title: Atomic force microscopy and scanning electron microscopy evaluation of efficacy of scaling and root planing using magnification: A randomized controlled clinical study.
abstract: OBJECTIVE
  A randomized controlled clinical study was undertaken to evaluate the effectiveness of scaling and root planing (SRP) by using Magnifying Loupes (ML) and dental operating microscope (DOM).
  
  
  METHODS
  A total of 90 human teeth scheduled for extraction from 18 patients aged between 25 and 65 years suffering from generalized chronic severe periodontitis were randomly assigned to three treatment groups. Group 1 consisted SRP performed without using magnification (unaided), Group 2-SRP with ML and Group 3-SRP with DOM. Following extractions, samples were prepared for (i) evaluation of surface topography by atomic force microscopy, (ii) presence of smear layer, debris by scanning electron microscopy (iii) elemental analysis by energy dispersive X-ray analysis. Data was subjected to statistical analysis using analysis of variance, post-hoc (Tukey-HSD) and Chi-square test.
  
  
  RESULTS
  Statistically significant (P < 0.001) difference was found among the different treatment groups. Group 3 was the best while Group 1 was the least effective technique for SRP. Order of efficacy in terms of the surface was found to be - Palatal < Lingual < Distal ≃ Mesial < Buccal. Efficiency in mandibular to maxillary teeth was found to be significant (P < 0.05), also anterior to posterior teeth (P < 0.05).
  
  
  CONCLUSIONS
  Magnification tools significantly enhance the efficacy of supragingival and subgingival SRP.
authors.affiliation: Department of Periodontics, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, India.
authors.forename: Ranjana
authors.initials: R
authors.lastname: Mohan
authors.forename: Sudhanshu
authors.initials: S
authors.lastname: Agrawal
authors.forename: Mohan
authors.initials: M
authors.lastname: Gundappa
keywords: Atomic force microscopy; dental operating microscope; energy dispersive X-ray spectroscopy; magnification; scaling and root planing; scanning electron microscopy