Efficacy of ultrasonic, electric and manual toothbrushes in patients with fixed orthodontic appliances

Objective: This crossover study compared the efficacy of an ultrasonic toothbrush for the reduction of plaque, gingival inflammation, and levels of Streptococcus mutans, in relation to an electric and a manual toothbrush. Materials and Methods: Twenty-one patients with orthodontic appliances were divided into three groups. All patients were evaluated by a periodontist and samples of saliva were collected for quantification of S mutans. The patients received their first brushes with appropriate instructions. For each crossover leg, patients used each toothbrush for a period of 30 days. At the end of each washout period, participants received a periodontal evaluation and new samples of saliva were collected. After 15 days of using their own toothbrushes, patients received the next toothbrushes in the experimental sequence. Results: The ultrasonic brush group presented significant improvement in the reduction of visible plaque on the buccal surfaces (-6.36%, P = .007). The counts of S mutans decreased in the electric (2.04 × 105 to 1.36 × 105 colony-forming units [CFU]/mL) and ultrasonic (2.98 × 105 to 1.84 × 105 CFU/mL) groups. There were no statistical differences among the three brushes for the clinical and microbiological parameters evaluated. Conclusions: This study did not demonstrate that the ultrasonic toothbrush was better in reducing gingival inflammation in adolescent orthodontic patients, but plaque scores were lowered on buccal surfaces of teeth with orthodontic brackets. In addition, S mutans counts were markedly decreased in the electric and ultrasonic groups, which should be related to a reduced risk of oral disease. © 2006 by The EH Angle Education and Research Foundation, Inc.

Comparison of manual versus sonic and ultrasonic toothbrushes: a review.

PURPOSE: This review of the literature intends to evaluate the effect of brushes with high frequency motion when compared with manual toothbrushes regarding the indices of plaque and gingival bleeding. METHODS: Patients presenting gingivitis and/or chronic periodontitis were evaluated in addition to patients having osseointegrated implants and fixed orthodontic appliances. Pertinent literature was reviewed to select articles according to previously defined inclusion criteria. RESULTS: In the assessed studies results showed significant decreases in plaque and gingival indices by utilization of both types of brushes. However, in the selected studies where sonic brushes were tested in orthodontic and dental implant patients there was a more significant decrease in the indices. Furthermore, there was no indication of gingival recession attributed to product use. CONCLUSION: Future studies with a more homogeneous methodology and better experiment designs will be needed.

Effect of ultrasonic instrumentation on the bond strength of crowns cemented with zinc phosphate cement to natural teeth. An in vitro study

Several studies have reported the benefits of sonic and/or ultrasonic instrumentation for root debridement, with most of them focusing on changes in periodontal clinical parameters. The present study investigated possible alterations in the tensile bond strength of crowns cemented with zinc phosphate cement to natural teeth after ultrasonic instrumentation. Forty recently extracted intact human third molars were selected, cleaned and stored in physiologic serum at 4°C. They received standard preparations, at a 16° convergence angle, and AgPd alloy crowns. The crowns were cemented with zinc phosphate cement and then divided into four groups of 10 teeth each. Each group was then subdivided into two subgroups, with one of the subgroups being submitted to 5,000 thermal cycles ranging from 55 ± 2 to 5 ± 2°C, while the other was not. Each group was submitted to ultrasonic instrumentation for different periods of time: group 1 - 0 min (control), group 2 - 5 min, group 3 - 10 min, and group 4 - 15 min. Tensile bond strength tests were performed with an Instron testing machine (model 4310). Statistical analysis was performed using ANOVA and Tukey's test at the 5% level of significance. A significant reduction in the tensile bond strength of crowns cemented with zinc phosphate and submitted to thermal cycles was observed at 15 min (196.75 N versus 0 min = 452.01 N, 5 min = 444.23 N and 10 min = 470.85 N). Thermal cycling and ultrasonic instrumentation for 15 min caused a significant reduction in tensile bond strength (p < .05).

