Download UPDATE ON ADVANCED PERIODONTAL INSTRUMENTATION

UPDATE ON ADVANCED PERIODONTAL INSTRUMENTATION
Copyright 2016 by Anna Matsuishi Pattison, RDH, MS
New trends in Instrumentation are the use of magnification loupes/ mircoscopes,
endoscopy, calculus detection probes, and lasers.
Periodontal Viruses: all 8 Herpes family viruses have been found in periodontal
pockets-millions of Epstein Barr and Human Cytomegalovirus in deep pockets.
There are more viruses in deep periodontal pockets than bacteria!!!!
A pre-procedural rinse for 30-60 seconds with Chlorhexidine or Listerine is
recommended to help minimize the bacteria count in the patient’s mouth.
Prior to the 1980’s, we thought that the purpose of root planing was to remove
imbedded endotoxin. Now we know that real purpose of root planing is to
remove imbedded calculus that can be burnished and not detected with an
explorer. It can only be detected with a dental endoscope or by the observation
of bleeding on probing while re-evaluating or during maintenance appointment.
The burnished leftover calculus deposits can be left in the deepest part of the
pockets, in furcations, and between non-overlapping strokes while scaling.
The use of Chlorhexidine Gluconate .12% is found to be not effective when placed
under the gum line at .12%. A higher concentration can be more effective,
although can only be found from a compounding pharmacy.
Betadine 10% is for dental office use only. It can kill bacteria, viruses, and fungi
effectively. Patients with iodine allergies, thyroid disorders and who are pregnant
should not use the product.
Patients can use diluted Bleach for office or home use. It can kill bacteria, viruses,
and fungi only for short term. Can be used in a water pik for maintenance but
must be diluted.
When used as an adjunct to scaling and root planing, mechanical, chemical, or
laser curettage has little to no benefit beyond scaling and root planing alone.
There is very minimal evidence to support the use of a laser for the purpose of
deep scaling, when used with scaling and root planing. Current evidence shows
laser therapy to be unpredictable and inconsistent to reduce bacteria otherwise
when doing scaling and root planing alone.
Key Words:
Scaling & Root Planing, Bacteria, and Tarter