Original Research Article http://doi.org/10.18231/j.ijohd.2019.023 International Journal of Oral Health Dentistry, April-June, 2019;5(2):104-112 104 Scanning electron microscopic evaluation of root surface morphology after root planing with curettes and ultrasonic perio mini-tip: An in vitro study Abhishek Sinha 1 , Sandeep Kaur 2* , Kirandeep Kour 3 1 Assistant Professor, 2 Lecturer, 3 Senior Lecturer, 1 Dept. of Orthodontics, 2 Dept of Oral Medicine & Radiology, 3 Dept. of Periodontology, 1 Patna Medical College, Patna Bihar, 2 Indira Gandhi Government Dental College & Hospital, Jammu, Jammu & Kashmir, 3 Institute of Dental Sciences, Jammu, Jammu & Kashmir, India *Corresponding Author: Sandeep Kaur Email: dr.sandeepkour@gmail.com Abstract Mechanical removal of plaque and calculus along with bacterial toxins from the root surface by root planing is an effective means of altering the etiology of inflammatory periodontal disease which can be achieved by manual instruments (curettes) as well as ultrasonics. Curettes routinely leave a smear layer, remove more amount of root substance and take a longer time to achieve the desired root surface smoothness. On the other hand, ultrasonic instruments are easy to use, cause less operator fatigue and provide simultaneous flushing by the coolant spray. However, their only drawbacks include bulky working tips, risk of gouging the root surface if not used properly and poor tactile sensation. But the problem of bulky working tips have been overcome to a great extent by the introduction of micro-ultrasonic tips and slimline inserts, specially designed for root debridement purposes. Through this study, an attempt has been made to compare and evaluate the micro-topography of the root surface under scanning electron microscope, following instrumentation with curettes as well as ultrasonic perio mini-tip. Keywords: Root planing, Curettes, Ultrasonic perio mini-tip, Scanning electron microscope. Introduction The role of microbial plaque in the aetiology of periodontal disease has been well established. Therefore, a major objective in the treatment of periodontal disease is to remove both supragingival as well as subgingival plaque and calculus and also to prevent recolonisation of periodontal pockets by pathogenic bacteria, thereby aiming at halting the disease progression as well as restoring the biological compatibility of the diseased cemental surface. 2,11 Scaling and root planing procedures are concomitantly aimed at removal of bacterial toxins embedded within the cementum and to achieve a smooth, hard, clean and biologically acceptable root surface which is conducive to new cementum formation and biologically compatible for new collagen fibre insertion. 6,7,14 Mechanical therapy in routine clinical practice can be accomplished with both hand instruments and ultrasonics, used alone or in combination. Manual instruments like curettes routinely leave a smear layer, remove more amount of root substance and take a longer time to achieve the desired surface smoothness. 9 On the other hand, ultrasonic instruments are easy to use, cause less operator fatigue and provide simultaneous flushing by the coolant spray. 5 However, their only drawbacks include bulky working tips, risk of undue damage to the root surface if not used properly, poor tactile sensation and aerosol contamination. 12 But the problem of bulky working tips have been overcome to a great extent by the introduction of ultra-fine micro-ultrasonic tips and slimline inserts, specially designed for root debridement purposes. 16 With these tips, gaining access to the most difficult-to-reach areas of mouth like distal surfaces of second and third molars, furcation areas of multirooted teeth, pocket depths exceeding 5mm and areas having complex root anatomy has become much more easier. 15,16 Aims and Objectives 1. To compare and evaluate the root surface morphology in-vitro, after instrumentation of cemental surface with hand instruments like Gracey curettes and with specialized ultrasonic piezoelectric root-planing tip, like the perio mini-tip. 2. To determine the optimum level of cemental surface instrumentation both with curettes and ultrasonic perio mini-tip towards obtaining a clean, hard, smooth and biologically acceptable root surface. 3. To determine the comparative efficacy of curettes and ultrasonic perio mini-tip towards obtaining a smooth, hard and clean cemental surface. Materials and Methods The present study was carried out on 120 selected numbers of periodontally involved, caries-free extracted human teeth. These teeth were extracted from 84 patients suffering from severely advanced periodontitis, attending the Out Patient Department (OPD). The study population consisted of both males and females in the age group of 28 to 70 years with a mean age of 45 years. All the teeth for experimental purpose were extracted randomly from the region of incisors, canines, premolars and molars the region of incisors, canines, premolars and molars of both the maxillary as well as mandibular arches. The cause behind the extraction for all the teeth was mobility (Miller’s Grade III) with a clinical attachment loss of 6mm or more. Hence, these teeth were rendered hopeless for any type of conservative dental therapy. With the help of a William’s periodontal probe, the amount of clinical attachment loss (CAL) was measured for all the teeth. Thereafter, each and every selected tooth was extracted with proper care so that the expected area of study which extends 5mm apically from the cemento-enamel