While the majority of clinicians in the United States have worked with magnetostrictive ultrasonic units since the 1960s, clinicians in Europe and Asia have predominately selected piezoelectric units to accomplish their ultrasonic scaling. European and Asian practitioners are more likely to use ultrasonic scaling because their dental units often have built in piezoelectric systems. The clinician simply attaches a sterile handpiece to the piezoelectric cord on the unit to begin scaling. These built-in piezoelectric units are multifunctional so they also offer endodontic and restorative functions with special tips for the dentist.
Another feature of piezoelectric units is that they offer a wide variety of scaling tips. These threaded tips are screwed into the handpiece and tightened with a wrench. All of the manufacturers offer large tips for heavy calculus removal and thin periodontal tips for deep pockets. ACTEON North America/Satelec, Mount Laurel, NJ; Brasseler NSK, Savannah, Ga; and Electro Medical Systems (EMS), Dallas, make special plastic implant tips. Satelec; Brasseler NSK; Vista Dental, Racine, Wis; and Hu-Friedy Mfg Co, Chicago, make tips that are designed like universal curets or Langer curets (Gracey type shanks with a universal blade) for light calculus removal and thin diamond coated tips used on low power for removing burnished/embedded calculus. If more than one piezo tip will be used, the additional tip can be attached to an extra handpiece prior to the appointment and the entire handpiece can be switched, rather than having to screw tips off and on while working.
The differing geometry of piezoelectric tips, especially those tips with rectangular or asymmetrical cross sections rather than round cross sections, allows them to accomplish efficient calculus removal. European and Asian clinicians routinely use thin piezoelectric tips that are rectangular rather than round in cross section in deep periodontal pockets with higher power to remove hard calculus from root surfaces.
The ultrasonic vibration from a piezo scaler is generated from a series of ceramic discs or quartz plates in the handpiece. This vibration is generated in a longitudinal plane creating a linear tip motion ranging from 25 to 50 thousand cycles per second. No magnetic field is present and little heat is generated so less water is required. However, sufficient irrigation is necessary for adequate lavage and scaling efficiency. Frictional heat does result from the scaling action of the tip against the tooth, so it is still important to use some water to provide cooling.
Linear motion allows the piezoelectric tip to move back and forth in a shaving motion rather than in a circular or elliptical motion like a magnetostrictive tip. This linear micromovement requires that the tip be used more like a hand instrument by adapting the sides or lateral edges of the tip against the tooth rather than the 360° adaptation that is used with a magnetostrictive tip. The linear movement also allows the use of bladed curet tips and tips with lateral edges that can engage biofilm and calculus differently than a smooth, round tip.
Many companies offer compact dental hygienist models as well as larger table top units and built-in modules for the dental unit. The new Hu-Friedy Symmetry IQ piezoelectric scaler and the Brasseler NSK Varios 350 offer compact units that feature handpieces with fiberoptic light. ACTEON Satelec offers a fiberoptic handpiece on its larger Suprasson P-Max Lux model.
Hu-Friedy MfG Co
Hu-Friedy has just introduced the newest piezoelectric scaler called the Symmetry IQ 3000 Multi-functional Piezoelectric Device (Figure 1). The versatile Symmetry IQ is designed for scaling, restorative procedures, and endodontic procedures. It has an ergonomic handpiece with a 360º fiber-optic light that shines a concentrated light on the working area. It comes with a full line of piezoelectric tips, including large heavy tips, thin perio tips, curet tips, and thin diamond coated tips, that are all protected by the color-coded Guardian Wrench/Tip Carrier system (Figure 1a). Additionally, this new unit offers clinicians several unique features including a touch-pad control and three digitally adjustable, predefined color-coded power modes.
Vista Dental is one of the leading American manufacturers of piezoelectric scalers (Figure 2). The company produces compact and tabletop models that also include subgingival irrigation handpieces and tips. They make a full line of various piezoelectric tips for periodontal scaling and debridement.
Vista Dental makes the innovative Harrel Diamond Safety Tip (Figure 2A). This tip allows removal of very heavy calculus with a unique diamond embedded tip design that protects the root surface from damage while efficiently cutting through tenacious deposits.
ACTEON is a French company that manufactures the Satelec Suprasson P-5 Newtron (Figure 3A) and the new P-5 Newtron XS with a 300 ml reservoir for self-contained irrigation (Figure 3). The larger table top model, the Suprasson P-Max Newtron, includes a LED light in the handpiece and the P-Max Lux has a fiberoptic light in the handpiece.
ACTEON offers the widest choice of ultrasonic units available in the marketplace and produces a full line of tips including large scaling tips, thin perio tips, diamond tips, curet tips, and plastic carbon composite implant tips. All of these tips are protected by a patented Satelec Color Coding System of plastic tip holder/wrenches that fit into an autoclavable box with the ergonomically designed handpiece.
Brasseler NSK offers the Varios 350 Compact Multifunction Scaler (Figure 4A), which is the smallest, most compact piezoelectric unit available. It is manufactured in Japan and features an ergonomic handpiece with fiberoptic light (Figure 4).
Brasseler produces an extensive line of tips including large scaling tips, thin perio tips, diamond tips, curet tips, and implant tips. One of three power modes can be selected, corresponding to the types of tips: G” (General), “E” (Endo), or “P” (Perio) mode. Brasseler NSK also makes the larger Varios 550 and 750 table top models.
EMS is based in Nyon, Switzerland, and manufactures the Piezon Master 600 (Figure 5), the MiniMaster, and the MiniPiezon® (Figure 5A) models of multifunctional piezoelectric units with a variety of high quality Swiss precision tips. These units are able to perform scaling, periodontal, endodontic, and restorative functions. A full selection of large tips, fine perio tips, diamond perio surgery tips, and implant tips come with an autoclavable box and each tip is protected by the Guardian wrench system.
The Piezon Master 600 features two ultrasonic handpieces that can be simultaneously connected to facilitate treatments requiring different tips. This model also has two large refillable bottles The MiniPiezon is one of the most compact ultrasound units but it is just as powerful as the larger EMS counterparts.
Pro-Dentec Corp, Batesville, Ark, manufacturer of the ProSelect 3 piezoelectric scaler (Figure 6), has been selling this unit for many years with a set of three periodontal scaling tips (Figure 6A). One tip is a straight universal tip and the other two are curved right and left. This unit also comes with three bottles that allow the use of different irrigants before, during or after scaling.
Although Parkell is well known for its magnetostrictive units and magnetostrictive inserts, the manufacturer also produces a low cost piezoelectric scaler called the TurboPiezo (Figure 7). This unit comes with three tips—a large tip for heavy calculus removal and two thinner tips for scaling of deeper periodontal pockets. It has a foot pedal turbo boost with an expanded low power range for comfortable debridement and a higher high power range for calculus removal.
From Dimensions of Dental Hygiene. July 2007;5(7): 20, 22-23.