srp-hand vs sonic/ultrasonic instrumentation
The short answer is that the operator is more important than the particular
tool. Having said that, traditionally a thin curet has been seen as more
effective, due to better tactile sensitivity. OTOH, Pat and Shirley have cited
research that demonstrates a disruption of bacterial flora in the perio pocket
with ultrasonic scaling that is superior to that found with hand instrumentation.
Some manufacturers now make periodontal tips that can reach deep into pockets.
Personally, I use a Cavitron for the heavy scraping, then go over the mouth
with a McCall curet to check for anything I might have missed.
How deeply can you effectively clean a pocket? What the periodontists
uniformly say is that root planing is the most painstakingly difficult thing in
dentistry to do effectively. In areas where perio surgery is done after root
planing, they always find calculus left behind. This may be a self-serving
argument, but no less true for being self-serving. The actual depth of effective
root planing varies with the operator, and also on the area of the mouth. It
would be far easier, for instance, to curet a deep pocket around a lower first
premolar with one round root than a deep pocket around an upper second molar,
where the roots have concavities, and furcations (where the roots separate) may be
open.
Steve
Quote:
> doing srp on upper teeth (there are 10 crowns), which would be better to use -
> hand, sonic/ultrasonic instrumentation? also, what pocket depth (mm) can
> successfully be reached?
--
Mark & Steven Bornfeld DDS
Brooklyn, NY
718-258-5001
http://www.dentaltwins.com
