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A COMPARISON SHOPPER’S GUIDE TO
ULTRASONIC SCALERS
We want you to know right up front that Parkell manufactures ultrasonic
scalers. We don’t pretend to be unbiased.
However, we believe that anything we can do to encourage dentists
and hygienists to shop around before they purchase, (to carefully
compare features, after-sale service, independent clinical evaluations)
will be to our advantage.
This short article contains information gleaned from manufacturers’
publications and research literature. We’ve tried like the
devil to make it as accurate and unbiased as possible, but the prudent
shopper will check our facts by calling the manufacturers at the
numbers listed below.
Decision #1: Do you want a sonic or ultrasonic
scaler?
Sonic scalers, like the Titan®, are small handpiece-size
devices. They sit conveniently in the delivery unit and hook up
to a conventional air/water handpiece connector. Research has shown
that the tip of a sonic scaler moves in an orbital pattern, tracing
the letter “O” as it vibrates at approximately 3000-9000
cycles per second.
Ultrasonic scalers involve a power-unit box that sits on the counter.
They must be connected to a water source and they plug into an electrical
wall outlet. Ultrasonics vibrate at much higher frequencies than
sonic scalers (25,000 cycles per second or higher.) The pattern
of vibration is much more linear than the sonic scaler, tracing
the letter “I” or a very narrow ellipse as it vibrates.
The primary difference between sonic and ultrasonic scalers is power.
The sonic scaler is a low-power device that removes plaque and fresh
calculus. However, it is not terribly effective on heavy calculus,
and it is useless on flinty old accretions that can be easily removed
with an ultrasonic scaler.
There is an additional advantage to the ultrasonic over sonic. High-frequency
ultrasonic tip vibration creates cavitation bubbles in the fluid.
When these bubbles contact a surface, they collapse and release
energy. Studies have suggested that the energy created by the collapsing
bubbles is sufficient to destroy a spirochaete cell membrane. In
other words, the ultrasonic spray itself may be lethal to the motile
pathogens frequently implicated in periodontal disease.
Though ultrasonic scalers are generally more expensive than sonic
scalers, there are some notable exceptions. For example as we write
this, the popular Titan S sonic scaler costs $548 in a mail order
catalog. As you can see in the table at the end, several ultrasonic
scalers feature price-tags lower than that.
If you want a sonic device, we suggest you call the suppliers below
for more information.
Suppliers of sonic scalers
(nation where manufactured in parentheses)
StarDental (USA) - 1-800-275-3320
MTI - 1-800-367-9290
KaVo America (Germany) - 1-888-528-6872
If you want an ultrasonic scaler, read on.
Decision #2: Do you want a Magnetostrictive
or Piezo Ultrasonic scaler?
In magnetostrictive devices (Cavitron®, Parkell,
Coltene) tip vibrations are created by a resonating stack of metal
strips on the back of the insert.*
In piezo devices (EMS, Parkell, Satelec, Amdent) the vibrations
are produced by oscillations of a quartz crystal in the handpiece.
Tip oscillation: For years, it has been generally believed
that piezo and magnetostrictive devices differ slightly in the pattern
traced by their tips. It is suggested that magnetostrictive tips
trace an elongated ellipse and piezo tips trace a linear back-and-forth
pattern.
Magnetostrictive advocates claim that their elliptical motion is
more effective because it generates pathogen-destroying cavitation
bubbles 360° around the tip. In contrast, the piezo design creates
them only at the two ends of their back-and-forth cycle.
Piezo advocates claim that their linear oscillation makes the piezo
design less likely to abrade the tooth.
If there is a difference in tip vibration between piezo and magnetostrictive
designs, it’s very subtle ... and probably without the clinical
importance we manufacturers ascribe to it.
From our work designing and manufacturing ultrasonics, the pattern
of tip oscillation appears to be influenced far more by the geometry
of the tip itself than by the design of scaler that powers it. For
example, “S” shaped tips like left- and right-curving
perio tips feature an elliptical vibration. But tips with a simple
curve, like the Cavitron TFI® and Parkell Universal
tip, are linear. In a paper presented at a recent research meeting,
independent researchers at the University of Kiel and the Max Planck
Institute reported that the vibration pattern of a magnetostrictive
scaler seemed virtually identical to that of a piezo scaler.1
But that isn’t to say there aren’t significant differences
between piezo and magnetostrictive scalers.
Heat: The metal stack in the magnetostrictive scaler generates
heat. To prevent overheating you must scale with plenty of water
irrigation. The quartz crystal in the piezo scaler doesn’t
generate much heat. This means you can run the device with very
little water irrigation. On the other hand, because the piezo handpiece
doesn’t heat the water, some patients may complain of cold
sensitivity.
