Classification of periodontal instruments

2. PRESENTATION BY:
Mohamed Abdul Haleem
1st Year Perio PG
KVG Dental college & Hospital, Sullia

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.

5. Parts of Instruments
 Periodontal instrument is composed of:
 Blade
 Shank
 Handle

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.

18. REMOVAL OF 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.

24. Bristle brushes:
 Available in wheel and cup shapes
 Used in hand piece with a polishing paste

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

28. Surgical Instruments
Excisional and incisional instruments:
 Periodontal knives (Gingivectomy knives); Example
Kirkland knife

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.

33. 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.

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.