3. • Periodontal instruments are designed for specific purposes, like
removing calculus, planing root surfaces, curetting the gingiva
and removing diseased tissue
• General principles of active instrumentation are common to all
periodontal instruments.
• Proper position of the patient and operator, illumination and
retraction for optimal visibility and sharp instruments are
fundamental prerequisites.
Introduction
4. • Accesibility : Positioning of Patient and
Operator
• Visibility, Illumination, and Retraction
• Condition and Sharpness of Instruments
• Maintaining a Clean Field
• Instrument Stabilization
• Instrument Activation
• Instruments for Scaling and Root Planing
GENERAL PRINCIPLES Of
INSTRUMENTATION
5. • Clinician should be seated on a comfortable
operating stool so that the clinician's feet are flat
on the floor with the thighs parallel to the floor
• The clinician should be able to observe the field
of operation keeping the back straight and the
head erect.
• The patient should be in a supine position and
placed so that the mouth is close to the resting
elbow of the clinician.
Accessibility: Positioning of Patient and Operator
10. • Whenever possible, direct vision with direct
illumination from the dental light is most
desirable
Visibility, Illumination, and Retraction
11. If this is not possible, indirect vision may be obtained
by using the mouth mirror and indirect illumination
may be obtained by using the mirror to reflect light
to where it is needed
13. • Stability of the instrument and the hand is the
primary requisite for controlled instrumentation
• The two factors of major importance in
providing stability are the instrument grasp
and the finger rest.
Instrument Stabilization
14. • A proper grasp is essential for precise control of
movements made during periodontal
instrumentation .
• The most effective and stable grasp for all
periodontal instruments is the modified pen
grasp
Instrument Grasp
15. Modified pen grasp. The pad of the middle
finger rests on the shank.
• Greatest control
• Enables to roll the instrument in precise degree
• Enhances tactile sensitivity
16. • Ensures the greatest control in performing
intraoral procedures
Pen grasp
17. • Stabilizing instruments during sharpening but
it is not recommended for periodontal
instrumentation
• Manipulating air and water syringes
Palm and thumb grasp
18. • The finger rest serves to stabilize the hand and
the instrument by providing a firm fulcrum
• A good finger rest prevents injury and
laceration
• The fourth (ring) finger is preferred by most
clinicians for the finger rest.
Finger Rest
19. Finger rests may be generally classified as
• Intraoral finger rests
• Extra oral fulcrums.
Intraoral finger rests on tooth surfaces ideally are
established close to the working area.
20. 1 Conventional:
• The finger rest is established on tooth surfaces
immediately adjacent to the working area
21. • 2 Cross-arch:
The finger rest is established on tooth
surfaces on the other side of the same arch
22. Opposite arch
The finger rest is established on tooth surfaces
on the opposite arch (e.g., mandibular arch
finger rest for instrumentation on the maxillary
arch)
23. Finger on finger:
• The finger rest is established on the index
finger or thumb of the non operating hand
27. • The two most common extraoral fulcrums are
used as follows:
Palm-up
Palm-down
Extraoral
28. The palm-up fulcrum is established by resting
the backs of the middle and fourth fingers on
the skin overlying the lateral aspect of the
mandible on the right side of the face
Palm up
29. The palm-down fulcrum is established by
resting the front surfaces of the middle and
fourth fingers on the skin overlying the lateral
aspect of the mandible on the left side of the
face
Palm down
31. Refers to manner in which working end is placed
against the surface of tooth.
• It minimises trauma to soft tissues and ensures
maximum effectiveness of instrumentation.
Adaptation
32. Refers to angle between the face of bladed
instrument and tooth surface (Tooth-blade
relationship).
0 degree : subgingival insertion
• 45-90 degrees :scaling & root planing
90 degrees: gingival curettage
Angulation
33. • Pressure created when force is applied against
the surface of tooth with cutting edge of the
instrument.
• The amount of pressure depends on nature of
calculus and whether the stroke is for scaling or
root planing.
• Can be firm, moderate, or light hence when
removing calculus it is applied firmly or
moderately initially & progressively diminished
for root planing strokes.
Lateral Pressure
34. Three basic types of strokes are used during
instrumentation :
exploratory stroke,
scaling stroke
root planing stroke.
Strokes
35. • Light feeling stroke to detect calculus, evaluate
dimensions of pocket & irregularities of tooth
surface.
• Used with probes and explorers and with
curettes (alternated with scaling and root
planing strokes).
