comparative evaluation of immediate effect of root instrumentation with curettes and mini-insert ultrasonic scalers on clinical attachment level

abstract: background and aim:  micro-ultrasonic tips are similar to hand instruments in their clinical application of subgingival scaling.  in spite of their favorable results, excessive penetration of mini-insert ultrasonic scalers to the bottom of gingival pocket may cause harmful effects. the aim of this study was to evaluate the immediate effect of root instrumentation with gracey curettes and mini-insert ultrasonic scalers on clinical attachment level. materials and methods: in this single-blind split mouth study, fifteen patients with moderate chronic periodontitis and at least five periodontal pockets around incisors and canines with clinical attachment level ranging from 2 to 4 mm were randomly allocated to one of the following groups: curette scaling (cs) and ultrasonic scaling (us).the teeth were probed with a pressure sensitive probe using an occlusal stent. immediately after scaling and root planing, the teeth were probed again. the difference in relative attachment level (ral) immediately before and after instrumentation was considered trauma from instrumentation. the mean values recorded before and after root instrumentation were compared by student’s paired t-test and the differences in ral measurements between the groups were compared by student’s non-paired t-test. results: there were statistically significant differences between the two groups regarding ral before and after scaling and root planing (0.43+0.65 mm for us and 0.47+ 0.6 mm for cs) (p<0.001). however, no statistically significant difference was observed in ral changes between the two groups (p=0.77). conclusion: within the limitations of this study, it seems that use of thin tip ultrasonic scaler for periodontal nonsurgical treatment will result in immediate attachment loss at a level equal to hand instruments