Ultrasonic material characterization using diffraction-free PVDF receivers

This work describes the use of a large aperture PVDF receiver in the measurement of density of liquids and elastic constants of composite materials. The density measurement of several liquids is obtained with the accuracy of less than 0.2% using a conventional NDT emitter transducer and a 70-mm diameter, 52-μm P(VDF-TrFE) membrane with gold electrodes. The determination of the elastic constants of composite materials is based in the measurement of phase velocity. It is shown that the diffraction can lead to errors around 1% in the velocity measurement when using a pair of ultrasonic transducers (1MHz and 19mm diameter) operating in transmission-reception mode separated by a distance of 100 mm. This effect is negligible when using a pair of 10-MHz transducers. On the other hand, the dispersion at 10 MHz can result in errors of about 0.5%, measuring the velocity in composite materials. The use of an 80-mm diameter, 52-μm thick PVDF membrane receiver allows measuring the phase velocity without the diffraction effects.

Evaluation of the dentin-pulp complex after cavity preparation with ultrasonic diamond tip

The aim of this paper was to compare the dentin-pulp complex response to cavity preparation in human teeth using ultrasonic chemical vapor deposition (CVD) diamond tip and high-speed diamond bur. Class V buccal cavities were randomly prepared in 40 premolars from 14 patients aged 11 to 15 years. The cutting time was recorded and the cavities had the axial walls protected with gutta-percha and were filled with glass ionomer cement. The teeth were extracted at intervals of 0, 5, 10 and 20 days, and were decalcified, sectioned and stained by Hematoxylin & Eosin, Masson's Trichrome and Brown & Brenn techniques. The inflammatory response and cell disorganization were blindly evaluated by two examiners. The remaining dentin thickness (RDT) was measured by a linear scale using computer software. Statistical analysis by one-way ANOVA showed no statistically significant difference (P≤0.05) among the cavities prepared with either type of instrument, with mean RDT of 1132.50 mm. Cutting time and the pulp-dentin complex responses were analyzed statistically by Kruskal-Wallis and Dunn tests (P≤0.05). The ultrasonic CVD diamond tip took 5 times longer to prepare the cavities and there were no typical inflammatory pulp responses in cavities prepared with either type of cutting instrument, only mild to moderate cell disorganization was present. Even taking longer to cut the dental substrate, the ultrasonic CVD diamond tip produced similar pulp response compared to the conventional high-speed diamond bur.

Effect of instrumentation using curettes, piezoelectric ultrasonic scaler and er,cr:Ysgg laser on the morphology and adhesion of blood components on root surfaces - A SEM study

This study used scanning electron microscopy (SEM) to evaluate the morphology and adhesion of blood components on root surfaces instrumented by curettes, piezoelectric ultrasonic scaler and Er,Cr:YSGG laser. One hundred samples from 25 teeth were divided into 5 groups: 1) Curettes; 2) Piezoelectric ultrasonic scaler; 3) Curettes plus piezoelectric ultrasonic scaler; 4) Er,Cr:YSGG laser; 5) Curettes plus Er,Cr:YSGG laser. Ten samples from each group were used for analysis of root morphology and the other 10 were used for analysis of adhesion of blood components on root surface. The results were analyzed statistically by the Kruskall-Wallis and Mann-Whitney tests with a significance level of 5%. The group treated with curettes showed smoother surfaces when compared to the groups were instrumented with piezoelectric ultrasonic scaler and the Er,Cr:YSGG laser. The surfaces instrumented with piezoelectric ultrasonic scaler and Er,Cr:YSGG laser, alone or in combination with hand scaling and root planing, did not differ significantly (p>0.05) among themselves. No statistically significant differences (p>0.05) among groups were found as to the adhesion of blood components on root surface. Ultrasonic instrumentation and Er,Cr:YSGG irradiation produced rougher root surfaces than the use of curettes, but there were no differences among treatments with respect to the adhesion of blood components.

Ultrasonic activation of internal bleaching agents

Aim: To evaluate the effectiveness of ultrasonic activation of bleaching agents during ex vivo internal bleaching. Methodology: Fifty canine human teeth were artificially stained, root filled and divided into five groups (n = 10) that received SP - sodium perborate plus deionized water (control group), CP - 37% carbamide peroxide gel, CPUS - 37% carbamide peroxide gel plus ultrasonic application, HP - 35% hydrogen peroxide gel or HPUS - 35% hydrogen peroxide gel plus ultrasonic application. In groups CP and HP, the bleaching agent was left inside the pulp chamber for three applications of 10 min. In groups CPUS and HPUS, the same process was performed, but ultrasonic vibration was applied to the bleaching agent by an alloy tip for 30 s, with 30 s intervals. Two sessions were performed. The colour was measured initially and after each session by an intraoral dental spectrophotometer. The variation (Δ) of the colour parameters based on the CIELab system L*, a* and b*, and the colour alteration ΔE* were calculated after first and second section. Data were analysed by one-way anova and Tukey's test. Results: There was no significant difference amongst groups for ΔL*, Δa* and ΔE*, but there was a significant difference for Δb* in the first and second sessions (P = 0.0006 and 0.0016, respectively). After the first session, Δb* was significantly greater for groups HP and HPUS, without a significant difference between them. For the second session, group HPUS had the greatest Δb* values, but they were similar to groups HP and SP; group CP had the lowest values, which were similar to groups CPUS and SP. Conclusion: Ultrasonic activation of bleaching agents during ex vivo internal bleaching was no more effective than conventional internal bleaching procedures, without activation. © 2012 International Endodontic Journal.