Tip design: Most piezo scalers use proprietary tips designed
specifically for that specific brand of scaler. If the manufacturer
of your scaler doesn’t offer the tip shape you want ... or
if the scaler manufacturer goes out of business, you’re out
of luck.
Manufacturers of magnetostrictive scalers would like you to use
their inserts in their machines. But the fact is, virtually all
brands are interchangeable. Any 25KHz Parkell insert will work in
any 25KHz Cavitron scaler ... and vice versa. That means owners
of magnetostrictive scalers aren’t married to a single supplier
for their inserts.
Though piezo and magnetostrictive designs each have passionate advocates,
both do a fine job of calculus removal. When an independent research
association clinically rated every scaler available in the US, there
were piezo and magnetostrictive devices at the top of the rankings
... and at the bottom.
Moral: It’s not whether a scaler is magnetostrictive or piezo
that determines whether it’s effective, but rather the design
of the entire device.
Major suppliers of Magnetostrictive Scalers
(nation where manufactured in parentheses)
Parkell (USA) - 1-800-243-7446
Dentsply/Cavitron®(USA) - 1-800-989-8826
Coltene/Whaledent (USA) - 1-800-221-3046
Major suppliers of Piezo Scalers
(nation where manufactured in parentheses)
Parkell (USA) - 1-800-243-7446
EMS Electro Medical Systems
(Switzerland) - 1-800-367-0367
Amdent Biotrol (Sweden) - 1-800-822-8550
Amadent/Satelec (France) - 1-800-289-6367
Prodentec (USA) - 1-870-698-2300
Decision #3: If you want a magnetostrictive
scaler, do you want a 30KHz scaler or 25KHZ scaler?
The number of times the scaler tip vibrates each second is called
its “frequency.”
Most magnetostrictive scalers are either 25KHz (25,000 cycles per
second) or 30KHz (30,000 cycles per second.)
Studies have proven conclusively that there’s no real difference
in calculus-removing ability between the two frequencies. However,
30KHz scaling is somewhat quieter, so operators and patients tend
to prefer the higher 30KHz frequency.
Operating frequency is generally hard-wired into the scaler. For
example, the Cavitron SPS operates at 30KHz, and only at 30KHz.
(A 25KHz insert won’t even fit into the handle.)
On the other hand, if you stick a 30KHz insert into a 25KHz device
like the Cavitron Bobcat or the Parkell Autotune Clean Machine,
it’ll just spit water.
So if you upgrade from a 25KHz scaler to a pure 30KHz device like
the Cavitron SPS, you won’t be able to use your old 25KHz inserts.
The Parkell TurboSENSOR and Coltene Whaledent Biosonic power both
25KHz and 30KHz inserts. This allows you to use your old 25KHz inserts
in the new scaler, and then replace them with 30KHz inserts as they
wear out.
PURE 25KHz SCALERS
Clean Machine™ 25KHz - Parkell
Clean Machine™ Manual/Auto - Parkell
Cavitron Bobcat®- Dentsply
Cavitron Select™ - Dentsply
Acclean 25KHz - Schein
PURE 30KHz SCALERS
Cavitron®SPS™ - Dentsply
Clean Machine™ 30KHz - Parkell
Acclean 30KHz - Schein
Cavitron Select™ SPS - Dentsply
30KHz/25KHz COMBINATION
SCALERS
TurboSENSOR™ - Parkell
Turbo 25/30™ Two-Handpiece - Parkell
BioSonic™ - Whaledent
Decision #4: Do you want an auto-tune or manual-tune
scaler?
This question applies only to magnetostrictive designs and is relevant
only if you plan to do extensive low-power subgingival scaling.
Early ultrasonic scalers were all manually-tuned. When auto-tune
scalers were introduced in the late 1960’s, they pretty much
drove the manual-tune devices off the market. As a result, most
manually-tuned scalers are now made by specialty manufacturers catering
to a niche market.
Whether you want a manual-tune or auto-tune device will probably
depend on who your hygiene heros are, because this is one of those
controversial topics where the experts simply don’t agree.
Some lecturers in subgingival debridement believe that you get better
vibration at very low power settings if the scaler is slightly mistuned.
Since autotune scalers always perfectly tune to the insert’s
frequency, to mistune, you need a manual tune scaler.
Other lecturers respond that mistuning an ultrasonic scaler may
have made sense a number of years ago when manufacturers and operators
were concerned primarily with the high end of the power range. Back
then, the only way to get a scaler to operate at low power was to
take them out of tune.
But things are different today. Now that low-power subgingival scaling
has entered the hygiene mainstream, manufacturers are paying a lot
more attention to adjustability at the low-end of the power-spectrum.
In these lecturers’ opinion, self-tuning is just a needless
complication.