• Instrument grasp lightly adapted with light
pressure-tactile sensitivity.
Exploratory
36. • Short powerful pull stroke used with bladed
instruments for removal of supra and subgingival
calculus.
• Scaling motion is initiated in the forearm and
transmitted from the wrist to the hand with the
flexing of the fingers
Scaling stroke
37. • Moderate to light pull stroke that is used for
final smoothing and planing of the root surface.
• Curettes are known to be the most effective
and versatile instrument for this procedure.
Root- planing stroke
38. Pull stroke
• The instrument moves towards the clinician in
incisal/occlusal direction.
Used during scaling to move the deposit away
from gingival sulcus and tooth.
Stroke-characteristics
39. • Opposite of ‘pull’ stroke-directed towards the
apex of tooth
• Little or no pressure is applied to the
instrument or the tooth during insertion.
Push stroke
40. Used when equal pressure is being applied on
both push/pull activations.
• Eg : explorer
Combination Push/Pull Stroke
41. • Instrument is ‘walked’ around the tooth surface
for evaluating periodontal status.
Walking Stroke
43. Periodontal Probes
Locate,measure and mark
pockets
Explorers
Locate calculus
deposits and
caries
Scaling , Root planing
and curettage Inst
Sickle Scalers
Remove supra
gingival calculus
Curettes Subgingival
scaling, root planing
and removal of
softtissue lining
Hoe,Chisel and Files
Subgingival calculus
and altered cementum
Sonic and
Ultrasonic
Scalers
Based on
Purpose
Periodontal Endoscopes
Visualize deep subgingival pkts,
Furcations to detect deposits
Cleansing and
polishing
instruments
46. • Used to locate, measure, and mark pockets, as
well as determine their course on individual
tooth surfaces.
• The typical probe is a tapered, rodlike
instrument calibrated in millimeters, with a
blunt, rounded tip
Periodontal Probes
47. • Periodontal probes (Philstrom 1992)
• First generation probes include conventional
hand held instruments Eg: Williams graduated
periodontal probe
Classification of Probes
48. • Second generation probes include those that
control force application during measurement
Eg. Hunter pressure sensitive probe, Borodontic
probe
• Third generation probes include those that have
controlled force application, automated measurement
and computerized data capture
Eg : Toronto, Florida, Foster miller probe
49. • Fourth generation probes aims at recording
sequential probe positions along the gingival
sulcus
• Fifth generation probes would have a ultra
sound device attached to the fourth generation
probes for identifying attachment level without
probing it
50. Uses
• Periodontal probe is the major instrument used
in diagnosis & evaluation of treatment
planning
• Most widely used diagnostic tool in the clinical
assessment of connective tissue destruction
51. • Calliberated probes
1. UNC-15
2. Marquis colour-coded
3. University of Michigan “O”
probe
4. Michigan “O” probe
5. WHO probe
Types of probes
53. • UNC-15 probe, a 15-mm long probe with
millimeter markings at each millimeter and
color coding at the fifth, tenth, and fifteenth
millimeters.
UNC-15
54. • Marquis color-coded probe. Calibrations are in
3-mm sections.
Marquis colour-coded
55. • University of Michigan “O” probe, with
Williams markings (at 1, 2, 3, 5, 7, 8, 9, and
10 mm).
University of Michigan “O” probe
56. • Michigan “O” probe with markings at 3, 6, and
8 mm.
Michigan “O” probe
57. WHO probe
World Health Organization (WHO) probe,
which has a 0.5-mm ball at the tip and
millimeter markings at 3.5, 5.5, and
11.5 mm and color coding from 3.5 to
5.5 mm.
58. For detection of bone support in furcation areas,
of bifurcated and trifurcated teeth
• The probe is inserted with a firm, gentle
pressure to the bottom of the pocket.
• The shank should be aligned with the long axis
of the tooth surface to be probed.
Nabers probe
59. • Two types
• Nabers I N - Do not have millimeter markings
2N - Black bands from 3 to 6 mm and
from 9 to 12 mm
Nabers I N
Nabers 2 N
60. • Probe is positioned parallel to long axis of
tooth (in the mesiodistal and faciodistal
dimension)
• Working end is well-adapted to tooth surface
Adaptation
61. • Used to locate subgingival deposits and carious
areas and to check the smoothness of the root
surfaces after root planing
• . Explorers are designed with different shapes and
angles, with various uses as well as limitations
Explorers
62. Types
• #17 or Orban
• #23 or Shepherd’s hook
• EXD 11/12
• #3
• #3CH or Pigtail or cowhorn
Five typical explorers
63. • Tip is bent at 90° angle to the lower shank
• This allows the back of the tip to be directed against the
soft tissue at the base of the pocket or sulcus.
