During my senior year in the Dental Hygiene program at Carrington College I ran across the article listed above in a Dimensions of
Dental Hygiene magazine. The author explains how important the use of an ultrasonic insert or tip (UIT) is in conjunction with
hand instrumentation. There are a wide variety of inserts available and should be used to the clinician's advantage whether
instrumenting the whole mouth with prophylaxis or scaling and root planning a single quadrant (Hodges, 2013). Selection of UIT is
also important for the effectiveness of instrumentation in a variety of environments (i.e. anatomy, restorations, location of calculus,
etc.).
The article is rightfully titled the Power of Selection. As clinicians we have the option to choose from the variety of UITs like the
beavertail, triple bend, universal, diamond tip, ultra-thin, just to name a few (Hodges, 2013). There are also curved tips for complex
posteriors with furcation involvement. The selection is also dependent on the deposit type, probing depths, contours of the gingiva,
access, and possible mobility. Hodges then begins to address the concern that thin inserts can actually create more immediate
attachment loss initially, but long-term healing is similar to standard UITs (Hodges, 2013). The author also discusses the need for
awareness of dental implants because the UITs made of conventional metal can alter the surface of titanium implants. She also
discussed that the use of a diamond tip must be used with caution because the tip can inadvertently remove root structure. This type
of damage can be avoided if used with care and caution. Damage can also occur due to the convex working tip, but that can easily be
avoided as well (Petersilka & Flemmig, 2004).
Hodges states that the active part of a UIT is the last 2mm-4mm of the tip and that this may vary with manufacturers. She describes
that angulation to the tooth should be between 0 degrees to 15 degrees to the root. The use is very similar to a probe except that it is
used in a crosshatch oblique, vertical, and horizontal pattern (Hodges, 2013). The adaptation of the UIT can sound straight forward,
but the chances for burnishing are still likely. Along with adaptation and clinical skill comes the power of the device. If the power
setting is incorrect for the tip, burnishing can occur. The author states that the insert must be able to reach the deposit and must
have at least moderate to high power.
In conclusion, UITs are at an advantage because they do not need sharpening, but they still need to be monitored for wear. Since
only 2mm-4mm of the tip is being used; UITs do need to be replaced over time. It is important to follow the manufacturer's
guidelines per insert. Also clinicians should check for the manufacturer's recommendations for design, purpose, angulation and
power settings to enhance the effectiveness and prevent unwanted damage (Hodges, 2013).
I feel this article while short, it was very educational in my time of dental hygiene education. It can be very beneficial for me while
in clinic here at Carrington College because it will help aid in awareness of my assessment and indications for use on the different
types of patients we see here. I feel this article is also helpful for clinicians who are out in private practice because the author does
mention that although there are universal UITs, they cannot always be used universally. I will definitely keep this magazine handy as
article and several others are very educational for me.
References:
Hodges, K. O. (2013). The Power of Selection. Dimensions of Dental Hygiene, January, 42-46.
Petersilka, G. J. & Flemmig, T. F. (2004). Periodontal Debridement with Sonic and Ultrasonic Scalers. Perio, vol. 1, Issue 4, 353-362.
Additional Information:
http://www.rdhmag.com/articles/print/volume-31/issue-5/features/ultrasonic-techniques.html
http://www.rdhmag.com/articles/print/volume-26/issue-6/columns/comfort-zone/the-power-of-ultrasonic-inserts.html
http://www.youtube.com/watch?v=7UQoDDRUP1o
Dental Hygiene magazine. The author explains how important the use of an ultrasonic insert or tip (UIT) is in conjunction with
hand instrumentation. There are a wide variety of inserts available and should be used to the clinician's advantage whether
instrumenting the whole mouth with prophylaxis or scaling and root planning a single quadrant (Hodges, 2013). Selection of UIT is
also important for the effectiveness of instrumentation in a variety of environments (i.e. anatomy, restorations, location of calculus,
etc.).
The article is rightfully titled the Power of Selection. As clinicians we have the option to choose from the variety of UITs like the
beavertail, triple bend, universal, diamond tip, ultra-thin, just to name a few (Hodges, 2013). There are also curved tips for complex
posteriors with furcation involvement. The selection is also dependent on the deposit type, probing depths, contours of the gingiva,
access, and possible mobility. Hodges then begins to address the concern that thin inserts can actually create more immediate
attachment loss initially, but long-term healing is similar to standard UITs (Hodges, 2013). The author also discusses the need for
awareness of dental implants because the UITs made of conventional metal can alter the surface of titanium implants. She also
discussed that the use of a diamond tip must be used with caution because the tip can inadvertently remove root structure. This type
of damage can be avoided if used with care and caution. Damage can also occur due to the convex working tip, but that can easily be
avoided as well (Petersilka & Flemmig, 2004).
Hodges states that the active part of a UIT is the last 2mm-4mm of the tip and that this may vary with manufacturers. She describes
that angulation to the tooth should be between 0 degrees to 15 degrees to the root. The use is very similar to a probe except that it is
used in a crosshatch oblique, vertical, and horizontal pattern (Hodges, 2013). The adaptation of the UIT can sound straight forward,
but the chances for burnishing are still likely. Along with adaptation and clinical skill comes the power of the device. If the power
setting is incorrect for the tip, burnishing can occur. The author states that the insert must be able to reach the deposit and must
have at least moderate to high power.
In conclusion, UITs are at an advantage because they do not need sharpening, but they still need to be monitored for wear. Since
only 2mm-4mm of the tip is being used; UITs do need to be replaced over time. It is important to follow the manufacturer's
guidelines per insert. Also clinicians should check for the manufacturer's recommendations for design, purpose, angulation and
power settings to enhance the effectiveness and prevent unwanted damage (Hodges, 2013).
I feel this article while short, it was very educational in my time of dental hygiene education. It can be very beneficial for me while
in clinic here at Carrington College because it will help aid in awareness of my assessment and indications for use on the different
types of patients we see here. I feel this article is also helpful for clinicians who are out in private practice because the author does
mention that although there are universal UITs, they cannot always be used universally. I will definitely keep this magazine handy as
article and several others are very educational for me.
References:
Hodges, K. O. (2013). The Power of Selection. Dimensions of Dental Hygiene, January, 42-46.
Petersilka, G. J. & Flemmig, T. F. (2004). Periodontal Debridement with Sonic and Ultrasonic Scalers. Perio, vol. 1, Issue 4, 353-362.
Additional Information:
http://www.rdhmag.com/articles/print/volume-31/issue-5/features/ultrasonic-techniques.html
http://www.rdhmag.com/articles/print/volume-26/issue-6/columns/comfort-zone/the-power-of-ultrasonic-inserts.html
http://www.youtube.com/watch?v=7UQoDDRUP1o