Tips on Technique: New Thin Tips for High Power

QUESTION: Are there any new or improved magnetostrictive thin ultrasonic tips that can be used on high power?

ANSWER: Yes, two brand new thin magnetostrictive inserts were introduced in 2011. They are both specifically designed to allow use on higher power and should be more effective for subgingival calculus removal. In January, Hu-Friedy introduced the Swivel XT™ Ultrasonic Insert, a thin, strong insert designed to remove moderate to heavy subgingival calculus from interproximal and subgingival areas (Figure 1). Previously, almost all thin magnetostrictive inserts have been recommended for light deposit or biofilm removal. Many clinicians have been frustrated by subgingival deposits that are tenacious and almost impossible to remove with thin tips on low power. Hu-Friedy’s new Swivel XT is thin enough to reach deep interproximal areas, but also strong enough to allow efficient, effective removal of moderate to heavy calculus. A proprietary blend of stainless steel allows the clinician to choose a wide range of power settings, however, the Swivel XT Insert is very effective in the medium power range for most patients. The insert is compatible with all major ultrasonic scalers, but is particularly well suited for use with Hu-Friedy’s new magnetostrictive SWERV3 unit, which offers more power than many conventional units.

DENTSPLY Professional launched the new SlimLine® 1000 in February 2011 (Figure 2). This new SlimLine tip is a hybrid of two of Cavitron’s best-selling inserts, the FSI® SLI 10S and FSI 1000. It is a thinner version of the FSI 1000 with the same beveled tip designed to break through subgingival calculus. This unique tip can be used from low to high power without danger of breakage.

In 2009, DENTSPLY Professional introduced the Cavitron® THINsert™ (Figure 3), which also can be used safely on high power. This tip is about half the diameter of a SlimLine so it inserts very easily into deep, tight pockets. This ultrathin, smooth tip is useful for biofilm removal or for removal of very new or very light calculus. For heavier or more tenacious calculus, the new beveled SlimLine 1000 tip is a better choice.

Parkell offers the Burnett Power Tip™ (Figure 4), another thin magnetostrictive tip that can be very effective, especially when used on high power with the Parkell magnetostrictive unit. All of these new tips can be used with any magnetostrictive ultrasonic unit.

Piezoelectric thin tips have been routinely used on higher power for efficient removal of subgingival calculus by skilled clinicians in Europe and Asia for many years. The ability of thin piezoelectric tips to be used on high power is one of the many reasons that more clinicians in the United States have started using piezoelectric ultrasonic units. EMS Electro Medical Systems, Hu-Friedy Mfg Co Inc, SATELEC®, Vista Dental Products, Parkell, Brasseler NSK, Zila, and PDT all offer excellent piezoelectric thin and conventional tips for moderate-to-heavy subgingival calculus removal.

Whether using piezoelectric or magnetostrictive tips on higher power, it is important to keep the tip parallel to the tooth surface to prevent root damage. Begin by using the tip in a probing motion to tap against the coronal edge of the calculus. Once the calculus begins to break away, be careful not to direct the point in toward the root because it can etch the surface. Use the terminal 1 mm to 2 mm of the tip to remove all calculus from the coronal to apical aspect using slow, deliberate, overlapping strokes. Use light strokes to finish the entire root surface, but remember that fast, low powered strokes will often burnish residual tenacious calculus to a smooth thin veneer.

Calculus in deep pockets can now be removed more easily with the use of these thin ultrasonic tips on higher power. Remember that before beginning instrumentation on medium to high power, sufficient pain control—either through local anesthetic block injections or infiltrations—is key to patient comfort.

From Dimensions of Dental Hygiene. February 2011; 9(2): 74.