Subtle differences in shape, size, water conduits, and range of vibration have significant clinical implications. Remember the most important feature is the design, meaning the size and shape of the tip itself. Dr. Thomas Holbrook is credited with the concept of conventional tip modification. Tips designed to reach deep inaccessible periodontal pockets have been slow to develop. Changing focus from supragingival to subgingival ultrasonic debridement has motivated manufacturers to design thinner inserts for better access, so personal modification is no longer necessary.
Universal inserts accomplish debridement in most areas of the mouth.
Curved inserts are also effective in debriding furcations, the CEJ between tight contacts, malpositioned teeth, and concave surfaces inaccessible with the universal tip. Elliptical tip motion allows the clinician to use all sides of the tip. Linear tip motion allows the clinician the use of two surfaces of the insert. Another important area of consideration is automatic tune equipment versus manual tuning. Manual tune allows the clinician control of the frequency as well as amplitude of the tip vibration.