23.40 μm).
• Surface roughness findings were inconsistent across studies, with air polishing showing varied effects.

Conclusions:

• Substance loss per second was highest with air polishing devices, followed by ultrasonic devices.
• Substance loss per stroke was greatest with hand instruments compared to ultrasonic scalers.
• Heterogeneity in study designs limits direct comparison of results.