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PRESENTATION BY:
Mohamed Abdul Haleem
1st Year Perio PG
KVG Dental college & Hospital, Sullia
CONTENTS
 Introduction
 Parts of Instruments
 Classification
 Diagnostic
 Periodontal probes
 Explorers
 Scaling an...
Introduction
 Periodontal instruments are designed for specific
purposes….
 such as…
 Removing calculus
 Planing root ...
Parts of Instruments
 Periodontal instrument is composed of:
 Blade
 Shank
 Handle
Classification of Periodontal Instruments
 Diagnostic
 Periodontal probes
 Explorers
 Scaling and Curettage
 For supr...
Periodontal probes
 A typical probe is a tapered
rod-like instrument
calibrated in millimeters
with a blunt, rounded tip....
• When measuring a
pocket, the probe is
inserted with a firm gentle
pressure to the base of the
pocket.
•The shank should ...
Types of periodontal probes
 CoIor-coded
 Noncolor-coded
 The Marquis color-coded probe:
 The calibrations are in 3 mi...
The UNC-15 probe:
 It Is a 15 mm long probe
 Color coding at the 5th, 10th, and 15th mm.
Williams probe:
 Has both color and non-color coding
 Markings at 1,2,3,5,7,8,9 and 10 mm
The Michigan “O” probe
 The Michigan “O” probe with Williams markings :At 1,
2, 3,5,7,8,9,10 mm (4 and 6 are missing)
 T...
The WHO probe:
 It has a 0.5 mm ball at the tip
 Millimeter marking at 3.5, 8.5 and 11.5 mm
 Color coding from 3.5 to 5...
Explorers
 Used to…
 Locate subgingival deposits in
various areas
 Check the smoothness of the
root surfaces after root...
Scaling and Curettage Instruments
(For supragingival scaling)
Sickle scalers:
 have a flat surface and two cutting edges ...
The Morse sickle
 Has a very small, miniature blade
 Useful in the mandibular, anterior
area where there is narrow,
inte...
Curettes
(For subgingival scaling)
 Instrument of choice for…
 Removing deep subgingival calculus
 Removing Altered cem...
REMOVAL OF SOFT TISSUE LINING THE PERIODONTAL
POCKET.
 Subgingival curettes can be adapted to provide good
access to deep pockets, with minimal soft tissue
trauma.
 There are cutting edges on both
sides of the blade.
 The curved blade and rounded
toe of the curette allows the
blade t...
Types of curettes
 There are two basic types of curettes.
 Universal curettes
 Barnhart curettes # 1-2 and 5-6
 Columb...
Difference between Gracey and
universal curettes
Gracey curette
 Set of many curettes
designed for specific
areas and sur...
Cleaning and polishing Instruments
 Rubber cups:
 They consist of a rubber shell with or without
configuration in the ho...
Bristle brushes:
 Available in wheel and cup shapes
 Used in hand piece with a polishing paste
Dental tape:
 Used with a polishing paste for polishing proximal
surfaces that are inaccessible to other polishing
instru...
Air powder polishing:
 A specially designed hand piece that delivers air powdered
slurry of warm water and sodium bicarbo...
Contraindications:
 Respiratory illness
 Hypertension
 Patients on medications affecting the
electrolyte balance
Disadv...
Surgical Instruments
Excisional and incisional instruments:
 Periodontal knives (Gingivectomy knives); Example
Kirkland k...
 Interdental knives:
Example, Orban knife
#1-2, Merrifield knife
#1,2,3 and 4
 Surgical blades: Example, #
12D, 15 and I...
 Electrosurgery techniques and instrumentation:
 Electrosection used for incisions, excisions and tissue planing.
 Elec...
 Electrofulguration, is a procedure to destroy and
remove tissue (such as a malignant tumor) using a
high-frequency elect...
 Electrodesiccation denatures a layer of the dermis
and the curette is then used over the surgical ulcer to
remove denatu...
Surgical curettes and sickles:
 Required for removal of …
 Granulation tissue
 Fibrous interdental tissue
 Tenacious s...
Periosteal elevators:
 Necessary to reflect and
move the flap after the
incision has been made for
flap surgery.
 Exampl...
