Using New Technology to Improve Periodontal Outcomes
Illumination essential to maximize proper periodontal inflammation treatment
Tim Donley, DDS
When to stop defines the endpoint of any periodontal debridement procedure. Creating a subgingival environment that is amenable to healing is key, and adequate interruption of the periodontal etiology is essential to achieve that goal. Most clinicians stop debriding when all of the calculus has been removed, but periodontitis begins with a microbial infection, which induces a host-mediated generation of inflammatory mediators that cause clinically significant connective tissue and bone destruction.1 Systemic inflammation plays a role in many chronic diseases.2 The evidence confirming the adverse relationship between oral inflammation and systemic disease3 suggests that consistently adequate debridement can pay dividends to oral and systemic health.
The bacteria that initiate periodontal disease are in the form of biofilm.4 The bacteria secrete extracellular polymeric substances, allowing them to develop complex, resilient communities attached to tooth surfaces. Interruption of the pathologic biofilm on tooth surfaces is essential to resolve inflammation, but removal of only visible plaque and calculus might not be enough, as biofilm is microscopic. Adequate illumination during ultrasonic debridement offers the greatest chance for achieving complete removal of etiology in all of its forms.
Ultrasonic instrumentation offers mechanical removal due to the vibratory movement of the insert tip, which can remove plaque and microscopic and macroscopic calculus, along with the production of concurrent cavitation that can interrupt microscopic biofilm.5 To get the full effect, intimate contact of the insert tip against the root surface is essential.
Subgingival root surface morphology can be tortuous. Illumination can show clinicians the presence of remaining detectable debris and help clinicians better define the subgingival topography and aid in proper insert positioning.
Parkell’s new TurboVue™ Illuminated Magnetostrictive Ultrasonic Scaler (Figure 1) makes it easy and predictable to maximize periodontal outcomes. When the innovative TurboVue is paired with the new Parkell light transmitting inserts, visibility dramatically improves (Figure 2). With the light source in the handpiece, the oral cavity is well lit even when conventional inserts are used. The light stays on for a short time after the foot pedal is released so that the operator can get vital feedback on root topography.
The LEDs can make the handpiece feel a bit warmer than a conventional magnetostrictive handpiece. This eliminates the need for any water-heater systems on the dental unit. Clinical protocol includes using more water flow than a conventional magnetostrictive unit. The cavitational effect of the water flow, along with improved comfort, make the procedure better for the dentist/hygienist and patient.
Inflammation is the root cause of many chronic diseases, and the mouth can be a significant contributor to systemic inflammation. To maximize the chance for resolution of periodontal inflammation, TurboVue can improve visibility and make periodontal outcomes more predictable, benefitting the doctor, practice, and patient.
1. Kornman KS, Page RC, Tonetti MS. The host response to the microbial challenge in periodontitis: Assembling the players. Periodontol 2000. 1997;14(14):33-53.
2. Prasad S, Sung B, Aggarwal BB. Age-associated chronic diseases require age-old medicine: role of chronic inflammation. Prev Med. 2012;54(suppl):S29-S37.
3. Linden GJ, Lyons A, Scannapieco FA. Periodontal systemic associations: review of the evidence. J Clin Periodontol. 2013;40(suppl 14):S8-S19.
4. Schaudinn C, Gorur A, Keller D, et al. Periodontitis: an archetypical biofilm disease. J Am Dent Assoc. 2009;140(8):978-986.
5. Geroge MD, Donley TG, Pershaw PM. Ultrasonic Periodontal Debridement: Theory and Technique. Oxford: Wiley-Blackwell. 2014.
About the Author
Tim Donley, DDS, is in private practice in Bowling Green, Kentucky. He is a leading expert in the treatment of gum disease and dental implants. Dr. Donley is an international speaker. He co-authored the first textbook on modern ultrasonic treatment for gum disease. He graduated from the University of Notre Dame, Georgetown University School of Dentistry, and did his specialty residency at Indiana Medical Center in Indianapolis. Numerous other offices interested in providing the highest level of care to their patients have adopted his diagnostic and treatment protocols.
Reasons to Buy TurboVue Illuminated Magnetostrictive Ultrasonic Scaler
30K light-transmitting inserts emit light from the handpiece; internal light in the handpiece illuminates even when used with traditional inserts
Built for Comfort
Water connection with quick disconnect, foot pedal, and dramatically expanded low-power range improves comfort
Control Amount of Power
Turn on power-boosting Turbo feature when more power is needed
Doesn’t take up valuable counter space