Dr. M. Lohith, MDS Sr. Lecturer

1. Presented by
Dr. M. Lohith
MDS Sr. Lecturer

2. PARTS OF PERIODONTAL INSTRUMENT
PERIODONTAL PROBE : HANDLE, SHANK, WORKING END

3. CLASSIFICATION
ACCORDING TO PURPOSES :
1. PERIODONTAL PROBES
2. EXPLORERS
3. SCALING, ROOTPLANING, CURETTAGE INSTRUMENTS
-- sickle scalers
-- curettes
-- hoe, chisel, and file scalers
-- ultrasonic and sonic instruments
4. PERIODONTAL ENDOSCOPE
5. CLEANSING and POLISHING INSTRUMENTS

4. 1. PERIODONTAL PROBES -- locate
-- measure
-- mark -- pockets
A. MARQUIS COLOR CODED – 3mm
B. UNC-15 – color coding – 5th, 10th, 15thmm
C. WILLIAMS PROBE – 4 and 6 missing
D. MECHIGAN “O” PROBE – 3, 6, 8mm
E. WHO – 0.5mm ball at tip
-- 3.5, 8.5 and 11.5mm
-- color coding from 3.5 – 5.5 mm

5. NABERS PROBE – FURCATION AREAS

6. PLASTIC PROBES

7. 2. EXPLORERS – locate -- calculus deposits
-- caries
FIVE TYPICAL EXPLORERS
A. # 17
B. # 23
C. EXD 11 – 12
D. # 3
E. # 3CH pigtail

8. 3. SCALING, ROOTPLANNING, CURETTAGE INSTRUMENTS
– removal of plaque and altered cementum
-- debridement of soft tissue lining the pocket
FIVE BASIC SCALING INSTRUMENTS
A. CURETTE
B. SICKLE
C. FILE
D. CHISEL
E. HOE

9. BASIC CHARACTERS OF
SICKLE SCALER U 15 / 30 SCALER
Triangle shape
Double-cutting edge
Pointed tip

10. POSTERIOR SICKLE SCALERS

11. HOE CHISEL and FILE SCALER

12. CURETTES
Instrument of choice for removing --
deep subgingival calculus
root planing
necrotic cementum
removal of soft tissue lining the pocket

13. TWO TYPES
UNIVERSAL AREA – SPECIFIC
GRACEY

14. BASIC CHARACTERS OF
CURETTE
Spoon – shaped blade
Rounded tip

15. UNIVERSAL CURETTES
Examples :
BARNHART CURETTES # 1- 2 / 5 - 6
COLUMBIA CURETTES # 13 – 14, 2R – 2L, 4R – 4L

16. AREA- SPECIFIC CURETTES / GRACEY CURETTES
A set of instruments designed and angled to
adapt to specific anatomic area of the dentition
Best instruments for subgingival scaling and
root
planing
Provide the best adaptation to tooth surface

17. 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

18. Recent additions to the Gracey curettes :
GRACEY # 15-16 --- MODIFICATION OF # 11-12 BLADE
AND SHANK OF # 13-14
-- USED FOR MESIAL SURFACES OF POSTERIOR TEETH
GRACEY # 17-18

19. GRACEY UNIVERSAL
AREA OF USE set of many curettes one curette
designed for specific
areas and surfaces
CUTTING EDGE one cutting edge used both cutting
edges used
CURVATURE curved in two planes curved in
one plane
BLADE ANGLE offset blade: face of not offset
the blade beveled at face of the
60 degrees to shank blade beveled at
90 degrees to shank

20. ULTRASONIC AND SONIC INSTRUMENTS
Used for :
removing plaque
scaling
curetting
removing stain

21. ULTRASONIC TIP VIBRATIONS
20000 to 45000 cycles/second [hertz]

22. TWO TYPES
1. MAGNETOSTRICTIVE :
Vibration of the tip is elliptical which means all
sides of the tip are active
2. PIEZOELECTRIC :
Vibration of the tip is back and forth which
means two sides of the tip are the most active

23. MAGNETOSTRICTIVE PIEZOELECTRIC

24. SONIC SCALER

25. All tips are designed to operate in a wet field
and have attached water outlets
The spray is directed at the end of the tip to
dissipate the heat generated by the ultrasonic
vibrations
Within the water droplets of this spray mist
are tiny vacuum bubbles that quickly collapse
releasing energy in a process known as
“cavitation”

26. ULTRASONIC AND SONIC TIPS

27. THE PERIODONTAL ENDOSCOPE
Device allows clear visualization of :
deep pockets
furcations
Caries
defective restorations
root fractures & resorption