Surgical chisels and hoes:
 Used during periodontal surgery for removing and
reshaping bone.
 Chisels are used with a pu...
Surgical files:
 They are used primarily to smoothen rough, bony,
ledges and to remove all areas of necrotic bone.
 Exam...
Scissors and nippers:
 Used for…
 Removing tags of tissue during gingivectomy
 Trimming the margins of flaps
 Enlargin...
Needle holders:
 They are used to suture
the flap at the desired
position.
 Example: Castroviejo
needle holder.
Ultrasonic and Sonic Instruments
 Used for removing plaque, scaling, curetting and
removing stains.
Types of ultrasonic units
 Two types of ultrasonic units are there:
 Magnetostrictive:
 Vibration of the tip is ellipti...
Periodontal Endoscope
 It is used subgingivally…. in the diagnosis and treatment of
periodontal diseases.
 Called as the...
 The fiber optic endoscope fits onto the periodontal probes and
ultrasonic instruments that have been designed to accept ...
Miscellaneous
Schwartz periotreivers:
 Set of two double- ended, highly-magnetized
instruments
 designed for the retriev...
Plastic instruments for implants:
 Rather than metal, Plastic instruments should be
used… to avoid scarring and permanent...
Hoe scalers:
 Used for scaling ledges or rings of calculus.
 The blade is bent at a 99-degree angle
 The cutting edge i...
 used in the following manner:-
 The blade is inserted to the base of the periodontal
pocket, so that it makes a two poi...
Files:
 They have a series of blades on a base.
 Their primary function is to fracture or
crush tenacious calculus.
 Fi...
Chisel scalers:
 Usually used in the too
closely spaced proximal
surfaces of anterior teeth
 It is a double-ended
instru...
Classification of periodontal instruments
Classification of periodontal instruments
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Classification of periodontal instruments

Classification of periodontal instruments

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Classification of periodontal instruments

  1. 1. PRESENTATION BY: Mohamed Abdul Haleem 1st Year Perio PG KVG Dental college & Hospital, Sullia
  2. 2. CONTENTS  Introduction  Parts of Instruments  Classification  Diagnostic  Periodontal probes  Explorers  Scaling and Curettage  For supragingival scaling  For subgingival scaling  Cleaning and polishing Instruments  Surgical Instruments  Periodontal Endoscope  Ultrasonic and Sonic Instruments  Miscellaneous  Schwartz periotreivers  Plastic instruments for implants  Hoe scalers  Files  Chisel scaler
  3. 3. Introduction  Periodontal instruments are designed for specific purposes….  such as…  Removing calculus  Planing root surfaces  Curetting the gingival wall  Removing diseased tissue.
  4. 4. Parts of Instruments  Periodontal instrument is composed of:  Blade  Shank  Handle
  5. 5. Classification of Periodontal Instruments  Diagnostic  Periodontal probes  Explorers  Scaling and Curettage  For supragingival scaling  For subgingival scaling  Cleaning and polishing Instruments  Surgical Instruments  Periodontal Endoscope  Ultrasonic and Sonic Instruments
  6. 6. Periodontal probes  A typical probe is a tapered rod-like instrument calibrated in millimeters with a blunt, rounded tip. • Periodontal probes are used to locate, measure and mark pockets.
  7. 7. • When measuring a pocket, the probe is inserted with a firm gentle pressure to the base of the pocket. •The shank should be aligned with the long axis of the tooth.
  8. 8. Types of periodontal probes  CoIor-coded  Noncolor-coded  The Marquis color-coded probe:  The calibrations are in 3 millimeter sections
  9. 9. The UNC-15 probe:  It Is a 15 mm long probe  Color coding at the 5th, 10th, and 15th mm.
  10. 10. Williams probe:  Has both color and non-color coding  Markings at 1,2,3,5,7,8,9 and 10 mm
  11. 11. The Michigan “O” probe  The Michigan “O” probe with Williams markings :At 1, 2, 3,5,7,8,9,10 mm (4 and 6 are missing)  The Michigan “O” probe with markings: At 3, 6, and 8 mm.
