SONIC AND ULTRASONIC INSTRUMENTATION -

1. SONIC AND ULTRASONIC
INSTRUMENTATION

2. Ultrasonic scaler is an instrument vibrating in
the ultrasonic range, which accompanied by the
stream of water, can be used to remove
adherent deposits from teeth.
Unit – electric generator, handpiece and
interchangeable tips.
Works by converting electrical current to
mechanical energy in the form of high
frequency vibrations of instrument tip.
Use water cooled instrument tip, vibrating at
20000 – 50000 cycles/sec

3. Magnetostrictive v/s Piezoelectric
Consists of nickel-iron or
ferrite insert fitted into a
handpiece.
Inside handpiece,
electromagnetic fields
are created leading to
expansion and
contraction of inserts.
Expansion and
contractions are carried
to scaler tip as
vibrations.
Consists of quartz
crystal in handpiece.
Alternating current is
passed through quartz
crystals.
Dimensions of crystal
changes because of
alternating current –
carried as vibrations to
scaler tip.

4. Frequency is 20,000 –
45,000 Hertz.
Amplitude is 13 – 72 um.
Motion is elliptical.
Hammering or scraping
action.
Power disperses on all
surface.
Frequency is 20,000-
45,000 Hz.
Amplitude is 72 um.
Motion is linear.
Tapping or scrapping
action.
Power disperses on
lateral surface.

5. Recommendations for ultrasonics
Use low power setting.
Use adequate supply of water.
Use quick, light, back and froth brush strokes.
Remove roughness on tips to prevent
scratching of tooth surface.
Wear protective glass and face mask.
Check tooth surfaces for remaining deposits.
Finish with hand instruments to obtain smooth
surface.
Do not apply pressure with tip, it will damage
tooth, root surfaces and restorations.

6. Do not use on patients with cardiac
pacemaker or any other electronic life
supportive devices.
Flush line of handpiece at beginning of
each day for 2 minutes to clear stagnant
water and reduce biofilms in the tubing.

7. Indications
Root planing
Supragingival and subgingival scaling
Orthodontic cement removal
To remove heavy tenacious calculus and stains
Overhanging margins of restorations

8. Contraindications
Porcelain inlays or crowns.
Composite resin restorations.
Patients with contagious diseases.
Patients with desaquamative gingivitis.
Patients with deep, pus producing pockets.
Patients with cardiac pacemakers.
In children, because it damages young
fibroblasts.

9. Advantages of ultrasonics
Design of tips – thin tips are easier to insert
and adapt to root surface concavities and
furcations.
Size and shape of tips are suitable for supra and
subgingival scaling and root planing.
Removes less cementum.
Water Lavage – Flushes calculus, debris and
plaque.
Periodontal pocket irrigation.
Remove blood and debris.
Antimicrobial effect and endotoxin removal

10. It is used with light touch.
Less fatigue to the clinician
Increased patient comfort and acceptance.
Requires less chair side time.
Less soft tissue trauma and post operative
discomfort.

11. Disadvantages
Less tactile sense to root surface.
Reduced visibilty due to water spray.
Requires high speed suction.
Produces contaminated aerosol.
Produces microscopic rippling of root surface.
Production of excessive heat can lead to pulp
damage and sensitivity.

12. Cavitation.
Vibratory motion of the instrument tip
-
Continous stream of water
-
Production of tremendous pressure
-
Collapse of water bubles
-
Release of shock waves
- CAVITATION

13. It is a combination of the vibrating tip against
the deposit, high frequency sound waves and
exploding bubbles that allow calculus removal.
Cavitation causes lysis of cell wall.

14. Ultrasonic v/s Hand instruments
Works based on
vibration, acoustic
streaming and cavitation.
Used on heavy
tenacious deposits and
stains.
Instrument tip is dull and
bulky.
Less tactile sensitivity.
Digital motion with light
pressure.
Inaccessible to some
areas – tip design.
Mechanical removal of
deposits.
Used on all amounts of
deposits.
Instrument tip is sharp
and thin.
Good tactile sensitivity.
Hard motion activation is
used with firm pressure.
Greater accessibility.

15. Less time required.
Less clinical fatigue.
Water spray cause
patient discomfort.
Possibility of damage to
tooth from heat build up.
Aerosol is produced.
Contraindicated in
patients with
pacemakers and
contagious disease.
More time required.
More clinical fatigue.
No water spray.
No heat build up.
No aerosol.
Not much
contraindication.

16. Smear Layer
Is defined as any debris, calcific in nature
produced by reduction or instrumentation of
enamel, dentin or cementum.
Is an amorphous microcrystalline layer of debris
on freshly cut dentinal tooth surface.
Composed of denatured collagen,
hydroxyapetite and other debris.
Agents to remove smear layer – citric acid,
EDTA and tannic acid.

17. Functions
Act as good protective layer and has weak
attachment to dentin.
Serves as bandage on freshly cut dentinal
surface and occludes dentinal tubules forming
smear plug, reduces sensitivity.
Removal is indicated in root biomodification as
it may interfere with formation of new
attachment.

18. Prophy Jet – air powder polishing
Combines water and baking soda ( Na
bicarbonate) to remove stains and debris from
teeth.
Sprays high-pressured water to blast away
soft deposits, baking soda acts as pumice to
scour off extrinsic tooth stains.
Indications:
- Remove stains, prior to bonding, before tooth
whitening, remove deposits from dentures,
appliances etc.

19. Contraindications:
- Hypersensitive patients, Pts with respiratory
infections, pts on medication affecting
electrolyte balance, high amount of aerosols.
Advantages:
Effective, well accepted by pts, can be used on
implants, polished tooth surfaces gives a “clean
slate” appearance.
Limitations:
Wont remove intrinsic stains, loss of cementum and
dentin by abarasive action, restorations may be
roughened, only soft deposits are removed

20. Dental Endoscope or perioscopy
system
Used subgingivally in diagnosis and treatment of
periodontal diseases.
0.99mm diameter reusable fiber optic endoscope
covered with a sterile sheath. It fits into
specially designed periodontal explorers with
24-46 power magnification and fiber optic
illumination.
Sheath delivers water for irrigation, that flushes
pocket and keeps field clear.
Attaches to CCD video camera, flat panel monitor
for viewing.

21. Uses
Allows clear visualization, subgingivally in deep
pockets and furcation.
Helps operator to detect and in removing sub
gingival calculus.
Possible to achieve levels of root debridement
and cleanliness

22. Schwartz Periotrievers
Set of two double ended, highly magnetized
instrument designed for retrieval of broken
instrument tips from pocket.
Long blade – for general use in pocket
Contraangled blade – for use in furcations