A2 HYGIENE TRIBUNE Dental Tribune Middle East & Africa Edition | 5/2021 User report – Proxeo Twist Cordless: Making prophylaxis fun By Monika Riedl, Germany Rotary polishing for removal of plaque and stains According to the Consensus Report published by the European Federa- tion for Periodontology (EFP), in ad- dition to daily oral hygiene at home, professional mechanical plaque re- moval (PMPR) represents one of the most important prophylactic meas- ures in the prevention of gingivitis and subsequent periodontitis/peri- implantitis. PMPR can, for example, be performed with motor-driven, ro- tary instruments1. PMPR also forms the basis for successful periodontal or peri-implant therapy2. According to dental hygienist Mon- ika Riedl, in addition to the removal of supra- und subgingival calculus and stains, biofilm management and the maintenance of surface smooth- ness are of the utmost importance. In her opinion, good and clean pol- ishing of the surfaces is one of the most important working steps in a prophylaxis session. “In addition, the polishing is often the most comfort- able 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. levels of the polishing cups allow me to tailor my work to the specific pa- tient situation. The transparent de- sign of the disposable prophy hand- pieces gives a hygienic impression (see figures 1 and 2). Good adaptation and simple han- dling “In my experience, air-powder pol- ishers often don’t remove very cal- cified, 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 com- pletely, 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 inva- sive for the patient. For my patients and especially those with thin gin- givae, 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 re- gion, 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 ma- terial displays a consistently high quality. The nubs on the outside reduce splattering of the paste (see figure 2). The two different hardness Optimal speeds of 1,250 to 2,500 rpm – such as seen with the new Proxeo TWIST Cordless – also permit mini- mally invasive treatment,” Monika Riedl declares. The optimal speed for rotary polish- ing recommended in dental educa- tion and in the international litera- ture is max. 3,000 rpm3. 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 hand- piece. The design is simple and per- fectly adapted to the requirements of day-to-day prophylactic polish- ing tasks. The operating function is controlled via a traffic light system and easy to understand. The battery performance poses no need for con- cern either: one charge of the Li-Ion battery is easily enough for 8-12 pa- tients.” The cordless foot control has a battery life of approx. two months. Monika Riedl particularly appreci- ates the fast and problem-free Blue- tooth communication between the foot control and the Cordless system as well as the fact that they do not in- terfere 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 re- sult. The new Proxeo TWIST Cordless PL-40 H, which was developed in col- laboration 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 ex- perienced 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 hand- piece’s cord is often too short and usually in the way between the pa- tient and hygienist... Switching treatment rooms is also no problem with the new Cordless. The flexible rotatability due to omis- sion 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 Fig. 1: The adaptation of the polishing cups to the tooth surface is very good and the thin, nubless edges of the cups render the cleaning of the sulcus region comfortable. The transparent design of the disposable prophy handpieces gives an hygienic impression. Fig. 2: The cups also reach the interdental spaces and the nubs simultaneously clean ad- jacent teeth and diminish splattering of the paste. Fig. 3: The low weight, ergonomically shaped Cordless is comfortable to hold and allows movements without tensile stress from cables. Fig. 4: Also hard-to-reach areas such as tubers, molars and the line angle region can be accessed well. has improved my polishing results, and the polishing itself is even more fun than it was before,” adds Monika Riedl. “The hygienic requirements for re- processing of the instruments are also satisfied efficiently and simply: the disposable prophy angle can be changed quickly and easily and dis- posed of without any problems. The remaining drive handpiece can be reprocessed rapidly with wipe dis- infection for the next use. Plus, the handpiece sleeve can be sterilised if and as needed,” Monika Riedl de- clares. 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 pol- ishing and it is far and away my favourite polishing tool. It reduces signs of fatigue and pain for the hy- gienist, allows reliable work at any lo- cation, satisfies all the requirements on hygiene and also offers good ac- cessibility to hard-to-reach areas in the patient’s mouth. I can really only recommend the Proxeo TWIST Cord- less to anyone who works in prophy- laxis and polishes regularly! It makes prophylaxis even more fun and even easier!” References 1. Tonetti MS, Eickholz P, Loos BG, Pa- papanou P, van der Velden U, Armit- age 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 Europe- an workshop on periodontology on effective prevention of periodontal and peri-implant diseases. J Clin Peri- odontol 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 con- sensus 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. About the author: Monika Riedl, Germany Dental hygienist Monika Riedl is passion- ate about her work and has been giving 100% for around 30 hours a week for more than twelve years to ensure her patients leave the practice with dazzling smiles. The specialist in prophylactic den- tal hygiene, periodontal and conservative treatment occupies a managerial posi- tion in a practice in Munich and was in- strumental in the establishment and de- velopment of its prophylaxis department with complex periodontal treatment programmes. In addition, she was also in- volved in the development of prophylaxis training programmes and has already personally hosted a number of sessions. She has given over 50 talks across Ger- many and participated in the production of around 35 short educational films on oral hygiene.