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.

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Periodontal probes

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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

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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

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Williams probe

Williams marking at : 1, 2, 3, 5, 7, 8,

9,10 mm

William

s p

rob

e

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Williams Goldman-Fox

- Goldman-Fox probe same as Williams probe`s calibration- But it is flattened not round

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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

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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.

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Scaling and root planning

instruments

instrument design

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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

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From A to B

is the shank

(The lower part is Terminal shank )

functional shank length

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Types of shank

(A)A) Straight

(B)B) Curved

(C)C) Contraangled

(double angles)

( A ) Rigid

( B ) fine design (finishing design)

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Blade ( working end )

(B) Tip (C) Toe (H) Heel (F) back (D) Face

(G) lateral surface (E) cutting edge (internal angle )

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Sickle scaler Curette

File Chisel not more

be used hoe

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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 ْ

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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 .

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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.

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204 S C103 CK6 Crane-Kaplan

Sickle scalers angled shank, curved blade, different blade sizes

Curved or straight sickle scalers ?

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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.

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curettes

Function : Removing deep subgingival

calculus Root planning

Two basic types : Universal. Area-specific.

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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?

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Universal curettes

-Universal curettes-

Columbia curettes

13-14 / 2R-2L / 4R-4L /

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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.

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Design of Gracey curette

2. Curved blade in two planes blade curves up and to the side

3. One cutting edge.

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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

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Universal curetteGracey curette

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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 .

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Double-ended Gracey curettes

are 7 instruments

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Standard Gracey Curettes

Reduced set of Gracey

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# 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.

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Gracey #15-16

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• 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

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Gracey curettes for posterior proximal surfaces

mesial surfaces distal surfaces

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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.

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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

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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.

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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.

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- 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.

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Plastic instruments be used to avoid scratching and damage to the implants.

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Plastic instruments for implants

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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.

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ultraonic scaler

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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

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Polishing instruments

Goals of polishing

Remove stains

Smoothening tooth surfaces

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Used in the handpiece with paste. There is disposable plastic

prophylaxis angle and rubber cup, may be used and then discarded.

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Rubber cup

Are available in wheel and cup shapes.

Is used in the handpiece with a polishing paste.

Should be used with low speed .

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Bristle brushes

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Periodontal surgical instruments

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Instruments will be used in Perio I

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- 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