O riginal Article www.ejournalofdentistry.

com

A COMPARATIVE IN VIVO STUDY OF MAGNETOSTRICTIVE AND PIEZOELEC-

TRIC ULTRASONIC SCALING DEVICE
Hojatollah Yousefimanesh1, Maryam Robati2, Mahdi Kadkhodazadeh3, Reza Molla*4.
1
Assistant Professor, Department of Periodontology, Ahwaz Jundishapour University of Medical sciences, Faculty of
Dentistry, Ahwaz, Iran.
2
Assistant Professor, Department of Oral Medicine,, Ahwaz Jundishapour University of Medical sciences, Faculty of
Dentistry, Ahwaz, Iran.
3
Assistant Professor, Department of Periodontology, Shahid Beheshti University of Medical sciences, Faculty of
Dentistry, Tehran, Iran.
4
Assistant Professor, Department of Periodontology ,Mashhad University of Medical sciences, Faculty of Dentistry,
Mashhad, Iran.
Correspondence: Reza Molla, Assistant Professor, Department of Periodontology ,Mashhad University of Medical sciences, Faculty of
Dentistry, Mashhad, Iran. Email:Reza.Molla@gmail.com
Received Jan 20, 2013; Revised Feb 10, 2013; Accepted Mar 20, 2013

ABSTRACT
Objective: The effects of magnetostrictive ultrasonic instruments and piezoelectric instrument on tooth surfaces
seem to differ considering remaining calculus & root surface roughness. The purpose of this study was to compare
a magnetostrictive ultrasonic scaler instrument with a piezoelectric ultrasonic scaler.
Methods: 40 human teeth were assigned to two treatment groups (n=20). Teeth were scaled and data related to the
duration of scaling and effectiveness of instrument in calculus removal and the amount of surface roughness were
collected and statistically analyzed by paired samples T- test.
Results: the results revealed that the mean of time needed for instrumentation in piezoelectric and magnetostrictive
ultrasonic instruments was 216 ± 52.05 s and 274.5 ± 87.74 s respectively. There was no statistically significant
difference between two ultrasonic instruments considering cululus removal. Furthermore, our study showed that
Magnetostrictive instrument left more smooth surface than piezoelectric devices.
Conclusion: From our study, it can be concluded that two scalers are able to remove calculus efficiently. The
magnetostrictinve ultrasonic device produces smoother surface in comparison to piezoelectric device. However, it
was also shown that instrumentation with the piezoelectric devices was faster than magnetostrictive devices.
Key words: in vivo, scaling, piezoelectric, magnetostrictive

Introduction: referred to as power-driven scalers and their efficiency of

The goal of periodontal therapy was to obtain by
eliminating supra- and subgingival plaque and establishing
conditions.
The removal of periodontal infections is an essential
characteristic in the treatment of periodontal diseases and
maintaining a healthy periodontium (1, 2). The manual
instrumentation, sonic and ultrasonic instrumentation, laser
scaling, demineralization and chemical scaling are the
available techniques which are used for removal of calculus
and infectious tissue (3). Ultrasonic and sonic scalers are
removing calculus from the tooth surfaces is different (4).
Ultrasound can be produced by magnetostriction or
piezoelectricity. Ultrasonic units in dentistry are currently
available in two basic types: magnetostrictive and
piezoelectric. Ultrasonic instrumentation is as effective as
manual scaling for plaque and calculus removal and the
successful healing of diseased periodontal tissues (5,6).
The mechanism of ultrasonic units is different.
Magnetostrictive units operate between 18 000 and 45 000
cycles per second (Cps), using flat metal strips in a stack or
a metal rod attached to a scaling tip and tip movement is

