title: Preservation of root cementum: a comparative evaluation of power-driven versus hand instruments.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effects of three distinct periodontal treatment methods in comparison with hand instrumentation on residual cementum of periodontal diseased teeth. Cementum can influence the activities of periodontal cells and may play an important regulatory role in periodontal treatment. The ideal method for periodontal therapy involves removal of biofilm, calculus and endotoxin while preserving root cementum.
  
  
  METHODS
  Forty-eight caries free, single-rooted teeth in patients diagnosed with severe chronic periodontitis were treated using four different methods prior to extraction. The teeth were instrumented subgingivally at one approximal site either by hand curettes (HC), piezoelectric ultrasonic scalers (U), piezoelectric ultrasonic scalers following air polishing (U + AP) or air polishing (AP) alone. Following extraction of teeth, instrumented and non-instrumented sites were analysed with a dissecting microscope and SEM for measurement of the amount of and surface characteristics of residual cementum.
  
  
  RESULTS
  The percentage of coronal cementum remaining following subgingival instrumentation was 84% for U, 80% for U + AP, 94% for AP and 65% for HC. Although subgingival instrumentation of apical portions of the cementum demonstrated 6% less retained cementum in comparison with coronal portions, the amount of retained cementum with AP was still significantly greater than with HC. SEM results found the smoothest root surfaces were produced by the HC followed by the AP, while root surfaces instrumented by U or U + AP presented grooves and scratches.
  
  
  CONCLUSIONS
  This study demonstrated that AP was superior to U devices in preserving cementum, whereas HC were the most effective instruments in removing cementum.
authors.affiliation: Section of Periodontics, Department of Dentistry and Maxillofacial Surgery, School of Dentistry, Sapienza University of Rome, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bozbay
authors.affiliation: Section of Periodontics, Department of Dentistry and Maxillofacial Surgery, School of Dentistry, Sapienza University of Rome, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Dominici
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
authors.forename: A Y
authors.initials: AY
authors.lastname: Gokbuget
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Cintan
authors.affiliation: Department of Odontostomatological, Orthodontic and Surgical Disciplines, Second University of Naples, Naples, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Guida
authors.affiliation: Department of Histology and Embryology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: M S
authors.initials: MS
authors.lastname: Aydin
authors.affiliation: Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA.
authors.forename: A
authors.initials: A
authors.lastname: Mariotti
authors.affiliation: Section of Periodontics, Department of Dentistry and Maxillofacial Surgery, School of Dentistry, Sapienza University of Rome, Rome, Italy.|Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA.
authors.forename: A
authors.initials: A
authors.lastname: Pilloni
mesh_terms: D000328:Adult; D055113:Chronic Periodontitis / Q000628:therapy*; D003646:Debridement / Q000295:instrumentation; D003739:Dental Cementum / Q000601:surgery* / Q000648:ultrastructure*; D003762:Dental Instruments; D003775:Dental Polishing / Q000295:instrumentation; D012534:Dental Scaling / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D059745:Piezosurgery / Q000295:instrumentation; D016745:Root Planing / Q000295:instrumentation*; D013499:Surface Properties; D014081:Tooth Extraction; D014092:Tooth Root / Q000601:surgery* / Q000648:ultrastructure*; D014464:Ultrasonic Therapy / Q000295:instrumentation
keywords: air polishing with glycine; cementum removal; hand instrumentation; residual cementum; root surface instrumentation; ultrasonic scaling