28. PERIOSCOPE EXPLORERS ENDOSCOPE in PCKT

29. 5 CLEANSING AND POLISHING INSTRUMENTS
rubber cups
brushes
dental tape
air-powder abrasive systems

30. SURGICAL INSTRUMENTS
1. EXCISIONAL AND INCISIONAL INSTRUMENTS
2. SURGICAL CURETTES AND SICKLES
3. PERIOSTEAL ELEVATORS
4. SURGICAL CHISELS
5. SURGICAL FILES
6. SCISSORS
7. HEMOSTATS AND TISSUE FORCEPS

31. 1. EXCISIONAL AND INCISIONAL INSTRUMENTS
A. PERIODONTAL KNIVES [GINGIVECTOMY KNIVES]
Kirkland knife – used for gingivectomy
B. INTERDENTAL KNIVES
Orban knife # 1-2 and merrifield knife # 1,2,3 and 4
-- used for interdental areas

32. C. SURGICAL BLADES
Most commonly used are # 15C , 15, 12D

33. D. ELECTRO[RADIO] SURGERY
Three classes of active electrodes
Single-wire electrode – incising or excising
Loop electrode -- planing tissue
Heavy electrode -- coagulation procedures

34. FOUR BASIC TECHNIQUES
ELCTROSECTION
ELECTROCOAGULATION
ELECTROFULGURATION
ELECTRODESICCATION

35. MOST COMMON
Electro section Electro coagulation

36. ELECTROSECTION
used for :
incisions
excisions
tissue planing

37. ELECTROCOAGULATION
Provides a wide range of coagulation or hemorrhage
control obtained by using electrocoagulation current
Electrocoagulation can prevent bleeding / hemorrhage
at the initial entry into soft tissue but cannot stop
bleeding after blood is present
Basic rule of electrosurgery -- always keep moving tip
Contraindicated : poorly shielded cardiac pacemakers

38. 2. SURGICAL CURETTES AND SICKLES
removal of :
granulation tissue
fibrous interdental tissues
tenacious subgingival deposits
#1, # 2 # 3

39. 3. PERIOSTEAL ELEVATORS
reflection of flap
# 24 G

40. 4. SURGICAL CHISELS AND HOES
removing and reshaping bone
A. OCHSENBEIN CHISELS A. LATERAL VIEW OF HOE
B. RHODES CHISEL B. FRONTAL VIEW OF HOE

41. 5. SURGICAL FILES
smooth rough bony ledges
remove bone
# 9-10

42. 6. SCISSORS AND NIPPERS
removing tabs of tissue during gingivectomy
trimming the margins of flaps
enlarging incisions in periodontal abscesses
removing muscle attachments in M G surgery
GOLDMAN – FOX # 16 NIPPERS

43. 7. NEEDLE HOLDERS
Suture the flap
A. CONVENTIONAL B. CASTROVIEJO

44. SHARPENING OF INSTRUMENTS
To avoid wasting time and operating
haphazardly, clinicians must be thoroughly
familiar with the principles of sharpening and
able to apply them to produce a keen cutting
edge on the instruments they are using

45. EVALUATED BY SIGHT AND TOUCH
1. When a dull instrument is held under a light
the rounded surface of its cutting edge reflects
light back to the observer and appears as a
bright line
The cutting edge of a sharp instrument on the
other hand has no surface area to reflect light
so no bright line can be observed

46. 2. Tactile evaluation of sharpness is performed
by drawing the instrument lightly across an
acrylic rod known as sharpening “test stick”
A dull instrument will slide smoothly without
“biting” into the surface in comparison with the
sharp instrument which raises a shaving

47. OBJECTIVE
Restore the fine, thin, linear cutting edge
It is important to store the cutting edge
without distorting the original angles of instrument

48. SHARPENING
NATURAL STONES SYNTHETIC STONES
- india - carborandum
- arkansas oil stones - ruby
- ceramic stones
FLAT INDIA STONE
FLAT ARKANSAS STONE
CONE-SHAPED ARKANSAS
CERAMIC STONE

49. A. MOUNTED ROTARY STONES
Generally not recommended
B. UN-MOUNTED STONES
Variety of sizes and shape
Rectangular
Cylindrical
Cone shaped
FLAT INDIA STONE
FLAT ARKANSAS STONE
CONE-SHAPED ARKANSAS
CERAMIC STONE

50. PRINCIPLES OF SHARPENING
1. Choose a stone of an appropriate shape and
abrasiveness
2. Use a sterilized sharpening stone
3. Establish proper angle between the sharpening
stone and surface of the instrument
4. Maintain a stable, firm, grasp of both the
instrument and the sharpening stone
5. Avoid formation of a “wire edge”
6. Avoid excessive pressure
7. Lubricate the stone during sharpening
8. Sharpen instruments at first sign of dullness