Advances in power driven pocket/root instrumentation.
OBJECTIVE
The primary aim was: "Does power-driven pocket/root instrumentation offer a clinical advantage over hand instrumentation"? Secondary aim was to update knowledge base of power-driven instrumentation post Tunkel et al. (2002).


METHODS
A literature search of power-driven instruments (in vitro, in vivo and controlled clinical trials) was performed from April 2001 using similar criteria to Tunkel et al. (2002). Primary outcome was whether power-driven instruments offered an advantage over hand instrumentation; secondary outcomes were effect on root surface, effectiveness of new instrument designs, and role of biophysical effects such as cavitation.


RESULTS
From a total of 41 studies, 14 studies involved comparison of power-driven devices with hand instrumentation for non-surgical therapy. These were subdivided into new designs of power instrumentation, full-mouth debridement and irrigation and patient acceptance. Use of power-driven instrumentation provides similar clinical outcomes compared with hand instrumentation. Difficulty of pooling studies continues to hinder the drawing of definitive conclusions.


CONCLUSIONS
Newer designs of powered instruments have not shown any benefit when compared with other ultrasonic devices in non-surgical periodontal therapy. New in vitro research shows there is variation in the performance of different tip designs and generators, but its clinical relevance remains unknown.
Walmsley
A Damien
AD
School of Dentistry, The University of Birmingham, St. Chad's Queensway, Birmingham, UK. a.d.walmsley@bham.ac.uk
Lea
Simon C
SC
Landini
Gabriel
G
Moses
Anthony J
AJ
D012534:Dental Scaling / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D010517:Periodontics / Q000295:instrumentation*; D016745:Root Planing / Q000295:instrumentation*; D014464:Ultrasonic Therapy / Q000295:instrumentation