Application of ultrasound in periodontics: Part II

Abstract

Ultrasound offers great potential in development of a noninvasive periodontal assessment tool that would offer great yield real time information, regarding clinical features such as pocket depth, attachment level, tissue thickness, histological change, calculus, bone morphology, as well as evaluation of tooth structure for fracture cracks. In therapeutics, ultrasonic instrumentation is proven effective and efficient in treating periodontal disease. When used properly, ultrasound-based instrument is kind to the soft tissues, require less healing time, and are less tiring for the operator. Microultrasonic instruments have been developed with the aim of improving root-surface debridement. The dye/paper method of mapping ultrasound fields demonstrated cavitational activity in an ultrasonic cleaning bath. Piezosurgery resulted in more favorable osseous repair and remodeling in comparison with carbide and diamond burs. The effect of ultrasound is not limited to fracture healing, but that bone healing after osteotomy or osteodistraction could be stimulated as well.

Keywords: LIPUS; microstreaming; microultrasonics; piezosurgery; ultrasonic cleaner; ultrasound probe.

Figure 1

Ultrasonic periodontal probe with probe tip at the gingival margin and ultrasound projected into the periodontal pocket. The echoes returning from the crest of the periodontal ligament are shown (Hinders M And Companion J; www.acoustics.org)

Figure 2

The hand piece contains a probe tip, which is small enough to permit scanning of the area between teeth. The ultrasonic transducer is mounted in a probe tip shell (a fluid-filled dual taper delay line), which has a throat diameter small enough to project the ultrasonic beam into the narrow space between the tooth and bone (Hinders M And Companion J; www.acoustics.org)

Figure 3

Ultrasonographic periodontal probe in use; (as.wm.edu/Faculty/Hinders/NDE-Projects.html)

Figure 4

Ultrasonic device (B) measuring gingival thickness at a grafted recession site. (Muller H P, Stahl M, Eger T; 1999)

Figure 5

Camera and micro ultrasonics for endoscopic instrumentation; (Kwan J Y; 2005)

Figure 6

Scaler, probe and microultrasonic insert. (Kwan J Y; 2005)

Figure 7

Angled insert, modified curved/ angled insert, and furcation probe. (Kwan J Y; 2005)