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Perio I ( pre-clinic periodontology course )
By /shaker al.samea
periodontal instrumentation
1. Periodontal probes.2. Scaling and root planning
instruments. 3. Polishing instruments.4. Periodontal surgical
instruments.
Apr 11, 2023 2
Periodontal probes
Apr 11, 2023 3
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.Apr 11, 2023 4
Apr 11, 2023 5
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
Types of periodontal probes
UN
C-1
5
Apr 11, 2023 6
Williams probe
Williams marking at : 1, 2, 3, 5, 7, 8,
9,10 mm
William
s p
rob
e
Apr 11, 2023 7
Williams Goldman-Fox
- Goldman-Fox probe same as Williams probe`s calibration- But it is flattened not round
Apr 11, 2023 8
CP 12-S CP11 CP12All of them color-codedCP 12 : 0,3 mm at the end ( tip )CP 12-S: modified/0,5 mm ball at the end/ Calibrations in 3-mm sections
Apr 11, 2023 9
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
WilliamsWHO CP12
Nabers probe : Curved Blunt for
furcation areas
we can detect the furcation areas also with straight probe.
Apr 11, 2023 10
Apr 11, 2023 11
Scaling and root planning
instruments
instrument design
Apr 11, 2023 12
Parts of each instrument
Working end (
blade )Shank handle
The blade at the same level with the handle.
Different handles,
Diameter range between 5 to 10 mm
Apr 11, 2023 13
From A to B
is the shank
(The lower part is Terminal shank )
functional shank length
Apr 11, 2023 14
Apr 11, 2023 15
Types of shank
(A)A) Straight
(B)B) Curved
(C)C) Contraangled
(double angles)
( A ) Rigid
( B ) fine design (finishing design)
Apr 11, 2023 16
Apr 11, 2023 17
Blade ( working end )
(B) Tip (C) Toe (H) Heel (F) back (D) Face
(G) lateral surface (E) cutting edge (internal angle )
Apr 11, 2023 18
Sickle scaler Curette
File Chisel not more
be used hoe
Apr 11, 2023 19
Types of scaling and root planning instrument
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 ْ
Apr 11, 2023 20
Sickle scaler
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 .
Apr 11, 2023 21
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.
Apr 11, 2023 22
Apr 11, 2023 23
204 S C103 CK6 Crane-Kaplan
Sickle scalers angled shank, curved blade, different blade sizes
Curved or straight sickle scalers ?
Apr 11, 2023 24
Apr 11, 2023 25
U15 CK6
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.
Apr 11, 2023 26
curettes
Function : Removing deep subgingival
calculus Root planning
Two basic types : Universal. Area-specific.
Apr 11, 2023 27
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?
Apr 11, 2023 28
Universal curettes
-Universal curettes-
Columbia curettes
13-14 / 2R-2L / 4R-4L /
Apr 11, 2023 29
Apr 11, 2023 30
Columbia: 2R/2L 4R/4L
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.Apr 11, 2023 31
Area-specific curettes
( Gracey curettes )
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.
Apr 11, 2023 32
Design of Gracey curette
2. Curved blade in two planes blade curves up and to the side
3. One cutting edge.
Apr 11, 2023 33
Universal curette Gracey curette
All areas and surfaces specific surfaces Area of use
two cutting edge One cutting edge Use of cutting edge
Curved in one plane Curved in two planes Cutting edge curvature
Not Offset , 90 degrees Offset blade, 70 ْ Blade angle
Apr 11, 202334
Universal curetteGracey curette
Apr 11, 2023 35
Rigid design(A
)
•Larger, stronger, and less flexible shank and blade•Used to remove moderate-to-heavy calculus
Finishing design
(B)
•Thinner shank, more flexible,•Enhanced tactile sensitivity, used to finish root planning.
Rigidity type of shank
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 .
Apr 11, 2023 36
Double-ended Gracey curettes
are 7 instruments
Apr 11, 202337
Standard Gracey Curettes
Reduced set of Gracey
Apr 11, 2023 38
# 5-6 # 7-8 # 11-12 # 13-14
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.
Apr 11, 2023 39
Gracey #15-16
Apr 11, 2023 40
• 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
extended shank instruments
- After Five curette -
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
Apr 11, 2023 41
Gracey curettes for posterior proximal surfaces
mesial surfaces distal surfaces
Apr 11, 2023 42
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.
Apr 11, 2023 43
They 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
Apr 11, 2023 44
Mini-bladed curettes- Mini Five-
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.
Apr 11, 2023 45
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.
Apr 11, 2023 46
- 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.
Apr 11, 2023 47
Plastic instruments be used to avoid scratching and damage to the implants.
Apr 11, 2023 48
Plastic instruments for implants
Apr 11, 2023 49
Oscillating scaler
Ultrasonic sonic Used to remove plaque,Calculus, stains.
Oscillating scaler systems
- power-driven scalers-
The vibrations range from 20000 to 45000 cycle/second.
Apr 11, 2023 50
ultraonic scaler
Apr 11, 2023 51
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 ) .
Sonic scaler
Apr 11, 2023 52
Polishing instruments
Goals of polishing
Remove stains
Smoothening tooth surfaces
Apr 11, 2023 53
Used in the handpiece with paste. There is disposable plastic
prophylaxis angle and rubber cup, may be used and then discarded.
Apr 11, 2023 54
Rubber cup
Are available in wheel and cup shapes.
Is used in the handpiece with a polishing paste.
Should be used with low speed .
Apr 11, 2023 55
Bristle brushes
Apr 11, 2023 56
Periodontal surgical instruments
Apr 11, 2023 57
Instruments will be used in Perio I
Apr 11, 2023 58
- blade 15 ( 2 pieces )- scalpel
- silk suture (000)
- needle holder - periodontal probe- U15/30 , CK6 , or another fine sickle scalers available
in dental market ( like H5/33 , H6/H7 , … )- Gracey curettes : / 5-6 / 7-8 / 11-12 / 13-14 /
- toothbrush
thanks