  12. 12. The WHO probe:  It has a 0.5 mm ball at the tip  Millimeter marking at 3.5, 8.5 and 11.5 mm  Color coding from 3.5 to 5.5 mm
  13. 13. Explorers  Used to…  Locate subgingival deposits in various areas  Check the smoothness of the root surfaces after root planing  Designed with different shapes and angles for a variety of use according to its needs.
  14. 14. Scaling and Curettage Instruments (For supragingival scaling) Sickle scalers:  have a flat surface and two cutting edges that converge in a sharply-pointed tip.  The arch-shape of the instrument makes the tip so strong that it will not break off during use.  They appear triangular in cross-section.  The sickle scaler is inserted under ledges of calculus no more than 1 mm below the gingival sulcus.  It is used with a pull stroke.
  15. 15. The Morse sickle  Has a very small, miniature blade  Useful in the mandibular, anterior area where there is narrow, interproximal space.  Sickles with straight shanks are designed for use on anterior teeth and premolars,  Sickle scalers with contra-angled shanks adapt to posterior teeth.
  16. 16. Curettes (For subgingival scaling)  Instrument of choice for…  Removing deep subgingival calculus  Removing Altered cementum  Root planing  Removing the soft tissue lining the periodontal pocket.
  17. 17. REMOVAL OF SOFT TISSUE LINING THE PERIODONTAL POCKET.
  18. 18.  Subgingival curettes can be adapted to provide good access to deep pockets, with minimal soft tissue trauma.
  19. 19.  There are cutting edges on both sides of the blade.  The curved blade and rounded toe of the curette allows the blade to adapt better to the root surface.  In cross- section the blade appears to be semicircular with a convex base.
  20. 20. Types of curettes  There are two basic types of curettes.  Universal curettes  Barnhart curettes # 1-2 and 5-6  Columbia curettes # 13 -14, 2R-2L and 4R-4L  Area-specific curettes  Gracey curettes  Double-ended Gracey curettes  Extended shank curettes / After Five Curettes  Mini-bladed curettes  Langer and mini langer curettes
  21. 21. Difference between Gracey and universal curettes Gracey curette  Set of many curettes designed for specific areas and surfaces.  One cutting edge used, work is done with the outer edge only  Curved in 2 planes blade curves up and to the side  Offset blade, face of blade beveled at 60 degrees to the shank Universal curette  One curette designed for ail areas and surfaces  Both cutting edges used, work is done with outer or inner edge  Curved in one plane blades curves up and not to the side  Not offset, face of blade beveled at 90 degrees to the shank. Area of use Cutting edge Curvature Blade angle
  22. 22. Cleaning and polishing Instruments  Rubber cups:  They consist of a rubber shell with or without configuration in the hollow interiors.  They are used in the hand piece with a specific angle.  A good cleansing and polishing paste that contains fluoride should be used.
  23. 23. Bristle brushes:  Available in wheel and cup shapes  Used in hand piece with a polishing paste
  24. 24. Dental tape:  Used with a polishing paste for polishing proximal surfaces that are inaccessible to other polishing instruments.
  25. 25. Air powder polishing:  A specially designed hand piece that delivers air powdered slurry of warm water and sodium bicarbonate.  This instrument is called prophy- jet.  Effective for the removal of extrinsic stains and soft deposits.
  26. 26. Contraindications:  Respiratory illness  Hypertension  Patients on medications affecting the electrolyte balance Disadvantages:  Tooth substance can be lost  Damage to gingival tissue  Amalgam , composite resins and cements can be roughened
  27. 27. Surgical Instruments Excisional and incisional instruments:  Periodontal knives (Gingivectomy knives); Example Kirkland knife
  28. 28.  Interdental knives: Example, Orban knife #1-2, Merrifield knife #1,2,3 and 4  Surgical blades: Example, # 12D, 15 and ISC.
  29. 29.  Electrosurgery techniques and instrumentation:  Electrosection used for incisions, excisions and tissue planing.  Electrocoagulation, coagulation or hemorrhage control  Eceltrofulguration not in general use in dentistry  Electrodessication not in general use in dentistry
  30. 30.  Electrofulguration, is a procedure to destroy and remove tissue (such as a malignant tumor) using a high-frequency electric current applied with a needlelike electrode
  31. 31.  Electrodesiccation denatures a layer of the dermis and the curette is then used over the surgical ulcer to remove denatured dermis over the living tissue.  Used in treatment of basal cell cancers and squamous cell cancers of the skin.
