Dental Asia May/June 2021

User Report
In addition, root caries was diagnosed at a
number of points. The patient has now been
attending recall appointments with me regularly
since 2014.
GENTLE REMOVAL OF PLAQUE
AND BIOFILM TO MAINTAIN THE
PERIODONTAL SITUATION
Periodontal therapy comprises a number of
different steps. Following the examination and
evaluation of the indicated findings, the patient
is briefed with the decision taken about the
treatment and treatment goals.
The patient’s motivation to perform oral
hygiene measures at home is decisive. If the
findings require it, the patient’s dentist is also
involved. The patient’s wishes are also decisive
for the type of treatment, but the primary goal
is always preservation of the dentition and
masticatory function.
My patients can expect professional
treatment that is both painless and complete
and in no way superficial. This is done so with
high-quality devices and instruments to help
satisfy these requirements.
In this case, the Tigon+ allows extensive and
atraumatic removal of the biofilm and flushing
of the pockets while still being relatively
comfortable for the patient.
Prior to 2016, the treatment in the recall
appointment involved deep scaling using
electronic and hand instruments (Gracey
curettes), which was painful for the patient.
In addition, hand instruments cannot reach
the bottom of the pockets. As such, the
treatment in the recall appointments was
always a great challenge for the patient and
treatment provider alike.
Figure 1 shows the periodontal improvement
since treatment with the Tigon+ was initiated.
MORE COMFORTABLE TREATMENT
CONTRIBUTES TO BETTER RECALL
COMPLIANCE
The excellent accessibility thanks to the long,
slender 1P tip and possibility of adjusting the
power setting makes it possible to clean the
biofilm out of the deep pockets and flush
them carefully (Fig. 2).
A control algorithm for the Tigon+ tip’s
oscillating system specific to W&H allows
the frequency to be adjusted to reflect the
external conditions.
The frequency of the oscillations is adjusted
continuously depending on the pressure,
water supply and other factors, which allows
much finer determination of the frequency.
Following the diagnosis, briefing and
discussion, hard and soft deposits are removed
carefully and gently. This is done by means of
supragingival and, if necessary, subgingival
scaling in the active, deep pockets using
electronic and hand instruments.
The combination of electronic and hand
instruments allows optimal and complete
biofilm and plaque management. The treatment
is concluded with final polishing with a
polishing compound for removal of the biofilm
and any persistent stains.
In my opinion, this is both a decisive and
intrinsic part of the treatment and an agreeable
treatment step for the patient.
The pleasant feeling in the mouth motivates
most patients to keep up oral hygiene measures
at home following their recall appointment,
maintain the stability of the periodontal
situation and to prevent the appearance of
carious lesions.
As patients with periodontal disease often
present with exposed tooth necks, it is essential
to remove hard and soft deposits as gently as
possible.
This patient was treated with the Tigon+ for
the first time in August 2016 and reported
considerably less pain during treatment.
Cleaning and flushing the pockets, which
is atraumatic for the hard and soft tissues
but still effective with the water heated to
around body temperature and the frequency
of the Tigon+, which is perceived as pleasant,
represent a considerable added value for the
patient.
The gentle and more relaxed treatment has
a positive effect on the BOP and the active
pockets are reduced.
International literature confirms BOP as a
clinical indicator for the progression and
stability of periodontal disease 3 .
It has been shown that an increase in the
number of BOP points is linked to recession
of the periodontium and an elevated risk of a
periodontal collapse 4,5,6 , whereas an absence
of BOP is an indicator of periodontal stability 7, 8 .
The pocket depth, which is directly related to
the bleeding on probing 4 , is connected to the
periodontal stability. The periodontal chart in
The patient says that the frequency
adaptation and the heated water are
Fig. 1: The BOP ratio has decreased considerably
since August 2016. Whereas 18% of all measurements
displayed bleeding on probing at the start of the
treatment on 22.08.2016, the figure is just 5% almost
two years later
DENTAL ASIA MAY / JUNE 2021 47