3. 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
4. Introduction
Periodontal instruments are designed for specific
purposes….
such as…
Removing calculus
Planing root surfaces
Curetting the gingival wall
Removing diseased tissue.
6. 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
7. 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.
8. • 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.
9. Types of periodontal probes
CoIor-coded
Noncolor-coded
The Marquis color-coded probe:
The calibrations are in 3 millimeter sections
10. The UNC-15 probe:
It Is a 15 mm long probe
Color coding at the 5th, 10th, and 15th mm.
11. Williams probe:
Has both color and non-color coding
Markings at 1,2,3,5,7,8,9 and 10 mm
12. 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.
13. 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
14. 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.
15. 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.
16. 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.
17. 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.
19. Subgingival curettes can be adapted to provide good
access to deep pockets, with minimal soft tissue
trauma.
20. 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.
21. 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
22. 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
23. 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.
25. Dental tape:
Used with a polishing paste for polishing proximal
surfaces that are inaccessible to other polishing
instruments.
26. 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.
27. 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
29. Interdental knives:
Example, Orban knife
#1-2, Merrifield knife
#1,2,3 and 4
Surgical blades: Example, #
12D, 15 and ISC.
30. 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
31. 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
32. 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.
34. Periosteal elevators:
Necessary to reflect and
move the flap after the
incision has been made for
flap surgery.
Example: Goldman Fox #14.
35. 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.
36. Surgical files:
They are used primarily to smoothen rough, bony,
ledges and to remove all areas of necrotic bone.
Example: Schluger and Sugarman files.
37. 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.
38. Needle holders:
They are used to suture
the flap at the desired
position.
Example: Castroviejo
needle holder.
39. Ultrasonic and Sonic Instruments
Used for removing plaque, scaling, curetting and
removing stains.
40. 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.
41. 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.
42. 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.
43. Miscellaneous
Schwartz periotreivers:
Set of two double- ended, highly-magnetized
instruments
designed for the retrieval of broken instrument tips
from the periodontal pocket.
44. Plastic instruments for implants:
Rather than metal, Plastic instruments should be
used… to avoid scarring and permanent damage to the
implants.
45. 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.
46. 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
47. 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.
48. 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.