Evaluation of Alterations That May Occur on Root Surfaces after Root Planing Procedures with a Scanning Electron Microscope

Abstract

Background: The aim of root debridement procedures in non-surgical periodontal treatment is the elimination of etiologic factors that cause periodontal disease, as well as the removal of cement affected by the disease. However, root debridement procedures for the treatment of periodontal diseases produce root surface irregularities that can adversely affect the healing of periodontal tissues. The objective of the present study is to evaluate the surface texture of a root after instrumentation, including an ultrasonic instrument, a Gracey curette, or a double Gracey curette. Methods: A total of 26 single-rooted teeth were used in this study; two specimens were used as controls, and the remaining 24 specimens were equally divided into three groups. Specimens from each group were then subjected to root planing using one of the following instruments: (1) an ultrasonic instrument; (2) a Gracey curette; or (3) a double Gracey curette. The control group was treated with no instrumentation. The extracted teeth were analyzed under a scanning electron microscope and graded in terms of the “roughness and loss of tooth substance index” and the “exposed dentin tubule index.” The SPSS (Statistical Package for Social Sciences) V.21 program was used to conduct a statistical analysis of the data obtained in this study. While evaluating the data, in addition to descriptive statistical methods (mean and standard deviation), a one-way analysis of variance (one-way ANOVA) was carried out to compare the quantitative data and evaluate normally distributed parameters between groups, while a post hoc multiple comparison test was carried out for subgroup comparisons. Results: There was no statistically significant difference between the roughness and material loss on the root surfaces in the samples treated with the ultrasonic instrument or the Gracey curette, and no exposed dentine tubules were observed. Meanwhile, it was observed that the double Gracey curette caused more roughness and material loss on the root surface, and exposed dentine tubules were observed in some samples. The time required for treatment using a double Gracey curette was significantly shorter than that required with the Gracey curette and ultrasonic instruments. Conclusions: The double Gracey curettes produced a relatively rougher root surface than the Gracey curettes or the ultrasonic instrument.