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Reza Molla et al
elliptical. Piezoelectric units operate in range of 25000–
50000 Cps and are reactivated by dimensional changes in
crystals housed within the hand-piece as electricity passed
over the surface of the crystals and tip movement is
primarily linear in direction (7).
During periodontal maintenance therapy using power driven
devices, alterations of tooth surfaces are particular concern.
The analysis of publications regarding the aggressiveness
to tooth substance comparing ultrasonic scaling devices
(magnetostrictive or piezoelectric) is different. Flemmig et
al. suggested that a magnetostrictive unit was more
aggressive than a piezoelectric device regarding root
substance removal (8). On the other hand, Busslinger et al.
reported that a piezoelectric device left a rougher surface
than a magnetostrictive device after instrumentation (9). The
tooth surface roughness after scaling procedure is a
considerable factor for maintenance, because it has also
been reported that bacterial plaque adheres easily to the
rough root surfaces after treatment (10,11). Tooth surface
roughness compared between piezoelectric or
magnetostrictive ultrasonic devices could be expected to
be different. The purpose of this present study was to
compare the results of scaling with the use of
magnetostrictive and piezoelectric devices based on in vivo
study. Furthermore; time needed to clean the root surface
was noted.
Method and materials:
This study was conducted in vivo on 44 human tooth
samples that exhibited advanced periodontal disease with
subgingival calculus. Tooth samples were evaluated by
periodontist both clinically and radiographically for
periodontal disease involvement.
Periodontal pocket depth (PPD), clinical attachment level,
furcation involvement, mobility was assigned before scaling
for all samples.
Inclusion criteria were teeth with evidence of chronic
periodontal disease with at least one tooth hopeless and
periodontal pocket>5mm, a clinical attachment loss of 8 to
12 mm, bone loss e” two-third of the root length
(radiographical examination), the presence of subgingival
calculus detected with an explorer probe and mobility grades
of 3.
Exclusion criteria were acute periodontal or endodontic
infection, periodontal treatment within the past 5 years,
root surface caries or any subgingivally placed restorations,
and aggressive periodontitis.
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All participants signed a consent form before study.
Patients were divided into 2 experimental groups and each
group contains 22 teeth. The first group contains 15 single
root and 7 molar teeth. The second group contains 16 single
root and 6 molar teeth. For all patients, subgingival calculus
scaling has been done under local anesthesia. In each
sample, teeth were scaled until the area of interest was
visually and tactilely clean and smooth with a sharp explorer.
Time for the mechanical debridement was exactly recorded
with a digital stopwatch and teeth were extracted after
scaling. There were no significant differences between the
initial calculus values among the groups. Teeth were rinsed
with running water for 2–3 min and with a millimeter reference
photographed by digital camera (fig1, 2).
The instrumentations with the ultrasonic devices were
carried out under water-cooling. In the first group, teeth
were scaled using Magnetostrictive device (Fig1) and the
second group teeth were scaled with the piezoelectric
device (Fig2). Tooth surface roughness was analyzed under
the scanning electron microscope (SEM). They were gold-
paladium sputtered with a sputtering device for 240
seconds and the surfaces were evaluated under the SEM
(LEO 1450VT) with 35kv and contrast of 2.5 nm at
magnifications of ×30, ×200 and ×500 (Fig3, Fig4a,b). Before
the evaluation, the examiner was trained and calibrated,
and then examiners compared groups together.
The statistical analysis was done with a commercially
available statistics computer program. The normal
distribution of data was tested by the Shapiro-Wilks test
and the homogeneity of variances was tested using
Levene’s test. The significance levels were set at á=5%
(Pd”0.05). The recorded time and surface roughness t-test
and non parametric test were used.
Results:
Regarding the time taken to clean the areas of interest under
scaling, the shortest scaling time was achieved in group
piezoelectric and another scaling time is shown in table1.
Mean scaling time in magnetostrictive device and
piezoelectric device was 274.5 ± 87.74 and 216 ± 52.05 s
respectively. The difference was compared with paired
sample t-test and this difference was significant (P= 0.003).
Tooth surface under 30x magnifications of SEM shows
calculus and crack.
Tooth surface roughness under x 200magnification of SEM
shows that magnetostrictive device had smoother surface
than piezoelectric device (Fig4).
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A comparative in vivo study of magnetostrictive and piezoelectric ultrasonic scaling device
Regarding the percent retained by calculus after scaling, it
was achieved in group piezoelectric and magnetostrictive
device and the percents retained by calculus were
23.48±13.93 and 19.28±9.80 respectively. The difference was
compared with paired sample t-test and this difference was
not significant (P = 0.131).
