Calculus removal from multirooted teeth with and without surgical access

Abstract The purpose of this study was to evaluate the efficacy of the calculus removal from multirooted teeth after closed root planing, open root planing and use of a rotary diamond for the furcation area. The effect of pocket depth on the effectiveness of calculus removal was also examined. 30 first and second lower molars scheduled for extraction, with a calculus index 2 and a degree II or III furcation involvement, were divided into 3 groups: 10 molars were scaled and root planed using a closed approach; 10 molars were scaled and root planed using an open approach; 10 molars were scaled and root planed with an open approach and rotary diamond was used for removal of deposits in the furcation area. After extraction, the teeth were assessed in a stereomicroscope and the % of residual calculus was calculated on external and furcation surfaces. The % of residual calculus on the external surfaces was significantly higher after closed than open root planing (p=0.002). Pocket depth affected the effectiveness of scaling and root planing, with more residual calculus observed for depths 7 mm for both groups. Differences between the 3 groups in the % of residual calculus on furcation surfaces were statistically significant (p<0.0001 and p<0.0005). The most effective method was the combination of open root planing and rotary diamond. More calculus was observed in all groups for pocket depths 7 mm but the difference was significant only in the closed group (p=0.006). Closed root planing left more surfaces with residual calculus in the flute (70%) and the roof (60%) of the furcation than open root planing (35% and 50%). However, the most effective method was the use of rotary diamond, particularly for the flute area where residual calculus was detected on only 5% of the surfaces.