periodontal instrumentation

Classification of periodontal instruments

1. Periodontal probes. 2. explorers 3. Scaling and root planning and curettage

instruments. 4. The periodontal endoscope. 5. Cleansing and polishing instruments.

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Periodontal probes

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Function : to measure the depth of the pockets. General characteristics :

- tapered - straight - millimeter calibration - blunt, rounded tip - thin ( 0,5 mm at the end ) - the shank is angled to allow easy insertion in the pocket.

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Types of periodontal probes

UNC-15 :
a 15-mm-long probe with markings at each millimeter Color coding between 4-5 mm, 9-10 mm, 14-15 mm . very useful in periodontal research
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UNC-15

Williams marking at : 1, 2, 3, 5, 7, 8, 9,10

mm

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Williams probe

Williams probe

WHO

Williams

CP12

WHO probe

0,5 mm ball at the tip millimeter markings at 3,5/ 5,5/ 8,5/ 11,5 mm color coding from 3,5 to 5,5 mm

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CP 12-S

CP11

CP12

All of them color-coded CP 12 : 0,3 mm at the end ( tip ) CP 12-S: modified/0,5 mm ball at the end/ Calibrations in 3-mm sections
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Williams Goldman-Fox

- Goldman-Fox probe same as Williams probe`s calibration - But it is flattened not round
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Nabers probe : Curved Blunt for furcation areas

we can detect the furcation areas also with straight probe.

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Explorers

Function :
1. Are used to locate subgigival deposits. 2. To check the smoothness of the root surfaces

after root planing. 3. To check the carious areas

Explorer are designed with different shapes and angles

Scaling and root planning instruments

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instrument design

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The blade at the same level with the handle.

Different handles, Diameter range between 5 to 10 mm

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From A to B is the shank (The lower part is Terminal shank )

functional shank length

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Types of shank
(A)A) Straight (B)B) Curved (C)C) Contraangled
(double angles)

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( A ) Rigid ( B ) fine design

(finishing design)

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Blade ( working end ) (B) Tip (C) Toe (H) Heel (F) back (D) Face (G) lateral surface (E) cutting edge (internal angle )
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Types of scaling and root planning instrument Sickle scaler Curette

File Chisel hoe

not more be used

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Sickle scaler
Characteristics ( design ) : 1. Triangular shape in cross section . 2. Two cutting edges . 3. pointed tip . 3. The angle between the blade and terminal shank is 90

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Function :
It is used primarily to remove supragingival calculus Some sickle scalers are small , curved , thin enough to be inserted a few mm below the gingiva .

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Types of scalers
1)- Different blade size.

2)- Different blade design

curved, or straight .

3)- Different shank type :

- Straight shanks are designed for use on anterior teeth and premolars. - Angled shanks adapt to posterior.

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Sickle scalers
angled shank, curved blade, different blade sizes

204 S
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C103

CK6
Crane-Kaplan

Curved or straight sickle scalers ?

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U15 CK6
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curettes
General characteristics ( design ) :
1. Rounded toe, no sharp points, can be inserted into deep pockets with minimal soft tissue trauma. 2. In cross section , the blade

appear semicircular ( spoon-shaped blade ) 3. Fine blade. 4. Curved blade.

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Function : Removing deep subgingival calculus Root planning Two basic types : Universal. Area-specific.

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The face is at a 90-degree angle with terminal ( lower ) shank. Two cutting edge.
What is the difference between universal Curette and sickle scaler?

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TYPES OF UNIVERSAL CURETTES

Columbia Barnhart Bunting Goldman Younger-Good Langer (gracey shank)

-Universal curettes-

Columbia curettes

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Columbia: 2R/2L
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4R/4L

Area-specific curettes ( Gracey curettes )

Gracey curettes are a set of several instruments designed to adapt to specific anatomic areas of the dentition. The best instruments for subgingival scaling and root planning because : - they provide the best adaptation to complex root surface anatomy. - only one cutting edge, less damage to the gingival soft tissues.
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Design of Gracey curette

1. Blade is at 70 degrees from the lower shank (offset blade). This angulation allows the blade to
be inserted in the precise position , provided parallel lower shank with the long axis of the tooth surface being scaled.

