The removal of calculus and plaque after having dental implants with an ultrasonic scaler, especially during a deep cleaning (also called a scale and root plane) can cause significant damage to dental implant hardware. However, managing plaque and calculus build up becomes even more important after having dental implant surgery. Periodontal disease (gum disease) can cause implant failure similar to how a natural tooth will become loose after untreated periodontal disease begins to destroy the underlying bone. A 1994 study revealed that when ultrasonic scalers are coated in Teflon, the same damage does not occur to plastic implant curettes or smooth titanium surfaces. On rough implant surfaces, however, instrument material residue was discovered. The study determined that coating ultrasonic and sonic scaler tips with Teflon material (also called a Teflon scaler) enables dental professionals to use high-frequency tools to professionally clean dental implants without significant damage.