Periodontal instruments
Types
Hand instruments (probes, sickle scalers, universal curettes,
area specific curettes, files, chisels, hoes)
Powered instruments: rotating, reciprocating, ultrasonic/sonic
instruments
Parts of hand instruments
Periodontal probes
Primary instrument in the periodontal exam (аssess gingival
health and periodontal status)
Exploratory – revealing subgingival cavities/calculus/restorations
margins
Vary in cross-sectional design (rectangular = flat, oval, round)
Millimeter markings
Calibrated at varying intervals
Periodontal probes
First generation
World Health Organization's
(WHO) probe
WHO (CPITN) probes are recommended for use when screening
and monitoring patients with the CPITN index
The probes have a ball tip of 0.5 mm, with a black band between
3.5 mm and 5.5 mm, as well as black rings at 8.5 mm and 11.5
mm
• CPITN–E (epidemiologic): 3.5-mm and 5.5-mm markings
• CPITN–C (clinical): 3.5-mm, 5.5-mm, 8.5-mm, and 11.5-mm
markings
World Health Organization's
(WHO) probe
University of Michigan O probes
markings at 3 mm, 6 mm, and 8 mm
University of Michigan probes
with William’s markings
markings at 4 mm and 9 mm
missing
University of North Carolina-15
(UNC-15) probes
color-coded at every millimetre
demarcation
the preferred probe in clinical
research if conventional probes
are required
Naber’s furcational probes
Naber's probe is used to detect and measure the involvement of
furcal areas by the periodontal disease process in multirooted teeth.
Naber's probe also is used in the assessment of more complex clinical
cases, including those with a restorative treatment.
These probes can be color-coded or without demarcation.
Periodontal Probes
First generation
UNC-15 probe
Marquise probe
Goldman-Fox probe Williams probe
Periodontal Probes
Second generation
Pressure-sensitive, allowing to improve the standardisation of probing
Periodontal Probes
Third generation
Computerised probes with automated recording system to store the results.
Periodontal Probes
Fourth generation:
3D probes to record the sequential position along the
gingival sulcus.
Under development.
Fifth generation:
3D probe utilising ultrasound waves.
Periodontal probing
Is used to assess:
Sulcus/Periodontal pocket depth
Gingival recession level
Clinical attachment loss
Furcation involvement
BOP
Periodontal probing
Inserted to the sulcus/periodontal pocket
Probe should be parallel to the long axis of the tooth
Working end should be well-
adapted to tooth surface
Periodontal probing
Interproximal probing
Slightly tilted
Apical to the contact point
Not enough Correct Too much
angulation angulation angulation
Periodontal probing
Probing
• “Walking”, making small “steps”
• Six readings:
Distal (DB & DL)
Buccal (B) or Lingual (L)
Mesial (MB & ML)
• Deepest reading within the designated
areas
Periodontal probing
Detection of smoothness of various
irregularities on the root surface with
outward motion of a probe or explorer
Furcation Assessment
Hand instruments
Sickle scalers
primarily used for supragingival calculus removal (sharp tip)
often the first instrument used to remove large, heavy
deposits thus improving access to subgingival area for other
instruments
Sharp tip
Triangular cross-section
Two cutting edges 90º
Hand instruments
Sickle scalers
Straight rigid shank
Two cutting edges
Straight or slightly curved
Back of the instrument pointed
or rounded
Hand instruments
Sickle scalers
Supragingival calculus
Stain
Slightly subgingival (1-2mm)
Hand instruments
Sickle scalers
A number of different sickle scalers are
available in a variety of shapes and
sizes
Hand instruments
Curettes
universal
area specific (Gracey)
Blunt tip Blunt tip
Semi-circular cross- Semi-circular cross-
section section
One cutting edge Two cutting edges
70º 90º
Hand instruments
Curettes
universal
two curved edges with a blade, both are used for
calculus removal
Hand instruments
Curettes
Area specific (Gracey)
• The original Gracey series was developed in the 1930's by Dr. Clayton
Gracey, a periodontist at the University of Michigan.
• They were designed to provide better access to root surfaces in deep
pockets.
• They feature long shanks and unique blades, some with bends improving
access to complex root surface morphology.
• The original series contained 7 double ended instruments (1/2; 3/4; 5/6; 7/8;
9/10; 11/12; 13/14).
• In the 1980's, 2 modified instruments were added to the collection (15/16;
17/18).
Hand instruments
Curettes
Area specific (Gracey)
Hand instruments
Curettes
Area specific (Gracey)
• Working end is tilted in relationship to the terminal shank (offset by 70°)
• Makes one cutting edge lower than the other
• This lower end is the one that is used for instrumentation
Hand instruments
Curettes
Advantages of area specific (Gracey) curettes
Allow insertion into deep pockets
Prevent tissue trauma
Correct cutting edge to tooth surface angulation
Easier adaptation
Reach around convex tooth crowns to access root surfaces
Gracey cutettes Indication
1/2 Incisors
3/4 Anterior teeth
5/6
7/8 Buccal and lingual surfaces of premolars and
molars
9/0
11/12 Mesial surfaces of molars, buccal surfaces of
incisors
13/14 Distal surfaces of molars, lingual surfaces of
incisors
15/16 Mesial surfaces of 2nd and 3rd molars
17/18 Distal surfaces of 2nd and 3rd molars
Hand instruments
Files, Chisels, Hoes
Periodontal files
Function: to crush large deposits of calculus
Can easily roughen root surface
Periodontal chisels
Are commonly used in the proximal surfaces of
anterior teeth to remove heavy deposits of calculus
Periodontal hoes
Blade is bent at 99 degrees
Is used to remove heavy deposits of calculus
Powered instruments
Sonic
Ultrasonic (piezo-electric, magnitostrictive)
Rotary (Perio burs)
Reciprocating and rotary (Perio TOR)
Powered instruments
Sonic scalers
• 2500-7000 cps
• all sides effective
• portable
• cheap
• noisy
Powered instruments
Ultrasonic scalers
Powered instruments
Ultrasonic scalers
Powered instruments
Rotary (Perio burs)
Are used for root planning
Powered instruments
Rotary and reciprocating (Per-Io-Tor)
For mechanical tooth cleaning
Safe root planning
Made of high quality stainless
steel
Made for long lasting
performance
Powered instruments
Rotary and reciprocating (Per-Io-Tor)
Recipricating for Profin Rotary
eciprocating handpiece
Powered instruments
Rotary and reciprocating (Per-Io-Tor)
Guess the instrument
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