It should be taken into account that it is different to work over a thick layer of supragingival calculus than over a thin subgingival layer, which is more adhered. This is the reason why large tips are used for superficial calculus, small tips for subgingival calculus, curette-like for scaling and thin and long for narrow and deep pockets Figure Hole in cementum due to a wrong ultrasonic instrumentation. Original magnification x Insert application and displacement for calculus removal.
Supra left and thin subgingival right ultrasonic tips should always work with abundant irrigation. When US are used with complementary water tank and an antiseptic liquid, it is convenient to wash the whole circuit with demineralized water after its use, so the obstruction of tubes with the substances used is avoided. In case of using only water, it is recommended to fill in the deposit with low mineralized water, in order to facilitate the cleaning and prevent obstructions in tubes and inserts.
Due to their lineal oscillation over the dental surface, the actual rounded-tip piezoelectric US, reduce abrasion and obtain a uniform and smooth surface.
With Vector decomposition of ultrasonic oscillation. Some of these US may incorporate two bottles, one for the bactericidal agent and the other for water for clearing or cleaning. They are also equipped with perio and endodontic tips. Ultrasounds present few contraindications. They are not recommended in children except in very concrete cases. They should be avoided in the proximity of composite resins, as they could produce roughness or even detachment of the filling.
They should not be used directly over ceramic partial fixed prosthesis or veneers, as ceramic could detach or break. In patients with certain types of pacemakers, interferences could be produced with inhibition and increase of the stimulation frequency. It is recommended the intermittent use of ultrasounds, avoiding the support of instruments over the generator as well as deprogramming the frequency modulation during the sessions. With a magnet, the pacemaker, which usually works at demand mode, converts into fixed-rate, not being sensitive to electromagnetic fields.
In case of non sensible to electromagnetic interferences pacemakers, US could be used in the same way as in patients without pacemakers. Sonicator and varied tips. These instruments present certain advantages and disadvantages in relation to ultrasounds. Their oscillation frequency is much lower, of 2, Hz, because the oscillation is produced by the air that arrives directly from the equipment and generates an orbital oscillation in the application tip.
Their efficacy is similar to that of ultrasounds, but they can only use water instead of antiseptic liquids and the set of tips is much more reduced than the ultrasounds. Ultrasounds are used as preventive and complementary to surgery treatment in implants. Fox et al. Something similar occurs when using Piezoelectric Ultrasonic Scalers with carbon, plastic and metallic tips on titanium implants. Remaining plaque and calculus index seemed to be similar with the three treatments.
When using a laser profilometer and a laser scanning electron microscope to evaluate the treated abutment surface characteristics, implants treated with carbon and plastic tips presented smoother surfaces than those treated with metallic tips, which were more damaged [ 19 ].
US were incorporated into this field in when Richman used them for root canal cleaning and instrumentation [ 20 ].
In , Martin improved endodontic treatment adding simultaneous irrigation, but its commercialization and use only were extended from by Martin et al. There are sonic apparatus in which special files are used, and several ultrasonic devices which work with standard files, with the usual colours and diameters Figure EMS ultrasonic handle and several endodontic K-files. Diagrammatic representation of the current observed in ultrasonic A and sonic B activated files [ 24 ].
As for ultrasonic instrumentation UI, it is discussed if the root canals thus instrumented are significantly cleaner than those prepared with files in the usual way. Some authors support UI cleaning is better [ 25 - 29 ], while other studies affirm the cleaning is similar [ 30 - 36 ]. For Ruddle, these differences could be due to the limited space available in the root canal to let the ultrasonic vibration [ 37 ].
Also the lack of space could be responsible of the lesions produced during ultrasonic instrumentation, such as perforations and deficient root canal preparations [ 38 ]. This is the reason why this technique is only recommended after the complete root canal preparation [ 39 ], by what is known as PUI. Passive ultrasonic irrigation was described by Weller [ 40 ] as a technique in which the effect of the ultrasonic tip reduces the risk of contact with the root canal surface, thus reducing the risk of perforation, while the cavitation and cleaning effects are preserved.
As the root canal has already been prepared, the file moves freely and the irrigant penetrates easily in the apical area of the root canal system [ 41 ]. In this technique two ways of irrigation may be used: continuous or discontinuous, in which irrigation works intermittently after each ultrasonic cycle. Both of them allow control of irrigation, so they seem to be equally efficient [ 42 ]. Sonic instruments may also be used for root canal therapy with similar results.
Jensen et al. Results are analysed with photomicrographs with a grid in order to quantify the debris and evaluate the root canal cleaning level in the three groups. Sonic and ultrasonic treated molars after manual instrumentation seemed to be cleaner than those only manually treated, while the level of cleaning among sonic and ultrasonically treated molars was similar [ 43 ]. Another recent in vitro study compares the ability of different ultrasound irrigation procedures to eliminate debris and to open the dentine tubules.
