User report - Proxeo Twist Cordless: Making prophylaxis fun

Monika Riedl
* first published in Prophylaxe Journal 3/2019, page 18-20

Rotary polishing for removal of plaque and stains

According to the Consensus Report published by the European Federation for Periodontology (EFP), in addition to daily oral hygiene at home, professional mechanical plaque removal (PMPR) represents one of the most important prophylactic measures in the prevention of gingivitis and subsequent periodontitis/periimplantitis. PMPR can, for example, be performed with motor-driven, rotary instruments [1]. PMPR also forms the basis for successful periodontal or peri-implant therapy [2].

According to dental hygienist Monika Riedl, in addition to the removal of supra- und subgingival calculus and stains, biofilm management and the maintenance of surface smoothness are of the utmost importance. In her opinion, good and clean polishing of the surfaces is one of the most important working steps in a prophylaxis session. “In addition, the polishing is often the most comfortable working step of the prophylaxis session for the patients, as it leaves them with a pleasant feeling in their mouths: everything feels clean, fresh and smooth. The polishing, removal of stains and smoothing of the surfaces of the teeth following the prophylaxis session are some of my favourite tasks when treating the patients,” the dental hygienist from Munich explains.

A number of options are available today for polishing: with air-powder systems or contra-angle handpieces and plastic rotary prophy cups or brushes, also referred to as rotary polishing.

Good adaptation and simple handling

“In my experience, air-powder polishers often don’t remove very calcified, adhesive biofilm completely, so it is usually necessary to polish subsequently with a rotary polishing system. In other words, we can never get away from rotary polishing completely, and it should be seen as an important complement to powder jet devices. Among other things, low-abrasive polishing pastes and soft, adaptable Prophy cups and brushes make the process minimally invasive for the patient. For my patients and especially those with thin gingivae, cleaning with the new Proxeo TWIST Cordless and the disposable Prophy angle with cup in the sulcus is considerably more comfortable, as the edges of the cups are thinner. The adaptation of the polishing cups to the tooth surface, the sulcus region, the interdental spaces and the difficult-to-reach areas is very good (see figures 1 and 2).

In addition, the Prophy Cups are very hardy, stable, do not fray and the material displays a consistently high quality. The nubs on the outside reduce splattering of the paste (see figure 2). The two different hardness levels of the polishing cups allow me to tailor my work to the specific patient situation. The transparent design of the disposable prophy handpieces gives a hygienic impression (see figures 1 and 2).

Optimal speeds of 1,250 to 2,500 revolutions per minute (rpm) – such as seen with the new Proxeo TWIST Cordless – also permit minimally invasive treatment,” Monika Riedl declares.
The optimal speed for rotary polishing recommended in dental education and in the international literature is max. 3,000 rpm [3]. The device maintains the speed automatically, which is extremely user-friendly and renders additional control options on the device unnecessary.

The dental hygienist confirmes: “The Proxeo TWIST Cordless can be easily controlled via a cordless foot control and an on/off switch on the handpiece. The design is simple and perfectly adapted to the requirements of day-to-day prophylactic polishing tasks. The operating function is controlled via a traffic light system and easy to understand. The battery performance poses no need for concern either: one charge of the Li-Ion battery is easily enough for 8-12 patients.” The cordless foot control has a battery life of approx. two months. Monika Riedl particularly appreciates the fast and problem-free Bluetooth communication between the foot control and the Cordless system as well as the fact that they do not interfere with other technical devices and instruments in the practice.

Cordless design offers flexibility and user-friendliness

“Good polishing takes about ten minutes,” the dental hygienist says. A low weight and ergonomic design are very important to the hygienist and ultimately also have a positive effect on the patient’s polishing result. The new Proxeo TWIST Cordless PL-40 H, which was developed in collaboration with dental hygienists, weighs just 110 grams, making it half as heavy as a contra-angle handpiece with electric motor, plus it sits well in the hand. This minimises signs of wrist fatigue. “The cordless Proxeo TWIST eliminates the unpleasant pain due to stress and strain usually caused by the tensile loading exerted by a cable (see figure 3),” says the experienced dental hygienist happily. “Compared with earlier, I now notice considerably fewer signs of fatigue in my shoulder. As we all know in the practice, the contra-angle handpiece’s cord is often too short and usually in the way between the patient and hygienist...

Switching treatment rooms is also no problem with the new Cordless. The flexible rotatability due to omission of the cord and the small head of the disposable prophy angle allow comfortable access to hard-to-reach areas such as tubers, molars and line angle region (see figure 4). This has improved my polishing results, and the polishing itself is even more fun than it was before,” adds Monika Riedl.

“The hygienic requirements for reprocessing of the instruments are also satisfied efficiently and simply: the disposable prophy angle can be changed quickly and easily and disposed of without any problems. The remaining drive handpiece can be reprocessed rapidly with wipe disinfection for the next use. Plus, the handpiece sleeve can be sterilised if and as needed,” Monika Riedl declares.

The dental hygienist from Munich is convinced: “I have been using the Proxeo TWIST Cordless in the scope of a long-term product test for polishing and it is far and away my favourite polishing tool. It reduces signs of fatigue and pain for the hygienist, allows reliable work at any location, satisfies all the requirements on hygiene and also offers good accessibility to hard-to-reach areas in the patient’s mouth. I can really only recommend the Proxeo TWIST Cordless to anyone who works in prophylaxis and polishes regularly! It makes prophylaxis even more fun and even easier!”

References

1. Tonetti MS, Eickholz P, Loos BG, Papapanou P, van der Velden U, Armitage G, Bouchard P, Deinzer R, Dietrich T, Hughes F, Kocher T, Lang NP, Lopez R, Needleman I, Newton T, Nibali L , Pretzl B, Ramseier C, Sanz-Sanchez I, Schlagenhauf U, Suvan JE, Fabrikant E, Fundak A. Principles in prevention of periodontal diseases–Consensus report of group 1 of the 11th European workshop on periodontology on effective prevention of periodontal and peri-implant diseases. J Clin Periodontol 2015;42 (Suppl. 16):5–11.
2. Tonetti MS, Chapple ILC, Jepsen S, Sanz M. Primary and secondary prevention of periodontal and peri-implant diseases–Introduction to, and objectives of the 11th European workshop on periodontology consensus conference. J Clin Periodontol 2015;42 (Suppl. 16):1–4.
3. Rethman J. Polishing angles, cups and pastes. Pract Hyg. 1997;1:32–9. Retraction in: Madan C, Bains R, Bains VK. Tooth polishing: Relevance in present day periodontal practice. J Indian Soc Periodontol 2009;13:58-9.