Influence of Scaler Tip Design on Patients' Pain Perception
Condition: Healthy Volunteers
Study type: Interventional

Summary: 
      Ultrasonic scalers have been shown effective in removing subgingival calculus. However, it
      may cause alteration to the tooth surface as well as discomfort to patients. Advances in
      scaler tip designs may reduce these effects. Limited studies have investigated the influence
      of scaler tip designs on tooth surface and patients' comfort. This study aimed to evaluate
      the influence of scaler tip designs on patients' pain perception.
    

Detailed description: 
      Scaling is a common procedure performed by general dental practitioners and dental
      specialists. Unfortunately, scaling has been associated with unpleasant dental treatment and
      to some extent, a painful experience (Berggren & Meynert, 1984). Studies also have
      demonstrated that scaling using ultrasonic scalers can cause tooth surface roughness and
      tooth substance loss (Jepsen et al., 2004; Kawashima et al., 2007). Rough tooth surface will
      increase retention of plaque and has been shown associated with early biofilm formation
      (Teughels et al., 2006). Subsequently, this would increase the risk for development and
      progression of periodontal disease. Whereas, tooth substance loss may lead to exposed
      dentinal tubules, and subsequently root sensitivity. Root sensitivity was reported to affect
      half of patients receiving periodontal therapy (Von Troil et al., 2002). This led to
      discomfort among patients and avoidance to dental treatment in future.

      Advanced development in scaler tip designs has provided opportunities to deliver scaling
      treatment that is less aggressive to tooth surfaces and most importantly, to reduce the
      discomfort to patients. The design of the scaler tip has influenced the performance of
      ultrasonic scalers characterised by the displacement amplitude (Lea et al., 2003b).
      Displacement amplitude is the lateral movement of scaler tip that is thought to contribute to
      the aggressiveness of scaling procedure. Several studies have investigated the factors that
      may influence displacement amplitude, such as power setting and type of generator (Lea et
      al., 2003a), tip wear (Lea et al., 2006) and scaler tip designs (Lea et al., 2003a). However,
      to date, there were limited studies that investigated the effect of ultrasonic scaler tip
      design particularly slim and wide scaler tip on tooth surface roughness, tooth substance
      loss, and patients' pain perception.

      In a clinical setting, if there were two treatment methods that provide similar levels of
      effectiveness but different levels of discomfort and damage to tooth surface patient will opt
      for the more comfortable and conservative method. Therefore, this study investigated the
      influence of scaler tip designs on tpatients' pain perception following scaling.
    

Intervention name(s): PS (DS-016A, EMS® Piezon, Switzerland) scaler tips. ); Conventional (FS-407, EMS® Piezon, Switzerland)
Intervention type(s): Other; Other
Intervention description(s): Supragingival scaling with a portable ultrasonic scaler device (EMS®) with Piezon, Switzerland using PS (DS-016A, EMS® Piezon, Switzerland) scaler tips; Supragingival scaling with a portable ultrasonic scaler device (EMS®) with Piezon, Switzerland using Conventional (FS-407, EMS® Piezon, Switzerland)
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Participant)
Primary purpose: Prevention