J Periodontal Implant Sci.  2016 Apr;46(2):107-115. 10.5051/jpis.2016.46.2.107.

Characteristics of the molar surface after removal of cervical enamel projections: comparison of three different rotating instruments

• Ko MJ
• Cho CM
• Jeong SN

• KMID: 2161987
• DOI: http://doi.org/10.5051/jpis.2016.46.2.107

Abstract

PURPOSE
The aim of this study was to evaluate and compare tooth surface characteristics in extracted human molars after cervical enamel projections (CEPs) were removed with the use of three rotating instruments.
METHODS
We classified 60 extracted molars due to periodontal lesion with CEPs into grade I, II, or III, according to the Masters and Hoskins' criteria. Each group contained 20 specimens. Three rotating instruments were used to remove the CEPs: a piezoelectric ultrasonic scaler, a periodontal bur, and a diamond bur. Tooth surface characteristics before and after removal of the projections were then evaluated with scanning electron microscopy (SEM). We analyzed the characteristics of the tooth surfaces with respect to roughness and whether the enamel projections had been completely removed.
RESULTS
In SEM images, surfaces treated with the diamond bur were smoothest, but this instrument caused considerable harm to tooth structures near the CEPs. The piezoelectric ultrasonic scaler group produced the roughest surface but caused less harm to the tooth structure near the furcation. In general, the surfaces treated with the periodontal bur were smoother than those treated with the ultrasonic scaler, and the periodontal bur did not invade adjacent tooth structures.
CONCLUSIONS
For removal of grade II CEPs, the most effective instrument was the diamond bur. However, in removing grade III projections, the diamond bur can destroy both adjacent tooth structures and the periodontal apparatus. In such cases, careful use of the periodontal bur may be an appropriate substitute.

Keyword

Dental enamel; Electron microscopic topography; Furcation defects; Root planing

MeSH Terms

Dental Enamel*
Dental Instruments
Furcation Defects
Humans
Microscopy, Electron, Scanning
Molar*
Root Planing
Tooth
Ultrasonics

Figure

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  Figure 1 Extracted molars embedded in a plaster model.

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  Figure 2 Rotary instruments used in this study: piezoelectric ultrasonic scaler tip (A), periodontal bur (B), and diamond bur (C).

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  Figure 3 Preparation of specimens 5×6×2 mm3 in size containing the cementoenamel junction.

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  Figure 4 Representative SEM photographs of tooth surface before (A) and after (B and C) removal of grade II cervical enamel projections with the use of an ultrasonic scaler (A, B: 20×, C: 200×).

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  Figure 6 Representative SEM photographs of tooth surface before (A) and after (B and C) removal of grade I cervical enamel projections with the use of a periodontal bur (A, B: 20×, C: 200×).

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  Figure 8 Representative SEM photographs of tooth surface before (A) and after (B and C) removal of grade II cervical enamel projections with the use of a diamond bur (A, B: 20×, C: 200×).

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  Figure 5 Representative SEM photographs of tooth surface before (A) and after (B and C) removal of grade III cervical enamel projections with the use of an ultrasonic scaler (A, B: 20×, C: 200×).

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  Figure 7 Representative SEM photographs of tooth surface before (A) and after (B and C) removal of grade III cervical enamel projections with the use of a periodontal bur (A, B: 20×, C: 200×).

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  Figure 9 Representative SEM photographs of tooth surface before (A) and after (B and C) removal of grade III cervical enamel projections with the use of a diamond bur (A, B: 20×, C: 200×).

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  Figure 10 Representative SEM photographs of dentinal tubules. (A) Ultrasonic scaler group (2,000×). (B) Periodontal bur group (2,000×). (C) Diamond bur group (2,000×). Each arrowhead indicates the occluded entrance of dentinal tubules.

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