Burnished Calculus

If cavitation kills bacteria in the pocket, then why should the polished stones need to be removed? Is the sound flow and lavage of dental equipment ultrasound sufficient to ensure a good clinical outcome, even after calculus has been left behind?
It all depends on how much calculus you have. Although it is impossible to remove 100% of the stones from teeth, all clinicians should try to remove as many stones as possible. Typical periodontal disease research shows that after the initial deep expansion, 50% of the gingivitis was left behind. With the help of the dental endoscope, 99% of the stones can be removed, and only 1% of residual polished stones remain in CEJ. As long as it is a tiny, smooth stone, the bacteria that remain on the porous surface will soon begin to proliferate and re-color. In a matter of hours, the biofilm is rebuilt on the root surface.
In other words, pockets can never be completely sterilized – not with ultrasound zooming, manual instrumentation, irrigation, laser, local delivery of antibiotics, periodontal surgery, and even systemic antibiotics. All of these treatments can temporarily or even dramatically reduce the number of bacteria and pathogens in the pocket, but no one can eradicate them completely. The biofilm inevitably recolutes the root surface within days, and pathogens can recover to levels that can cause inflammation in a few weeks.
The idea that ultrasonic cavitation kills pathogens in periodontal pockets is a widely circulated myth that has no scientific basis. This is based entirely on laboratory experiments, which are usually carried out in beakers filled with water and phytoplankton. Baehni, 35-38, and colleagues found that the bacteria were significantly reduced after the ultrasonic descaling, but the effect was probably due to mechanical cleanser and irrigation, rather than holes that actually killed the pathogen. There is no cavitation in the periodontal pocket space, because the dental ultrasound is unable to produce the intense cavitation needed to kill various pathogens.
According to a study, a kind of very powerful laboratory ultrasonic cell division, it’s about the size of the size of human fingers, can be in 2.5 minutes after killing the pathogens in the water in the beaker. The ultrasonic scaler used in this study did not kill any detected periodontal pathogens. There is not enough strong dental ultrasound scalp in the periodontal pocket to produce this empty effect. In another laboratory study, after the bacteria were killed, the researchers again concluded that there was no cavitation. The bacteria may have died, because in this experiment the deflection of the water and the smallest lavage led to a rise in temperature. There must be sufficient strength and fluid between the tips and teeth or the actual cavitation of the tissues. Obviously, more research is needed to understand the cavitation phenomenon in the pocket.
The decrease in the amount of bacteria in the pocket is mainly due to the dental supplies physical destruction of calculus and biofilm and the irrigation of water flow (acoustic flow). Adequate water flow, thoroughly flushed out of the pockets of calculus and bacteria, is the best feature of ultrasound zooming, which is essential to ultimate success.