• Straight lower shank allows insertion into narrow
pockets.
Orban type explorer
64. • Name given as it resembles the long stick with a
curved end that was used by ancient shepherds
to catch sheep.
Use
• Supragingival examination of dental caries and
irregular margins of restoration.
Shepherd Hook Explorer
65. • Used in calculus detection in normal sulci or
shallow pockets.
Curved Explorer ( #3)
66. • Long complex shank design makes it useful to
work in the anterior and posterior teeth with
normal sulci or deep periodontal pockets.
• Helps in the assessment of root surfaces on
anterior and posterior teeth.
EX 11/12
67. • Gets its name as they resemble a pig’s tail or a
bull’s horn.
• Used for calculus detection in normal sulci or
shallow pockets extending no deeper than the
cervical-third of the root .
Pigtail and Cowhorn Explorers
68. The five basic scaling instruments . A, Curette;
B, sickle; C, file; D, chisel; E, hoe.
Scaling and Curettage Instruments
70. • Sickle scalers have a flat
surface and two cutting
edges that converge in a
sharply pointed tip.
• The sickle scaler is used
to remove supragingival
calculus
Sickle Scalers
71. Lateral surfaces Straight meet in
a pointed tip
Relationship of face
to shank
90°
No of cutting edges 2 per working
end
Working end in cross
section
Triangular
Functional shank Short rigid
Use on crown & root
surface
Limited to use
on enamel
surface
72. Types of Sickle Scalers
Anterior: straight shank
with the handle, shank
and working end in the
same plane
Posterior or universal
scalers: paired with
mirror images at ends &
have contra-angled
73. . Sickle scalers are used with a pull stroke.
Small, curved sickle scaler blades such as the
204SD can be inserted under ledges of calculus
several millimeters below the gingiva
74. • The U15/30 Ball, and Indiana University sickle scalers are
large.
• Both ends of a U15/30 scaler
• The Jaquette sickle scalers #1, 2, and 3 have medium-size
blades.
75. • The curved 204 posterior sickle scalers are
available with large, medium, or small blades
76. The Nevi 2
• Curved posterior sickle scalers that are thin to
be inserted subgingivally for removal of light to
moderate ledges of calculus.
• Sickle scalers with straight shanks are
designed for use on anterior teeth and
premolars.
• Sickle scalers with contra-angled shanks adapt
to posterior teeth.
78. • Curette is instrument of choice for removing
deep subgingival calculus, root planing , altered
cementum , and removing the soft tissue lining
the periodontal pocket
79. • The curette is finer than sickle scalers and does
not have any sharp points or corners other than
the cutting edges of the blade
Basic characteristics of a curette: spoon-shaped
blade and rounded tip.
80. • Curettes can be adapted and provide good
access to deep pockets with minimal soft tissue
trauma
Basically of 2 types
Universal
curettes
Area
Specific
curettes
81. Universal
• Primarily used for subgingival scaling & root planing
• Gingival curettage
• Supragingival scaling in cervical area
Gracey
• Scaling & root planing in periodontal pockets
• Ideal for furcation areas, depressions &concavities
• Easy adaptation in areas that are difficult to access
82. Design (Universal Curette)
Working end Curves upward
Relationship of
face to shank
90° to lower shank
No of cutting
edges
2 -uses both outer and
inner edge
Cutting edges Straight , parallel to each
other
Working end in
cross section
Semi-circular
Functional shank Vary :short-long,
rigid-flexible
Use on crown &
root surface
Enamel & cementum
surfaces
Application Can be used on all ant. &
post. surfaces
83. Design(Gracey Curette)
Working end Curves upwards & to one side
Relationship of face
to shank
Face is tilted in relation to lower
shank(60°)
No of cutting edges 1/ Working end –use outer edge
only
Cutting edges Curved
Working end in cross
section
Semi-circular
Functional shank long or extended rigid flexible
Use on crown & root
surface
Enamel & cementum surfaces
Application limited use(area specific)
84. Types of Gracey curettes
No Area of Use
1/2 Anterior
3/4 Anterior
5/6 Anterior & Premolar
7/8 Posterior-buccal & lingual
9/10 Posterior-buccal & lingual
11/12 Posterior-mesial
