The patients were instructed to report if any discomfort was felt during each treatment and 1 week after all treatment procedures. The adverse effects associated were as follows: (1) postoperative pain and dentinal hypersensitivity; (2) staining of tooth surfaces associated with medication; (3) subgingival emphysema related to the new-type scaler tip, which might manifest as noticeable swelling and crepitus of soft tissues; (4) fracture of the new-type scaler tip, which was monitored by checking post-treatment length and shape changes with the customized alginate impression of each labeled tip.

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