BASIC

PERIODONTAL
INSTRUMENTS
WITH QR CODES
2017

MOHAMMED KHAN
BDS

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INDEX

CLASIFICATION 5
DIAGNOSTIC INSTRUMENTS 7
SCALING INSTRUMENTS 15
ROOT PLANING & CURRETING 22
CLEANING & POLISHING 29
SURGICAL INSTRUMENTS 31
REFERENCES 37
 ‫◊‹‡‪pb‬‬
‫إﻃﻤﺢ أن ﺗﺼﻞ ﻟﻠﻨﺠﻮم‬
‫ﻓﺎن ﻟﻢ ﺗﺼﻞ رﺑﻤﺎ ﺗﻜﻮن ﻗﺪ ﺗﻜﻮن ﺑﻠﻐﺖ اﻟﻘﻤﺮ‬

‫ﻣﺤﻤﺪ ﺧﺎن‬

‫ﻻ ﺗﺘﻮﻗﻒ ﻋﻦ اﻟﻤﺤﺎوﻟﺔ ‪ ,‬ﻓﺎﻟﻨﺠﺎح ﻳﺤﻘﻘﻪ ﻓﻘﻂ اﻟﺬﻳﻦ ﻳﻮاﺻﻠﻮن‬

‫ﻣﻼك ﺑﺎش اﻣﺎم‬

‫اžﻧﺴﺎن ﻛﺎﺋﻦ ﻣﻌﻘﺪ اﻟﺘﺮﻛﻴﺐ‪ ,‬آﻟﺔ ﻣﺘﻌﺪدة اﻟﻮﻇﺎﺋﻒ وﺗﺤﺘﻮي ﻋﻠﻰ اﻻت أﺻﻐﺮ ﻣﻨﻬﺎ‬
‫ﻣﻨﻬﺎ ﻣﺎ ﻫﻮ ﻣﺮﺋﻲ وﻏﻴﺮ ﻣﺮﺋﻲ‬
‫ا†ﺧﻴﺮ ﻳﺘﻤﺜﻞ ﻓﺎﻟﺮوح واﻟﻄﻤﻮح واﻟﺘﻄﻮر‬
‫ﻧﺤﻦ ﻧﺴﻌﻰ ﻟﺘﺤﺮﻳﻚ ﻫﺬه ا†ﻟﺔ‪ ,‬و ﺗﻄﻮرﻳﻜﻢ أﻫﻢ أرﻛﺎن ﻃﻤﻮﺣﻨﺎ‬
‫ﻣﺮوان اﻟﺠﻼح‬

‫اﻟﺘﻘﻨﻴﺔ ‪ +‬اﻟﻤﻌﺮﻓﺔ ‪ +‬ﺣﺴﻦ ا†داء‬

‫) ﻃﺒﻴﺐ أﺳﻨﺎن أﻓﻀﻞ(‬

‫ﻧﻮران ﺑﺎزﻳﻨﺔ‬

‫‪ALWAYS DESIRE TO LEARN SOMETHING USEFUL‬‬

‫ﻣﺤﻤﺪ اﺑﻮدﺑﺮة‬

‫إن اﻟﺬﻳﻦ ﺗﻮﻗﻔﻮ ﻋﻦ ﻃﻠﺐ اﻟﻌﻠﻢ ‪ ,‬اﻛﺘﻔﻮا ﺑﻤﺎ ﺗﻌﻠﻤﻮا‬

‫ﻓﺸﻠﻮ ﻓﻲ ﺗﻄﻮﻳﺮ ﻧﻔﺴﻬﻢ ‪.‬‬
‫ﻻ ﺗﻴﺄس إن وﺻﻠﺖ ﻣﻨﺘﺼﻒ اﻟﻄﺮﻳﻖ وﺗﻬﺎﻟﻜﺖ ﻗﺪﻣﺎك وإﻧﻔﻚ رﺑﺎط ﺣﺬاﺋﻚ‬
‫ﻓﻘﻂ ﺿﻊ ﻫﺪﻓﻚ ﻧﺼﺐ ﻋﻴﻨﺎك وأﻣﻀﻲ‪..‬‬
‫أﻧﻮار زﻳﺘﻮن‬