13/14 Posterior-distal
15/16 Posterior-mesial(modification)
85. Difference between Universal and Area Specific Curettes
Universal Area specific
Area of use All areas &
surfaces
Designed for
specific areas and
surfaces
Cutting edge Two One
Use Both working
edge
(outer/inner)
Outer working edge
only
(outer edge )
Curvature In one plane;
blade curved
up
Curved in two planes;
blade curved up and
to the side
Blade angle Not offset:
face of blade
bevelled at 90°
Offset blade : face
bevelled at 70°
86. • Gracey # 15-16 is a modification of the standard #11-12
• designed for the mesial surfaces of posterior teeth
• Consists of #11-12 blade with more acutely angled #13-14
shank
• Gracey#17-18 is a modification of # 13-14
• Terminal shank elongated by 3mm and angulation of shank
for occlusal clearance and access to posterior distal
surfaces
Recent additions to Gracey curettes include Gracey # 15-16 and # 17-18
#15 -16
87. After Five curettes
• Modification of standard Gracey
design
• Terminal shank is 3mm longer
allowing extension into deeper
periodontal pockets(>5mm)
• Thin blade with a large –diameter
tapered shank
Eg : All standard Gracey no.s
except #9-10
Extended –Shank Curettes
88. Mini Five Curettes
• Modificationof After Five curettes
• Blades are half the length of After Five or standard Gracey curettes
• Shorter blades allows easier insertionand adaptationto deep, narrow pockets, furcations, developmental grooves and tight pockets
• They are availablein both rigid and finishingdesigns
• Availablewith all standard Graceyno.s except #9-10
Mini-Bladed Curettes
Comparison of After five
and mini five curette
Shorter mini five blade
89. • Is a set of another four mini blade curettes
• Blade length 50% shorter than conventional
Gracey curettes
• They adapt closely to tooth surface on anterior
teeth and on line angles
• Carries a risk of “gouging”or “grooving” into the
root surfaces
Gracey Curvettes
90. Sub0, #1-2 Used for anterior teeth and
premolars
#11-12 Used for posterior mesial
surfaces
#13-14 Used for posterior distal
surfaces
91. • Set of three curettes combines the shank design of
the standard Gracey #5-6, #11-12 and # 13-14 with a
universal blade honed at 90°
Langer and Mini-Langer Curettes
92. 5-6-adapts to mesial
and distal surfaces of
anterior teeth
#1-2 adapts to mesial
and distal surfaces of
mandibular posterior
teeth
#3-4 adapts to mesial and
distal surfaces of
maxillary posterior teeth
Gracey type shanks with
universal curette blades
#5-6 #1-2 #3-4
93. • New type of area-specific curet designed to
remove light residual deposits and bacterial
contaminants from the entire surface.
• Shape of working-end – tiny circular disk.
O’Hehir Debridement Curets
94. CUTTING EDGE – Entire circumference of working end
• The working end curves into the tooth for easy
adaptation in furcations, developmental grooves and
line angles.
95. Curet Area of use
O’ Hehir 1/2 facial and lingual surfaces of
posterior teeth
O’ Hehir 3/4 Mesial and distal surfaces of
posterior teeth
O ‘Hehir 5/6 Anterior teeth
O’ Hehir 7/8 Anterior teeth with deep pockets
96. • Set of double-ended, highly
magnetized instruments
• Long blade is for use in
pockets,contra-angled tip for
use in furcations
• Designed for the retrieval of
broken instrument tips from the
periodontal pocket
Schwartz Periotrievers
97. • Broken instrument tip attached to the magnetic
tip of the Schwartz Periotriever.
They are indispensable when the clinician has
broken a curette tip in a furcation or deep
pocket.
98. • These instruments are for use on
titanium and other implant abutment
materials
• Plastic to avoid scarring and
permanent damage to the implants
Colorvue (Hu-Friedy, Chicago).
Plastic Instruments for Implants
100. Scaling of ledges or rings of calculus
Used only in easily accessible area
Blade is bent at 99-degree
angle.Cutting edge bevelled at 45
degree
Eg : McCall’s #3,4,5,6,7and 8
provide acess to all tooth surfaces
Hoe Scalers
101. Adjunct to scaling
To crush, fracture or
roughen heavy tenacious
calculus
Used for removing
overhanging margins of
restorations
File
102. Blades are slightly curved and
have a straight cutting edge
beveled at 45 degrees.
