Scaling and root planing without overinstrumentation: hand versus power-driven scalers.

This review focuses on select current articles chosen for their unique contribution to the literature in scaling and root planing. New studies suggest that thorough root debridement can be achieved without overinstrumentation using certain sonic and ultrasonic scalers. Evaluation of residual plaque and calculus after instrumentation with hand- and power-driven scalers showed sonic and ultrasonic scalers to be equivalent, and in some cases, superior to hand scaling. When modified ultrasonic inserts were compared with unmodified ultrasonic inserts and hand curets, the modified ultrasonic inserts produced smoother roots with the least amount of damage, better access to the bottom of the pocket, better calculus and plaque removal, less operator time, and less operator fatigue than did hand scaling or ultrasonics equipped with unmodified inserts.