‫‪LDS TEAM‬‬
CLASIFICATION 5
PERIODONTAL INSTRUMENTS

DIAGNOSTIC - MOUTH MIRROR

- PERIODONTAL PROBE
INSTRUMENTS - EXPLORERS

SUPRA
SICKLE SCALER
GINGIVAL
MANUAL
SCALING SUB - HOE SCALER
- CHISEL SCALER
INSTRUMENTS GINGIVAL - FILE SCALER

SONIC
SCALER
POWER PIEZO-ELCTRIC
DRIVEN SCALERS
ULTRA
SONIC
MAGNETOSTRICTIVE
SCALERS

UNIVERSAL
CURRETES
ROOT PLANING
&
CURRETING
AREA SPECIFIC GRACEY
CURRETE CURRETES

CLEANING RUBBER CUPS

& BRISTLE BRUSH
POLISHING DENTAL TAPE

KNIFES
SURGICAL BLADES
INSTRUMENTS NEEDLE HOLDER
OTHERS

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CLASIFICATION 6
PARTS OF PERIODONTAL INSTRUMENTS:

A Handle

B Shank

C Working-end

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DIAGNOSTIC INSTRUMENTS 7
MOUTH MIRROR:
USES:

- Indirect vision
- Illumination ( reflection of light )
- Transillumination ( reflection of light through the tooth )
- Retraction

Indirect vision Illumination

f Transillumination - Retraction D
DIAGNOSTIC INSTRUMENTS 8
PERIODONTAL PROBE:
- Primary Function: Detect and measure the periodontal pockets to determine
the health status of the periodontium
- Other Functions
- Measure clinical attachment loss
- Assess bleeding on probing
- Measure the size of intraoral lesions

TYPES
Williams Probe:

MISSING 4 -6
1-
2-
3-
5-
7-
8-
9-
10

- Thin, round working-end.

- Millimeter grooves at 1, 2, 3, 5, 7, 8, 9, and 10 mm.

- markings at 4 and 6 mm are missing to avoid confusion in

reading the markings.

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DIAGNOSTIC INSTRUMENTS
9
World Health Organization (WHO) PROBE:
- Has a unique ball-end of 0.5 mm in diameter
- 16-mm-long working-end
- Markings at 3.5, 5.5, 8.5, and 11.5 mm
- Used in routine periodontal screening in general dental practice
- Thin, round ball working-end

Ball-end

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DIAGNOSTIC INSTRUMENTS 10
Goldman Fox Probe:
- Millimeter grooves at 1, 2, 3, 5, 7, 8, 9, and 10 mm (markings at 4 and 6 mm are missing)
- Flat working-end
- Same markings as williams probe
- Used in palatal area

Cross- section

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DIAGNOSTIC INSTRUMENTS 11
Plastic Probe ( Implant probe ):
- Color-coded in a variety of millimeter calibrations

- Round, tapered working-end

- Color-coding facilitates reading

- Recommended if probing dental implants

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DIAGNOSTIC INSTRUMENTS 12
Nabres probe:
- Color-coded at 3 . 6 . 9 . 12 mm
- Used for detection of furcation areas

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DIAGNOSTIC INSTRUMENTS 13

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DIAGNOSTIC INSTRUMENTS 14
Explorers:
- Have a flexible wire-like working-ends
- Used to detect subgingival calculus deposits and carious areas
- Check the smoothness of the root surfaces after root planing

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SCALING INSTRUMENTS 15
Manual Supra Gingival :
Sickle scaler:
A sickle scaler is a periodontal instrument used to remove calculus deposits
from the crowns of the teeth ( supra gingival )
- Limited to use on enamel surfaces and should NOT be used on root surfaces
DESIGN
Working-End Design
- Pointed tip
- Triangular cross section
- Two cutting edges per working-end
- The face is perpendicular to the lower shank
Triangular Cross Section

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SCALING INSTRUMENTS 16
Sickle scaler:

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SCALING INSTRUMENTS 17
Manual Sub Gingival Scalers :
Hoe Scaler :
- Used for scaling of ledges or rings of calculs ( subgingival )
- Remove tenacious sub gingival calculus and alterd cementum
- Blade is bent at 99 degree angle

99 degree angle

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SCALING INSTRUMENTS
18
Manual Sub Gingival Scalers :
Chisel Scaler :
- Designed for the proximal surfaces to permit the use of other scalers
- Usually used in the anterior part of the mouth
- Double ended instrument with one straight and one curved shank
- Inserted from facial surface and activated with Push motion
- limited use compared with curretes