Sealing ability of MTA used as a root end filling material: Effect of the sonic and ultrasonic condensation

Despite the excellent properties of mineral trioxide aggregate (MTA), the condensation technique may have some influence in its sealing ability. The purpose of this study was to compare the sealing ability of sonic and ultrasonic setting of MTA. Thirty-four extracted human teeth had their canals prepared and filled with Sealapex sealer and gutta-percha using the active lateral condensation technique. The teeth were rendered waterproof and apicoectomy performed at 3 mm from the apex. Root-end cavities (3.0 mm deep and 1.4 mm diameter) were prepared with diamond ultrasonic tips. The root-end cavities were filled with Pro-Root MTA® with ultrasonic vibration, sonic vibration or no vibration. The positive control group did not receive any material while the negative control group was totally rendered waterproof. After material set, the specimens were immersed in Rodhamine B for 24 h, under vacuum in the first 15 min, then washed, dried and split longitudinally for evaluating the infiltration at the dentin/material interface. Data were analyzed using ANOVA and Tukey's tests at 5% significance level. Sonic vibration promoted the lowest infiltration values (p<0.05). It was concluded that sonic vibration could be considered an efficient aid to improve the sealing ability of MTA when used as root-end filling material.

Ultrasonic non-destructive testing of plate-like structures using piezoelectric array transducers

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of the Etching Duration and Ultrasonic Cleaning on Microtensile Bond Strength Between Feldspathic Ceramic and Resin Cement

This study assessed the effect of different etching durations of feldspathic ceramic with hydrofluoric acid (HF) and ultrasonic cleaning of the etched ceramic surface on the microtensile bond strength stability of resin to a feldspathic ceramic. The research hypotheses investigated were: (1) different etching times would not affect the adhesion resistance and (2) ultrasonic cleaning would improve the adhesion. Ceramic blocks (6 x 6 x 5 mm) (N = 48) were obtained. The cementations surfaces were duplicated in resin composite. The six study groups (n = 8) were: G1Etching with 10% aqueous HF (30 s) + silane; G 210% HF (1 min) + silane; G3-10% HF (2 min) + silane; G4-10% HF (30 s) + ultrasonic cleaning (4 min) in distilled water + silane; G5-10% HF (1 min) + ultrasonic cleaning + silane; G6-10% HF (2 min) ultrasonic cleaning + silane. The cemented blocks were sectioned into microbars for the microtensile test. The etching duration did not create significant difference among the groups (p = .156) but significant influence of ultrasonic cleaning was observed (p = .001) (Two-way ANOVA and Tukey's test, p > 0.05). All the groups after ultrasonic cleaning presented higher bond strength (19.38-20.08 MPa) when compared with the groups without ultrasonic cleaning (16.2117.75 MPa). The bond strength between feldspathic ceramic and resin cement was not affected by different etching durations using HF. Ultrasonic cleaning increased the bond strength between ceramic surface and resin cement, regardless of the etching duration.

Instantaneous Phase Threshold for Reflector Detection in Ultrasonic Images

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Ultrasonic waves: Bioeffects on yeast cells

