The removal of root surface deposits.

The importance of adequate root surface instrumentation has received increasing emphasis. The purpose of this study was to determine the extent to which root planning could produce surfaces free of stainable deposits. Initial laboratory investigations on extracted, periodontally involved roots demonstrated that after meticulous root preparation, totally non-stainable surfaces could be obtained. These surfaces were shown to consist of either thin cementum or dentine. The efficacy of instrumenting periodontally involved buccal root surfaces on the anterior teeth of 33 patients, undergoing routine periodontal flap surgery was then evaluated. Root surfaces were instrumented either before or after the reflection of surgical flaps. Remaining bacterial deposits were disclosed with a gentian violet solution and the root surfaces then photographed. Further root planing, disclosure and photography were then carried out. These photographic slides were analysed for stainable deposits on the root surfaces using an image analysis system, based on densitometric principles, to measure the areas of stainable root surface deposits. The findings revealed that root planning under direct vision at the time of surgery was more effective than blind instrumentation. However, in no instance was any root surface found to be completely free of stainable deposits.