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 SCALING INSTRUMENTS
19
Manual Sub Gingival Scalers :
Files:
- Files have a series of blades on a base
- Used to crush and fracture large deposits of tenacious calculus or burnished
sheets of calculus
- can easliy roughen root surfaces when used improperly
- not suitable for final scaling and root planing
- used for removing overhanging margins of dental restorations

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 INSTRUMENTS FOR RETRACTING SOFT TISSUE 20
Power driven scaling instruments :
Rapidly vibrating instrument tip to dislodge calculus from the tooth surface,
disrupt plaque biofilm, and flush out bacteria from the periodontal pocket.

consist of a handpiece that attaches to the dental unit or an electronic generator

and interchangeable tips .

- Sonic-powered instruments: operate at a relatively low frequency to 3,000 to

8,000 cycles per second and are driven by compressed air from the dental unit ( elliptical
tip motion )
- Ultrasonic-powered instruments operate inaudibly at 18,000 to 45,000 cycles
per second (kHz).

Ultrasonic devices can be further categorized based on the mechanism

used to convert the electrical current used for energy to activate the tips:

- Magnetostrictive : uses electrical energy to activate crystals

within the handpiece to vibrate the tip ( elliptical or orbital
tip motion ) four active workind ends.

- Piezoelectric: transfer electrical energy to metal stacks made

of nickel-iron alloy to a ferrous rod ( Linear tip motion ) two active
working ends.

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INSTRUMENTS FOR RETRACTING SOFT TISSUE 21
Power driven scaling instruments :
Contraindications for Powered Instrumentation:
- Communicable disease (e.g., hepatitis, tuberculosis, respiratory infections).

- High susceptibility to infection: infection can be transmitted by

contaminated dental unit water or inhaled aerosols

- High susceptibility to infection: infection can be transmitted by

contaminated dental unit water or inhaled aerosols
- Respiratory risk: Individuals with respiratory disease or difficulty in breathing
- Unshielded cardiac pacemaker: healthcare workers should avoid exposing
patients with cardiac pacemakers to magnetostrictive devices.
Piezoelectric ultrasonic devices do not interfere with pacemaker functioning

- Oral conditions: Avoid contact of instrument tip with hypersensitive teeth,

porcelain crowns, composite resin restorations, demineralized enamel surfaces,
or exposed dentinal surfaces.

Not for use with titanium implants, unless the working-end of the powered
instrument is covered with a specially designed plastic sleeve.

f ( elliptical or orbital ( Linear tip motion ) two active D

tip motion ) four active workind ends working ends
ROOT PLANING & CURRETING 22
Universal Currets:
- A universal curet is a periodontal instrument used to remove small- and
medium-size calculus deposits
- Universal curets can be used both supragingivally and subgingivally—on
crown and root surfaces.
- A universal curet usually is a double-ended instrument with paired,
mirror-image working-ends.

- This type of curet is called “universal” because it can be applied to both

anterior and posterior teeth. In other words, this type of curet is used
universally throughout the entire mouth.

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ROOT PLANING & CURRETING 23
Universal Curets:
Cross section : Semi-circular cross section; this design allows the working-end to
be used both supragingivally and subgingivally

Working-end :Rounded back and toe Two working cutting edges per working-end

Face : Face is at a 90° angle to the lower shank, the two cutting edges on a working-end are
level with one another Because the face is perpendicular to the lower shank, the lower shank
must be tilted slightly toward the tooth surface to establish correct angulation

Cutting edges : Two parallel cutting edges meet in a rounded toe

Application : One double-ended instrument is used on both anterior and posterior teeth

Primary functions : Instrumentation of crown and root surfaces Removal of small-

to medium-size calculus deposits

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ROOT PLANING & CURRETING 24
AREA SPECIFIC CURRETE:

GRACEY CURRETES:
- 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 name “area-specific” signifies that each instrument is designed for

use only on certain teeth and certain tooth surfaces

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 Instrument for controlling hemorrhage
ROOT PLANING & CURRETING 25
AREA SPECIFIC CURRETE:

GRACEY CURRETES:
Cross section : Semi-circular cross section

Working-end : Rounded back and toe ONE working cutting edges per working-end

Face : Face tilts at approximately a 70° angle to the lower shank; one cutting edge is
lower than the other in relation to the lower shank

Cutting edges : Curved cutting edges and rounded toe to enhance adaptation to
rounded root surfaces and root concavities

Application : Each instrument curet is limited to use on certain teeth and certain surfaces

Primary functions : Standard curets are used to remove light calculus deposits and
for deplaquing.
- rigid Gracey curets can remove medium-size deposits

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 ROOT PLANING & CURRETING 26

Curet Area of Application

Gracey 1 and 2
Gracey 3 and 4
Gracey 5 and 6
Anterior teeth: all tooth surfaces

Gracey 7 and 8
Gracey 9 and 10 Posterior teeth: facial and lingual surfaces

Gracey 11 and 12
Gracey 15 and 16
Posterior teeth: mesial surfaces
Gracey 13 and 14
Gracey 17 and 18 Posterior teeth: distal surfaces

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ROOT PLANING & CURRETING 27

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ROOT PLANING & CURRETING 28
GRACEY CURRETES:

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CLEANING & POLISHING 29
Rubber cups:
- USED IN HANDPIECE WITH A SPECIAL PROPHYLAXIS FOR POLISHING THE TEETH

- A GOOD CLEANSING & POLISHING PASTE CONTAIN FLOURIDE SHOULD BE USED & KEPT MOIST TO MINIMIZE
FRICTION HEAT

- AVAILABLE IN WHEEL & CUP SHAPES USED IN PROPHYLAXIS ANGLE WITH A POLISHING PASTE

prophylaxis angle

Bristle Brush:
- Avilable in wheel and cup shape
- Used in the prophylaxis angle with Polishing paste
- the Use of the brush should be confined to the crown ONLY to avoid
injuring to the cementum and gingiva

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CLEANING & POLISHING 30
Dental Tape:
- Used with polishing paste to polish proximal surfaces that are
inaccessible to other polishing instruments.
- The tape passes interproximally and activated with firm labio-lingual
motion, care is taken to avoid injuring the gingiva.

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 SURGICAL INSTRUMENTS 31
Excisional and incisional instruments
Periodontal Knifes (Gingivectomy knives):

- Kirkland is the knife typically used for gingivectomy.

- These knives can be obtained as either double- ended or single-ended
instruments.
- The entire periphery of these kidney-shaped knives is the cutting edge

kidney-shaped

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SURGICAL INSTRUMENTS 32
Excisional and incisional instruments
Interdental Knifes:
- Used in interdental areas.
- Orban knife and Merrifield knife are examples of interdental knifes.
- Spear-shaped blade that have cutting edges on both sides of the blade.
- These knives can be obtained as either double- ended or single-ended
instruments.

Spear-shaped

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SURGICAL INSTRUMENTS 33
Excisional and incisional instruments
Bard Parker handle:
- Used for cutting gingival tissue and making surgical incisions.
- Scalpel blades of different shapes and sizes are used in periodontal
surgery .
- The most common blaes are 12 D,15,15C.
- The 12D blade is a beak –shaped blade with cutting edges on both sides,
allowing to engage narrow,restricted areas with both pushing and
pulling cutting motions.

Bard Parker handle

Both sides

12 D Blade 15C Blade 15 Blade

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SURGICAL INSTRUMENTS 34
Periosteal elevator:

- Used to reflect and move the flap after the incision has been made
for flap surgery.
- Prichard and woodson are examples of periosteal elevators

woodson

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SURGICAL INSTRUMENTS 35
Surgical chisel:
- Back-action chisel used with pull motion
- The Ochsenbein is a semicircular indentation on both sides of the
shank that allows the instrument to engage around the tooth into the
interdental area.

- Ochsenbein is Designed for pull stroke, it is ideal for removing bone

adjacent to the tooth without causing trauma, and is especially useful
on the distal of last molars.
LEFT MOLARS

Ochsenbein
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EXTRACTION FORCEPS AND ELEVATORS
36
Needle holder:
- used to suture the flap at the desired position.

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REFERENCES 37
Carranza's Clinical Periodontology, 12E 2015

Fundamentals of Periodontal Instrumentation and

Advanced Root Instrumentation, 7E (2012)

Textbook of dental hyginist- 3rd edition

www.hufriedy.com

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