Dislodge and remove heavy
calculus
Designed to use on proximal
surface where the interdental
papilla is no longer present
Best used in anterior mandibular
sextant
Chisel
103. • They are hoes with a shallow, half moon radius that
fits into the roof or floor of the furcation
The shanks are slightly curved for better access
• Tips are available as two widths
Quetin Furcation Curets
BL1and MD1(small and
fine)
Blade width 0.9mm
BL2and MD2(larger and
wider)
Blade width 1.3mm
104. • BL2 : larger
BL1 : smaller
• Instruments remove burnished calculus from
recessed areas of the furcation where curettes,
even the mini-bladed curettes, are too large to
gain access.
105. • Using mini-bladed Gracey curettes and Gracey
Curvettes in the roof or floor of the furcation
may unintentionally create gouges and grooves.
• The Quétin instruments , are well suited for
this area and lessen the likelihood of root
damage.
106. • Diamond-coated files are unique instruments
used for final finishing of root surfaces.
• They are coated with very-fine-grit diamond
• These files produce a smooth, even, clean,
highly polished root surface
Diamond Coated Files
107. • The most useful diamond files are the buccal-lingual
instruments , which are used in furcations and also adapt well
to many other root surfaces.
• Diamond files. A, #1,2 (Brasseler, Savannah, GA);
B, #3,4 (Brasseler).
C, SDCN 7, SDCM/D 7 (Hu-Friedy,Chicago).
110. Advantages:
1. Decrease time spent in deposits removal
2. Debris, blood,necrotic tissue flushed away
3. Decreased fatigue, increased patient comfort
4. Delivery of antimicrobial agents
Contraindications :
1. Immunocompromised individuals
2. Pt. with cardiac pacemakers
3. Pt. with demineralised tooth structure
4. Pt. with restorative materials
Ultrasonic and Sonic Instruments
111. • Ultrasonic
instruments may be
used for removing
plaque, scaling,
curetting and
removing stain
They are of two types
Vibrations range from 20,000 to 45,000Hz
Magnetostrictive
• Pattern of
vibration of the
tip is elliptic
• All sides of the tip
are active when
adapted to tooth
• These tips
generate heat and
require water for
cooling
Piezoelectric
• Pattern of
vibration is linear
• Two sides of the
tip are most
active
• These units do
not generate heat
but utilize water
for cooling
frictional heat
and flushing
away debris
112. • Consist of a handpiece that attaches to compressed–
air line and uses a variety of specially designed tips
• Vibrations at the sonic tip ranges from2000 to 6500 Hz
• Sonic scaler tips are large in diameter and universal in
design
• Stroke pattern-elliptical to orbital in shape
• The water droplets of the spray mist are tiny vaccum
bubbles that collapse releasing energy in a process
known as CAVITATION .This serves to flush deposits by
vibrating tip
Sonic Instruments
113. • They possess tips with different shapes
available for scaling, curetting ,root planing and
surgical debridement
• All tips designed to operate in a wet field with
a water spray directed at the end of the tip
• The water droplets of the spray mist are tiny
vaccum bubbles that collapse releasing energy
in a process known as CAVITATION. This serves
to flush deposits by the vibrating tip from the
pocket
Ultrasonic and Sonic Instruments
114. • Grasp : Modified pen grasp, Pen grasp
• Fulcrum: Intraoral(ant.)
Extraoral(max. post)
• Adaptation: tip is adapted to tooth surface
approx. 10-15 degree
• Strokes: light brush strokes, multidirectional strokes are
used to avoid grooving & gouging
115. • Used subgingivally in the diagnosis &
treatment of periodontal disease
• Consists of 0.99mm-diameter,
reusable fibreoptic endoscope over
which is fitted a disposable sterile
sheath
• Fits onto periodontal probes &
ultrasonic instruments designed for its
use
Periodontal Endoscope
116. • The fibreoptic endoscope attaches to a charged
coupled device(CCD) video camera and light source
and produces a image on monitor for viewing
• Magnification ranges from 24X to 46X enabling
visualization of even minute plaque and calculus
• Can also be used to evaluate subgingival areas for
caries, defective restorations, root fractures and
resorption
117. Rubber cups:
Used in a handpiece with a special prophylaxis angle
• Used with cleansing & polishing paste(Fluoride)
• Aggressive use of the rubber cup with any abrasive
may remove the layer of cementum, which is thin in
the cervical area.
Cleansing & Polishing Instruments
118. Bristle Brushes:
• Available in wheel & cup shapes
• Used with cleansing & polishing paste(F)
• Stiff-confined to crown to avoid injury to gingiva
and cementum
119. Dental Tape:
• