Periodontal Instrumentarium PDF

# The Periodontal Instrumentarium ## Periodontal Instruments - Periodontal Probes - Explorers - Scaling and Curettage Instruments - Cleansing and Polishing Instruments - Surgical instruments ### Periodontal Probes - Periodontal probes are used to locate, measure, and mark pockets, as well as det...

# The Periodontal Instrumentarium ## Periodontal Instruments - Periodontal Probes - Explorers - Scaling and Curettage Instruments - Cleansing and Polishing Instruments - Surgical instruments ### Periodontal Probes - Periodontal probes are used to locate, measure, and mark pockets, as well as determine their course on individual tooth surfaces. - Typical probe is a tapered, rodlike instrument calibrated in millimeters, with a blunt, rounded tip. - **Left:** The University of Michigan "O" probe, with Williams markings (at 1, 2, 3, 5, 7, 8, 9, and 10 mm). - **Right:** Nabers probe for detection of furcation areas. ### Calibrations - **A, The Marquis color-coded probe.** Calibrations are in 3-mm sections. - **B, The UNC-15 probe**, a 15-mm-long probe with millimeter markings at each millimeter and color coding at the 5th, 10th, and 15th mm. - **C, The University of Michigan "O" probe**, with Williams markings (at 1, 2, 3, 5, 7, 8, 9, and 10 mm). - **D, The Michigan "O" probe** with markings at 3, 6, and 8 mm. - **E, The WHO (World Health Organization) probe**, which has a 0.5 mm ball at the tip and millimeter markings at 3.5, 8.5, and 11.5 millimeters and color coding from 3.5 to 5.5 mm. ## Explorers - Explorers are used to locate subgingival deposits and carious areas and to check the smoothness of the root surfaces after root planning. - They are used for removal of plaque & calcified deposits from the crown & root of a tooth, removal of altered cementum from the subgingival root surface, & debridement of the soft tissue lining the pocket. - Scaling: removal of calculus (both supragingival or subgingival) - Root planning: removal of infected cementum - Curettage: removal of epithelium lining of the pocket (removal of granulation tissue) - There are 2 families: Scalers & Curettes ### Sickle Scalers (Supragingival Scalers) - Used for supragingival scaling. #### Basic Characteristics of a sickle scaler: - Flat surface. - Triangular in shape. - Triangular in cross section . - Two cutting edges. - Pointed tip. - The angle between the blade and shank is 90. #### Types of sickle scaler: - **CK-6 scaler:** Used for surgical debridement. - **Jaquette scaler** ### Mitchel Scaler - Has and end like a scaler but the other end is a spoon shape. - Used for interproximal scaling below the cingulum or for a bridge of calculus. ### Curettes - The curette is the instrument of choice for removing deep subgingival calculus, root planning of altered cementum, and removing the soft tissue lining the periodontal pocket (curettage) - Principal types of curettes as seen from the toe of the instrument. - A, Universal curette. - B, Gracey curette. #### Basic characteristics of a curette - Rounded toe - Semi-circular cross section - Spoon-shaped blade - Convex base ## Comparison of Specific (Gracey) and Universal Curettes | | Gracey Curette | Universal Curette | |---|---|---| | Area of use | Set of many curettes designed for specific areas and surfaces | One curette designed for all areas and surfaces | | Cutting Edge Use | One cutting edge used; work with outer edge only | Both cutting edges used; work with either outer or inner edge. | | Curvature | Curved in two planes: blade curves up and to the side | Curved in one plane: blade curves up, not to side. | | Blade angle | Offset blade: face of blade beveled at 60 degrees to shank | Not offset: face of blade beveled at 90 degrees to shank. | ### Double-ended Gracey curettes are paired in the following manner: - 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 lingual - Gracey #11-12: Posterior teeth: mesial - Gracey #13-14: Posterior teeth: distal - **Columbia #4R-4L universal curette** # INSTRUMENTATION ## A) INSTRUMENT GRASP - Modified pen grasp - Palm and thumb grasp ## B) FINGER REST (Fulcrum) ### (1) Intra Oral Finger Rest - Conventional Finger Rest - Cross arch finger rest - Opposite arch finger rest - Finger in finger ### (2) Extra oral finger rest - Palm up finger rest - Palm down finger rest # INSTRUMENT ACTIVATION ## (How to use a scaler) ### Supragingival Scaling - Adaptation : Tip directed towards the contact area - Angulation: Blade perpendicular to the tooth surface - Strokes: short pulling strokes ### Uses of scalers : supragingival scaling ## (How to use a curette) 1. Adaptation: curved part of the blade is adapted to the line angle of the tooth 2. Angulation 3. Lateral pressure 4. Stroke: short pulling strokes ### Uses of curette: - Subgingival scaling - Root planning : removal of necrotic cementum on root surface - Curettage: removal of soft tissue lining of the pocket # WORKING STROKES (types of pulling strokes) - a) Oblique - b) Vertical - c) Horizontal - d)Circumferential ### Gracey curettes. From left, #5-6, #7-8, #11-12, and #13-14 - Gracey #11-12 curette - Gracey #13-14 curette