Applications of ultrasound were starting from 1912 with the primary objective the detection of icebergs on prevention of maritime accidents. Algae, fish deaths and destruction were observed in the vicinity of sonar that equipped ships and submarines during the First World War.The evolutions of research and studies with ultrasound have big advances following the discovery of piezoelectric transducers in science and technology. As an example we can mention its application in microsurgery, fatigue detection in aerospace mechanics, catalysis sonochemical, biotechnology and others.The work presented here aims to demonstrate the application of ultrasonic in pulsed mode beams in biotechnology with the aim of improving the fermentation of a culture broth containing biological agents. In these experiments we used as ultrasound equipment and oscilator Sonics VCX-600 (20KHz), probe type wave guide. The experiments were conducted in a glass reactor of 200 mL of biomaterial containing cane juice and Saccharomyces cerevisiae in suspension. The parameters analyzed were related to the content Alcohlic (FID gas chromatography), and cell viability (Neubauer chamber), TRS (refractometry). Analysis of results showed that the total production exceeded in irradiated samples compared to normal fermentation (without ultrasound), suggesting additional advantage of ultrasound activation. Lastin Trials 1400 min, showed ethanol production systems 12% more than non-enabled systems. In this context alternatives for ethanol production, bio fuel and many other byproducts of the alcohol industries and chemicals could benefit from the use of ultrasound beams in this range of frequencies.

Effect of ultrasonic ecxitation on the ultimate tensili strength of glass ionomer cements after different water storage times

The application of ultrasound waves with a conventional dental ultrasonic scaler on glass ionomer cements surface accelerated initial setting reaction and improved the mechanical properties. Objective: This study evaluated the ultimate tensile strength of glass ionomer cements after ultrasonic excitation and different water storage times. Material and method: Twelve specimens of each material (Fuji IX GP, Ketac Molar Easymix and Vitremer) were prepared, and six of each received a 30-second ultrasound application during initial setting of the cements. After storage of the 24 hours or 30 days, the specimens were sectioned into stick to microtensile testing and the mean ultimate tensile strength values were submitted to Welch’s ANOVA and Tamhane’s test. Result: The results showed that the Vitremer presented the highest mean tensile strength. The chemically set Fuji IX GP presented significantly higher mean tensile strength after 30 days than after 24 hours of storage (p < 0.05). At 24 hours, the ultrasonically set Fuji IX GP presented significantly higher mean tensile strength than their counterparts set under standard conditions (p < 0.05). Conclusion: Treatment with ultrasound increased the tensile strength of Fuji IX GP in the early period of maturation.

Innovation in pediatric surgery: the use of ultrasonic CVD tips: case report

The non-eruption of teeth due to highly keratinized gingival mucosa is a frequent event in the pediatric dentistry, which harms the oral aesthetics and function. A surgical excision of the involved area is indicated, exposing the non-erupted tooth. This procedure involves anesthesia and cutting instruments that may increase the fear and anxiety in young patients. The use of new technologies has avoided these instruments and has promoted more comfort to the patients. This study presents clinical cases in which gingivectomy was performed using the innovative method with an ultrasound-activated CVD tip. It was concluded that this method presented effectiveness, promoted more comfort, and less fear to the patients, making its use a viable alternative to pediatric surgery.

Morphology and adhesion on blood components in root surfaces treated by a piezoelectric ultrasonic: an in vitro study

The aim of this study was to evaluate the morphology and adhesion of blood components on root surfaces instrumented with piezoelectric ultrasonic Piezon Master Surgery. Methods 10 teeth were used in this study. The teeth had their proximal divided into four areas that received different treatments: Group 1: untreated control Group 2: scaling with manual instrument; Group 3: scaling with ultrasound; Group 4: Scaling with manual instruments and ultrasound. We obtained 20 samples, 10 of which were used to analyze the morphology and the other 10 were used for analysis of adhesion of blood components. The specimens were analyzed by scanning electron microscopy. Photomicrographs were analyzed by the scores of adhesion of blood components and the index of root morphology. The results were statistically by the Kruskall-Wallis and Mann-Whitney with a significance level of 95%. Results The morphological analysis showed that the Group 1 had a surface unchanged in relation to other groups (Group 1 X Group 2 = 0.0025; Group 1 X Group 3 = 0.0003; Group 1 X Group 4 = 0.0003) and Group 2 presented a smoother surface compared to Group 1 and groups instrumented with ultrasound (Group 2 X Group 3 = 0.0025; Group 2 X Group 4 = 0.0025) there were no statistical differences between the Groups 3 and 4. analysis of adhesion of blood components showed that the Groups 2, 3 and 4 had no statistically significant differences between themselves, but more biocompatible surfaces promoted the surface untreated control (Group 1 X Group 2 = 0.02; Group 1 X Group 3 = 0.04; Group 1 X Group 4 = 0.005). Conclusion The instrumentation with piezoelectric ultrasonic promoted an irregular root surface, but did not negatively affect the adhesion of blood components.