In piezoelectric samples, crack with different and irregular
length was seen at 1/3 cervical of tooth (CEJ).
Magnetostrictive device had very wide crack that this was
due to larger tip of magnetostrictive device compared with
piezoelectric devices.
Discussion:
Many studies have demonstrated the effectiveness of initial
periodontal therapy procedures for the improvement of
clinical signs of periodontal diseases. In the present study,
the magnetostrictive instrument was significantly smoother
than the piezoelectric device. According to study of
Flemming et al., the efficacy of the assessed
magnetostrictive ultrasonic scaler may be adapted to the
various clinical needs by adjusting the lateral force, tip
angulation, and power setting. Scaling with high power of
ultrasonic instrument had been less effective at calculus
removal and roughness surfaces and in this study; we use
high power of instrument(12).
Evaluation of the remaining calculus using these devices
showed no significant differences between the two groups
(hand and power driven). This result showed that two
devices had ability to remove calculus. These results were
similar in study of Abed(13, 14). Busslinger et al. showed
lower retained calculus at in vivo study and this might be
due to difference in pocket depth and lateral forces, power
setting and angulation can influence root substance
removal(8,9) . This study was done under local study to
control pain of patients and this parameter might cause
difference between this study and another study. We did
not measure the lateral forces during treatment, although
the investigators were trained to remove calculus with little
force, using periodontally involved extracted teeth in vitro.
Time for scaling
This study demonstrated difference between times taken
using magnetostrictive and piezoelectric device. Busslinger
et al. comparing magnetostrictive and piezoelectric device
demonstrated that time taken between them was significant
and this was in line with our study. This similarity reflecting
that magnetostrictive device was more powerful than
piezoelectric device to remove calculus at the same time
(9). Several studies have suggested that hand instruments
produced a significantly smoother root surface than
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ultrasonic scalers (15, 16); whereas another study suggested
that an ultrasonic scaler produced a smoother surface than
hand instruments .This controversy shows different
methods for study (17).
Type of devices
The SEM images compared two groups after
instrumentation. Tooth surface roughness under SEM
shows that magnetostrictive device had smoother surface
than piezoelectric instruments and this difference was not
significant. In our similar study, Santos et al. under SEM do
not show any difference between magnetostrictive and
piezoelectric devices. The main reasons for the similarity
are the methodology used such as in vivo study(18).
In addition, the results were similar to those obtained by
Busslinger et al. in that the magnetostrictive instrument
produced a better surface finish than piezoelectric
manipulation (9).In contrast to our study, Lea et al. found
that root surfaces instrumented by piezoelectric scalers
were smoother than those following instrumentation with
magnetostrictive scalers (19). Studies on working parameters
and roughness showed that higher instrument power
setting resulted in higher mean and maximum surface
roughness at both low and high lateral forces (20).
Many studies show that a smooth, hard root surface is
needed for completion of mechanical root planning.
However, smooth, hard root surfaces may replicate the
unnecessary elimination of hard tissues, which has been
reported to cause root hypersensitivity or reversible or
irreversible pulpitis (21). Consequently, others have
advocated gentle scaling of the root surface, based on
observations that endotoxin does not penetrate into the
exposed root cementum, but is loosely attached on the
surface of root (22).
Conclusion:
An adequate periodontal procedure includes the removal
of plaque, calculus, and perhaps diseased cementum and
dentin to control disease. The sonic and ultrasonic
instruments have a common field of usage because of their
facilitating effects on mechanical periodontal treatment.
However, occasionally a wrong application, which seems
straightforward to us may cause tooth damage or loss, if
attention is not paid to possible harmful effects of the
instrument used, and perhaps, there are some reversible or
irreversible pathologies not only in the patient but also in
the clinician. These results have shown that instruments
of piezoelectric scalers were faster and caused rougher
surface than magnetostrictive instruments.
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Reza Molla et al www.ejournalofdentistry.com

Fig1: Tooth scaled with piezoelectric device. Fig4b: Tooth surface roughness under SEM: Roots treated
with magnetostrictive device.

Table1. Mean time taken to scale the areas and calculus at

difference groups.

Group Time (second) Retained calculus

Mean Standard Mean Standard

deviation deviation

Piezoelectric 216 52.05 23.34 13.03

Magnetostrictive 274.5 87.74 19.28 9.80

Fig2: Tooth scaled with magnetostrictive device.

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Source of Support : Nil, Conflict of Interest : Nil

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