Instrumentation of furcation with modified sonic scaler inserts: study on manikins, part I

The purpose of this study was to determine the suitability of different scaling instruments for the debridement of furcations. 12 upper and 12 lower replicated molars with through-and-through furcations were instrumented 3x with 5 different types of instruments: (i) hand instruments; (ii) hand instruments in conjunction with diamond burrs; (iii) a conventional ultrasonic scaler insert; (iv) a conventional sonic scaler insert; (v) a set of 2 modified diamond coated sonic scaler inserts with different angulated shafts. The plastic replicas were fixed in a manikin head without replicated soft tissues. Following debridement, weight loss and % of instrumented furcation area were assessed. In the case of lower molars, it made little difference whether they were treated with hand instruments, hand instruments combined with diamond burrs, or diamond-coated sonic scaler inserts. On upper molars, however, significantly more area was instrumented with the diamond-coated inserts than with the other instruments. Substance removal was greater with diamond-coated inserts than with the other devices. In conclusion, an effective debridement of the furcation seems possible only with an odontoplasty, in which a furcation is fitted to the instrument by means of intensive instrumentation, thus leading to substance loss. To improve results with these instruments, further research is necessary.