In addition to the safe and efficient removal of hard and soft deposits, ultrasonic instruments also detoxify the areas being treated. The lavage or acoustic streaming that occurs simultaneously when treating with ultrasonic scalers causes a constant flushing action, removing loosened debris and bacterial biofilm from the area. Cavitation is created when the vibrating tip comes in contact with the fluid and forms millions of bubbles. When the bubbles implode, they produce shock waves or bursts of energy in the liquid, tearing apart the cell wall of the pathogens. This shifts the subgingival environment through elimination of the microbiology, essentially detoxifying the pocket.
There is also some evidence that the heat generated during ultrasonic scaling with magnetostrictive in particular, may contribute to detoxifying the pocket. Additionally, cavitation combined with acoustic turbulence reaches root surfaces beyond where the tip has physical contact with the tooth. In other words, a halo effect occurs reaching additional pathogens through both of these mechanisms.3,4
Another distinct advantage of ultrasonics over hand scaling is the efficient removal of the smear layer. Scaling the root surface not only leaves a smear layer behind, but bacteria may be also “forced” into the tubules by the action of the scaler as it moves across the surface.8,9 The ultrasonic, by way of acoustic streaming, cavitation, and acoustic turbulence, literally “power washes” the root surface, eliminating the smear layer entirely.