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2. Curved blade in two planes

blade curves up and to the side

3. One cutting edge.

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Gracey curette

Universal curette

Gracey curette
Area of use Use of cutting edge Cutting edge curvature Blade angle

Universal curette
All areas and surfaces two cutting edge Curved in one plane Not Offset , 90 degrees
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specific surfaces One cutting edge Curved in two planes Offset blade, 60

Rigidity type of shank

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Double-ended Gracey curettes are 7 instruments

Gracey # 1-2 and 3-4 : anterior teeth. Gracey # 5-6 : anterior teeth (and premolars). Gracey # 7-8 and 9-10: posterior teeth : facial and ligual. Gracey # 11-12 : posterior teeth : mesial Gracey # 13-14 : posterior teeth : distal .

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Standard Gracey Curettes

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# 5-6

# 7-8

# 11-12

# 13-14

Reduced set of Gracey

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Langer curettes
Set of 3 curettes. It is a combination of the shank design of the standard Gracey with universal blade. Blade not offset. Available with either a rigid and a finishing types of shank. Available in after five version. Available in mini five version.

Consiste of
5-6 (gracey 5-6 shank adapte to mesial and distal surfaces of anterior teeth). 1-2 (gracey 11-12 shank adapte to mesial and distal surfaces of mandibular posterior teeth). 3-4(gracey 13-14 shank adapte to mesial and distal surfaces of maxillary posterior teeth).

TYPES OF UNIVERSAL CURETTES

Columbia Barnhart Bunting Goldman Younger-Good Langer (gracey shank)

Gracey #15-16
It is a modification of the standard 11-12 Combines a Gracey : #11-12 blade with a #13-14 shank . It is allows better adaptation to posterior mesial surfaces, especially on the mandibular molars with an intraoral finger rest.
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extended shank instruments - After Five curette They are modifications of the

standard Gracey curette design. New features :

1. The terminal shank is 3 mm

longer ( allowing extension into deeper periodontal pockets of 5 mm or more). 2. A thinned blade . For smoother insertion , and reduced tissue stretching. 3. 1mm shorter blade
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Available After Five instruments : #1-2, 3-4, 5-6, 7-8, 9-10 , 11-12, 13-14 Available in finishing (fine) or rigid designs: - rigid After Five Gracey curettes - finishing After Five Gracey curettes

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Gracey curettes for posterior proximal surfaces

mesial surfaces

distal surfaces

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Rigid standard #13-14 adapted to the distal surface of the first molar. And rigid After Five #13-14 adapted to the distal surface of the second molar. Notice the extra long shank which allows deeper insertion and better access.

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Mini-bladed curettes - Mini FiveThey are modifications of the After Five curettes

Features:
1. Blades are half the length of the After Five or standard Gracey curettes. 2. Extended shank
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Function
Easier insertion and adaptation in any area where root morphology or tight tissue prevents full insertion of standard Gracey or After Five blade : 1. deep, narrow pockets, 2. furcations, 3. developmental grooves, 4. line angles, 5. Deep, tight pockets.
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Comparison of a standard Gracey # 5-6 with a Mini Five # 5-6 curette on the palatal surfaces of the maxillary central incisors. The Mini Five can be inserted to the base of these tight pockets with vertical stroke.
standard Gracey # 5-6 or after five curette usually cannot be inserted vertically in this area because the blade is too long.

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- Available in both: - rigid Mini Five Gracey curette - finishing Mini Five Gracey curette - available in all standard Gracey numbers except for the # 9-10 - advantages : 1. can be used easily with vertical strokes, 2. With reduced tissue distention, 3. and without tissue trauma.

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Schwartz periotrievers

Is there another mini-bladed instruments?

Gracey curvette blade

Working Stroke

oblique

vertical

horizontal

circumferential

Blade Adaptation to Tooth Surface

0 insertion

<45 Healthy tissue Plaque removal

45-90 Ideal Calculus Removal

> 90 Tissue Trauma

Adaptation of lower third of blade to tooth surface

Correct Lower 1/3

Incorrect Middle 1/3

Incorrect Toe 1/3

Relationship of Lower Shank to Blade Angulation

Lower shank parallel

Lower shank Too far Toe is coronal

Lower shank To far forward

Plastic instruments for implants

Plastic instruments be used to avoid scratching and damage to the implants.

Oscillating scaler systems - power-driven scalers-

Used to remove plaque, Calculus, stains.

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Sonic scaler
Consists of a handpiece that attaches to compressed air in dental unit. Vibrations at the sonic tip range from 2000 to 6500 cycle per seconds ( Hz ) .

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Polishing instruments

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Bristle brushes
Are available in wheel and cup shapes. Is used in the handpiece with a polishing paste. Should be used with low speed .

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Intraoral fulcrum

Periodontal surgical instruments

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