Ultrasonic/Sonic Scalers Flashcards
Ultrasonic/Sonic Scalers: SOnic
o Air driven (attach to unit handpiece hose)
o Produce less heat
o 2,000-6,000 Hz (slowest of the three)
● Ultrasonic
o Piezoelectric
▪ Electrical current applied to reactive crystal to produce vibration
▪ Produces less heat
● Water just used for flushing
▪ 30,000-45,000 Hz (fastest of the three)
▪ Linear motion—back and forth
● As you turn the power up high, that motion is a wider motion, which can make the patient sensitive
o Magnetostrictive
▪ What we’ll use in clinic
▪ Transfer electrical energy to metal stacks to produce vibrations
▪ 20,000-25,000 Hz (oscillations per second)
▪ Water spray necessary because there’s a lot of heat generated
● Also use water to flushing
▪ Elliptical motion
▪ Do not use on patient with a pacemaker (shielded nowadays so probably okay, but still don’t)
● If patient can’t use a microwave oven, then they can’t use this
● Power Settings
o High: removal of heavy, tenacious deposits
o Medium: general debridement
o Low: de-plaquing and removal of endotoxin
o Power determines amplitude = length/size of your stroke
▪ If you’re using an ultrasonic on a patient and they’re having sensitivity, try turning your power down
o Frequency is determined by the unit: amount of times it moves back and forth per second
▪ A 25k unit will always be a 25K unit
● Contraindications
o Pacemaker—magnetorestrictive
o Communicable diseases
▪ If you’re treating your patients with standard precautions it shouldn’t be necessary, but if your patient has a known communicable disease, might choose not to use a cavitron
▪ Aerosol might be hard for patients with respiratory diseases to handle
o Titanium implants
o Porcelain or bonded restorations—tendency to scratch
● Technique
o Don’t use the tip! Use the side!
▪ Exception = beaver tail
o Keep tip moving
o Move from coronal to apical
o Light grasp and light pressure
▪ Heavy lateral pressure will decrease effectiveness and cause more root damage
o Strokes should overlap and be multidirectional
o Tip must contact all aspects of root surface to thoroughly remove plaque and toxins
● Power Driven Scalers vs. Manual Scalers
o Similar reductions in probing depths and BOP
o Similar decrease in sub gingival micro flora
o Similarly effective in removing endotoxin from root surface
o Furcas
▪ Class I: similar
▪ Class II and III: ultrasonics superior
o Access to base of the pocket
▪ Neither instrument reaches the base of moderate to deep pockets, but ultrasonics fared better than manual scalers
o Root surface alterations—results of studies are inconclusive
▪ Current evidence suggests ultrasonics on medium setting may cause less damage to root than hand or sonic scalers
● Increasing setting from medium to high also increases root alterations
▪ Contact time, pressure, and tip to tooth angle influence root surface damage
o Sonic/ultrasonic scaling should always be followed by hand scaling
▪ The best results are achieved with a combination of manual and sonic/ultrasonic scaling