Parkell doesn’t have a dog in this fight. Or rather we have
two dogs. Our TurboSENSOR is autotune with a dramatically expanded
low-power range. But we also manufacture the Clean Machine Manual/Auto
scaler, a 25KHz device, that allows you to convert from auto-tune
mode to manual-tune mode by flipping a switch.
Suppliers of Manual Tune Scalers
Parkell - 1-800-243-7446
Ultrasonic Services, Ltd - 713-665-4949
Decision #5: Is autoclavability important
to you?
In this day of unspeakable diseases and heightened consumer awareness,
you might think that all scalers would automatically allow autoclaving.
But they don’t.
Allow autoclaving
TurboSENSOR™ - Parkell
Clean Machine™ Manual/Auto - Parkell
Turbo 25/30™ Dual Handpiece - Parkell
Cavitron®SPS™ - Dentsply
Cavitron Select™ SPS - Dentsply
Don’t allow autoclaving
Bobcat®- Dentsply
Cavitron®Select - Denstply
Biosonic® - Coltene/Whaledent
Acclean - Schein
Clean Machine™ - Parkell
TurboPIEZO™ - Parkell
What do current users say?
Manufacturers should be willing to give you names of people in your
area already using their device.
If the manufacturers can’t supply names, or if the names they
do supply aren’t in your area, it may suggest that there aren’t
many devices being used … or alternatively that the user is
a sponsored endorser.
When you talk to current users don’t just ask them how they
like their machine. Ask how long they’ve had it … How
frequently they use it … If they use other scalers as well,
ask how it compares. Also ask them about any problems they’ve
had. If their scaler has required servicing, find out how long it
took to get it repaired, and if the repair fixed the problem.
What kind of warranty?
Many shoppers never consider the warranty until their scaler requires
servicing. This is unfortunate, because manufacturers differ dramatically
in the coverage they offer.
For example, the Coltene BioSonic scaler and Dentsply Bobcat come
with a 1-year warranty ... about average for the industry.
The Cavitron SPS comes with a 2-year warranty. (But you can purchase
an extended warranty that’ll cover the scaler for an additional
2 years.)
All Parkell scalers come with a 5-year warranty on parts and labor.
Remember: The warranty never covers everything, so be sure to ask
what isn’t covered. The Parkell 5-year warranty covers everything
except the cables, hoses and handpiece. Those are all covered by
a one-year warranty. (The replaceable autoclavable sheath isn’t
covered at all.)
The handpiece is a scaler’s most vulnerable component. Coincidentally,
it’s generally covered by the shortest warranty. So when you’re
comparing warranties, be sure to ask specifically how long the handpiece
is covered.
By the way, most manufacturer warranties provide both parts and
labor. Some warranties, however, cover only the cost of parts. In
other words, you’ll still be charged for the labor. If it isn’t
absolutely clear from the promotional literature that the warranty
includes both parts AND labor, call the company and ask for a copy
of the warranty.
What if your scaler breaks down?
This is another topic that many don’t consider till it’s
too late.
Sooner or later, even the best ultrasonic scaler will require servicing.
There are three questions to ask.
Who will be repairing the device? As a rule, the repair will
be made by the manufacturer. But this should be clarified ... particularly
if the scaler is imported.
How long will the repair take? Fast repairs may not be all
that important if you rarely use your ultrasonic scaler or if you
practice in a large office with a number of ultrasonic scalers.
But if you only have one scaler and rely on it heavily, downtime
due to lengthy repairs can pose a serious problem.
97% of all Parkell ultrasonic repairs are on their way back to the
owner within 72 hours of arriving at our plant.
How much will the repair cost? The two most common repairs
for ultrasonic scalers are (1) replacement of the handpiece and
(2) an inability to shut off the water due to sediment in the solenoid.
For comparison sake, why not ask each supplier what these repairs
would cost.
Because of our extensive warranty, most Parkell repairs are performed
at no cost. If a scaler is out of warranty, installation of a new
TurboSENSOR handpiece will cost approximately $90 - a new TurboPIEZO
handpiece about $200. The charge to replace a solenoid that's clogged
with sediment is $90.**
Where can you go for independent information?
By far the best independent source for information about ultrasonic
scalers is Clinical Research Associates. Every five years or so,
they test all sonic and ultrasonic scalers on the market and publish
their ratings in their highly respected newsletter. They are absolutely
independent with no relationship at all with the manufacturers.
Clinical Research Associates
3707 N. Canyon Rd. Suite 6
Provo, UT 84604
801-226-2121
* The exception is the Odontoson® magnetostrictive
scaler which employs a vibrating ferrite rod instead of strips.
1 Menne AOL, et al. Vibration characteristics of oscillating scalers.
Jour Dent Res. 73:Spec, Abstr. #2661, p434, Mar 94
** Obviously, these are the current charges as
we write this. They may change with time.
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