Previously instrumented with mechanical rotatory technique single-rooted extracted teeth are treated with US. The amount of debris and the number of open dentinal tubules were established by SEM. In the apical third, ultrasonic activation of the irrigation with Irrisafe tips seemed to be the most effective method to eliminate debris and open dentinal tubules [ 44 ].
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Advertisement Advertisement. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. These cookies track visitors across websites and collect information to provide customized ads. Others Others. Date of Patent: June 9, Inventors: Philip T. Dempster, John Y. Ultrasonic apparatus for manufacturing brassiere tapes. Abstract: Brassiere tapes having a body portion and a pair of overlapping tabs extending outwardly therefrom are manufactured by providing a continuous strip of material for the tapes having fastener elements spaced along the strip and layers in the body portion and in each of the tabs weldable with ultrasonic vibratory energy.
The tabs are separated physically from each other such that the individual layers in the strip may be simultaneously severed and welded across the body portion and the tabs when interposed between ultrasonically vibrating horn and anvil devices, except that the tabs which are physically separated from each other are not welded to each other. Compliant means for mounting of the anvil is provided so that the cutting edge for severing the tapes from the strip which is associated with the anvil is not readily dulled by the repetitive contacting engagement of the horn and anvil surfaces in the operative position.
Filed: January 5, Date of Patent: March 17, Inventors: Robert A. Clarke, Peter J. Kuhl, Richard H. Ultrasonic aspirator. Abstract: Apparatus for the surgical removal of tissue is disclosed comprising a handpiece having a resonant vibrator with a magnetostrictive stack and connecting body encompassing a hollow elongated tool which is ultrasonically vibrated at its tip longitudinally to a peak to peak stroke of at least 0.
A generator powers the vibrator and is automatically controlled at the frequency to maintain the resonant vibration. Aspiration is provided by suction through the hollow tool at its tip, and a manifold enclosing the tool end of the handpiece provides irrigation. Filed: December 19, Date of Patent: September 23, Inventors: David G. Wuchinich, Alan Broadwin, Robert P. Aerosol interface. Abstract: An aerosol interface comprises a housing defining a fluid receiving chamber in open communication with the atmosphere, with inlet means operatively associated with the housing for permitting continuous delivery to the chamber of a flow of an aerosol fluid so as to obtain an accumulation of the aerosol fluid therein for inhalation by a patient using the aerosol interface.
Breath transmission means, operatively associated with the housing, has a passageway therethrough defined by an inner end and an outer end, the outer end being adapted for communication with the breath of a patient using the aerosol interface for the inhalation through the passageway of the aerosol fluid in the chamber and the exhalation of expired fluid by the patient into the passageway.
Filed: March 25, Date of Patent: November 13, Inventor: Henry L. Abstract: A system and method analyzes tonosignals and other electrical signals representative of force-displacement information from applanating probes such as those initially to determine the presence of an acceptable waveform or tonosignal.
Filed: October 5, Date of Patent: August 21, Ultrasonic method for manufacturing brassiere tapes. Abstract: Brassiere tapes having a body portion and a pair of overlapping tabs extending outwardly therefrom are manufactured by providing a continuous strip of the tape material having elements spaced there along and layers at least in the body portion-forming part thereof. The material is weldable with ultrasonic vibratory energy, and the tabs are separated physically from each other while simultaneously maintained in acoustical energy coupling relation to each other, such that the individual layers of material in the strip are welded together across the body portion of a tape defined thereby and the tabs are individually welded along an edge but not welded together when interposed between an ultrasonically vibrating horn and an anvil.
The strip is advanced on an intermittent basis between the horn and the anvil by the elements for continuously producing tapes having a desired number of elements thereon. Filed: June 14, Date of Patent: July 17, When using magnetostrictive technology, it is important to understand all sides of the tip are active.
The lateral sides are most commonly used, but the face and back are also active. To compare, only the lateral sides of piezoelectric technology are active. When using both technologies, it is very technique sensitive, and understanding which sides to use is a biggie! There can also be a learning curve when using one technology and then switching to the other.
Rule of thumb, the direct tip should never be applied to the tooth as this can damage the tooth. The tip can be used on large pieces of calculus using a tapping method. But remember, it should not be placed directly on the tooth surface!
The goal of ultrasonic scaling is to effectively remove subgingival and supragingival calculus, reach deeper into periodontal pockets, and access furcation areas. In addition, ultrasonic devices act as irrigation and can flush the pockets of toxins. There is a big question regarding solely using ultrasonic technology rather than following up with hand-activated instruments.
It also shows results are achieved in a faster time frame. When it comes to ergonomics, pressure is not needed during power-drive instrumentation, so we are helping our bodies when using ultrasonic technology as well.
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