  32. 32. Surgical curettes and sickles:  Required for removal of …  Granulation tissue  Fibrous interdental tissue  Tenacious subgingival deposits.  Examples:  Kramer curettes # 1, 2, 3 and Langer curettes.  Kirkland surgical instruments.  Ball scaler # B2-B3.
  33. 33. Periosteal elevators:  Necessary to reflect and move the flap after the incision has been made for flap surgery.  Example: Goldman Fox #14.
  34. 34. Surgical chisels and hoes:  Used during periodontal surgery for removing and reshaping bone.  Chisels are used with a push stroke whereas surgical hoes are used with a pull stroke.  Example: Rhodes chisel.Ochsenbein #1-2, chisel.
  35. 35. Surgical files:  They are used primarily to smoothen rough, bony, ledges and to remove all areas of necrotic bone.  Example: Schluger and Sugarman files.
  36. 36. Scissors and nippers:  Used for…  Removing tags of tissue during gingivectomy  Trimming the margins of flaps  Enlarging incisions in periodontal abscesses  Removing muscle attachments in mucogingival surgery  Example: Goldman - Fox # 16 scissors.
  37. 37. Needle holders:  They are used to suture the flap at the desired position.  Example: Castroviejo needle holder.
  38. 38. Ultrasonic and Sonic Instruments  Used for removing plaque, scaling, curetting and removing stains.
  39. 39. Types of ultrasonic units  Two types of ultrasonic units are there:  Magnetostrictive:  Vibration of the tip is elliptical.  Hence all the sides can be used.  Piezo-electric:  Pattern of vibration of the tip is linear  Only two sides of the tip are active.  Ultrasonic vibrations range from 20,000 to 45,000 cycles/second. They operate In a wet field and have attached water outlets.
  40. 40. Periodontal Endoscope  It is used subgingivally…. in the diagnosis and treatment of periodontal diseases.  Called as the perioscopy system.  It consists of re-usable fiber optic endoscope, over which there is a sterile sheath.
  41. 41.  The fiber optic endoscope fits onto the periodontal probes and ultrasonic instruments that have been designed to accept it.  The sheath delivers water for irrigation that flushes the pocket while the endoscope is in use, and it keeps the field clear.  This device allows clear visualization, subgingivatly, in deep pockets and in furcations.  It enables the operator to detect the presence and location of subgingival deposits and guides the operator in their thorough removal.  Using this device it is possible to achieve levels of root debridement and cleanliness that are much more difficult to produce without it.
  42. 42. Miscellaneous Schwartz periotreivers:  Set of two double- ended, highly-magnetized instruments  designed for the retrieval of broken instrument tips from the periodontal pocket.
  43. 43. Plastic instruments for implants:  Rather than metal, Plastic instruments should be used… to avoid scarring and permanent damage to the implants.
  44. 44. Hoe scalers:  Used for scaling ledges or rings of calculus.  The blade is bent at a 99-degree angle  The cutting edge is beveled at 45 degrees.
  45. 45.  used in the following manner:-  The blade is inserted to the base of the periodontal pocket, so that it makes a two point contact with the tooth.  This stabilizes the instrument and prevents nicking of the tooth.  The instrument is activated with a firm pull stroke towards the crown, with every effort being made to preserve the two point contact with the tooth.  Me. Cafis Hoe scalers # 3, 4.5.6.7 and 8 are a set of six Hoe scalers designed to provide access to aLl the tooth surfaces
  46. 46. Files:  They have a series of blades on a base.  Their primary function is to fracture or crush tenacious calculus.  Files can easily gouge and roughen root surfaces when used improperly.  Therefore they are not suitable for fine scaling and root planing.  They are sometimes used for removing overhanging margins of dental restorations.
  47. 47. Chisel scalers:  Usually used in the too closely spaced proximal surfaces of anterior teeth  It is a double-ended instrument with a curved shank at one end and a straight shank at the other.  The instrument is activated with a push motion.

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