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Potential of shock waves to remove calculus and biofilm

Müller, Philipp ; Guggenheim, Bernhard ; Attin, Thomas ; Marlinghaus, Ernst ; Schmidlin, Patrick

In: Clinical Oral Investigations, 2011, vol. 15, no. 6, p. 959-965

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    Titre
    • Potential of shock waves to remove calculus and biofilm
    Auteur
    • Müller, Philipp. Clinic for Preventive Dentistry, Periodontology and Cariology, Center for Dental and Oral Medicine and Maxillofacial Surgery, Plattenstrasse 11, 8032, Zurich, Switzerland
    • Guggenheim, Bernhard. Institute for Oral Biology, Section for Oral Microbiology and General Immunology, Center for Dental and Oral Medicine and Maxillofacial Surgery, University of Zurich, Zurich, Switzerland
    • Attin, Thomas. Clinic for Preventive Dentistry, Periodontology and Cariology, Center for Dental and Oral Medicine and Maxillofacial Surgery, Plattenstrasse 11, 8032, Zurich, Switzerland
    • Marlinghaus, Ernst. Storz Medical, Tägerwilen, Switzerland
    • Schmidlin, Patrick. Clinic for Preventive Dentistry, Periodontology and Cariology, Center for Dental and Oral Medicine and Maxillofacial Surgery, Plattenstrasse 11, 8032, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Clinical Oral Investigations, 2011, vol. 15, no. 6, p. 959-965. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:310914
    Summary
    Effective calculus and biofilm removal is essential to treat periodontitis. Sonic and ultrasonic technologies are used in several scaler applications. This was the first feasibility study to assess the potential of a shock wave device to remove calculus and biofilms and to kill bacteria. Ten extracted teeth with visible subgingival calculus were treated with either shock waves for 1min at an energy output of 0.4mJ/mm2 at 3Hz or a magnetostrictive ultrasonic scaler at medium power setting for 1min, which served as a control. Calculus was determined before and after treatment planimetrically using a custom-made software using a grey scale threshold. In a second experiment, multispecies biofilms were formed on saliva-preconditioned bovine enamel discs during 64.5h. They were subsequently treated with shock waves or the ultrasonic scaler (N = 6/group) using identical settings. Biofilm detachment and bactericidal effects were then assessed. Limited efficiency of the shock wave therapy in terms of calculus removal was observed: only 5% of the calculus was removed as compared to 100% when ultrasound was used (P ≤ 0.0001). However, shock waves were able to significantly reduce adherent bacteria by three orders of magnitude (P ≤ 0.0001). The extent of biofilm removal by the ultrasonic device was statistically similar. Only limited bactericidal effects were observed using both methods. Within the limitations of this preliminary study, the shock wave device was not able to reliably remove calculus but had the potential to remove biofilms by three log steps. To increase the efficacy, technical improvements are still required. This novel noninvasive intervention, however, merits further investigation