Periodontal Instruments Overview

Periodontal Instrument Components

• Every periodontal instrument has a handle, shank, and working end.
• The handle provides ergonomic balance and can vary in texture, flexibility, and rigidity based on clinician preference.
• The shank connects the handle to the working end and can be simple (for anterior teeth) or complex (for posterior teeth).
• The working end is the part that contacts the tooth and comes in various types like sickles, curettes, and explorers.
• Features of the working end include the toe, heel, face, and cutting edge, each suited for specific tasks.

Shank Design and Function

• The functional shank extends from the first bend to the working end, while the lower terminal shank adapts the instrument to the tooth.
• Thinner shanks offer tactile sensitivity but are less effective for heavy deposits.
• Thicker shanks are more rigid and suitable for removing heavy calculus.

Working End Anatomy

• Curettes have a rounded toe and are suitable for subgingival scaling.
• Sickles have a pointed tip and are designed for supragingival scaling.
• The face is the top of the blade, and the cutting edge is the sharp side for removing calculus.
• The toe/tip is rounded for curettes and pointed for sickles.
• The heel is the rear part of the working end.

Hand Scaling Instruments

• Periodontal probes measure pocket depth and detect calculus.
• Explorers are thin, flexible instruments for detecting calculus, restorations, and caries with high tactile sensitivity.
• Sickle scalers are used for supragingival scaling with a triangular cross-section and two cutting edges.
• Curettes are universal (two cutting edges) or site-specific (one working edge) and designed for specific tooth surfaces.

Classification of Hand Scaling Instruments

• Instruments are classified by name (often tied to the designer) and number (identifying the specific design and area of use).
• Gracey curettes are designed for specific tooth surfaces, with a 70° angle to the tooth surface.
• Gracey curette numbers 1/2, 11/12, and 13/14 apply to different tooth surfaces.
• Gracey 5/6 is used for both mesial and distal surfaces of anterior teeth and premolars.
• Gracey 9/10 is designed for buccal and lingual surfaces of posterior teeth.
• Gracey 11/12 is used for mesial surfaces of posterior teeth.
• Gracey 13/14 is used for distal surfaces of posterior teeth.
• Gracey curettes have one cutting edge per working end for site-specific use and a flexible shank for tactile sensitivity.

Handle

• Handles have a weight which is evenly distributed for ergonomic use
• Handles are textured to increase clinician preference
• The material of handles can be flexible or rigid depending on the user's preference

Shanks

• Shanks can be simple or complex
• Shanks can be standard, extended, flexible or rigid
• Flexible shanks enhance tactile sensitivity
• Rigid shanks have a larger diameter and can withstand pressure

Working End - Macro-anatomy

• Working ends are available in a variety of shapes, commonly sickle or curette
• Sickle working ends are used for supra-gingival/crown use only
• Curettes are used supra-gingivally and sub-gingivally
• Curettes are used for removal of light to moderately sized calculus

Working End - Micro-Anatomy

• The working end of an instrument includes the face, lateral surface and cutting edge
• The micro-anatomy includes the toe (tip), middle and heel

Classification of Periodontal Instruments

• Periodontal instruments are split into two categories, assessment instruments and deposit removal instruments
• Assessment instruments include probes and explorers
• Deposit removal instruments include sickles, curettes and files

Periodontal Probes

• Probes are either round or rectangular in cross section
• Some probes have millimetre markings
• Probes are used for measuring and evaluation

Explorers

• Explorers are fine, wire-like in shape with a sharp point
• Explorers are circular in cross section
• Explorers are used to determine the location and extent of calculus deposits

Sickles

• Sickles are identified by the number M23 and H6/H7
• Sickles have 2 cutting edges
• The cutting edges meet in a pointed tip
• Sickles are triangular in cross-section
• Sickles are typically used supra-gingivally

Curettes

• Curettes are a spoon shaped working end with 2 cutting edges
• The cutting edges meet in a rounded toe
• Curettes are semi-circular in cross section
• Curettes can be used supra and sub-gingivally for removal of light to moderately sized calculus
• Curettes are inserted into the sulcus or pocket without inflicting trauma

Site Specific Curettes

• Site specific curettes have a rounded toe, back and semi-circular cross section
• Site specific curettes only have one working edge
• They are specific to certain surfaces and areas of the mouth
• Site specific curettes are not used on all surfaces and need to be used with a set of curettes to instrument the whole mouth
• Site specific curettes are used sub-gingivally
• The most popular site specific instruments are Gracey curettes

Gracey Curettes

• Gracey 1/2 has a rounded side and a cutting side
• Gracey 5/6 has a rounded side and a cutting side
• Gracey 9/10 has a rounded side and a cutting side
• Gracey 11/12 has a rounded side and a cutting side
• Gracey 13/14 has a cutting side and a face
• Gracey curettes are used subgingivally
• Gracey curettes can only be used on the specific tooth surface they have been designed for

This quiz covers the components and anatomy of periodontal instruments, focusing on handles, shanks, and working ends. Learn about the various designs, functions, and features suited for different clinical tasks. Essential for dental students and professionals.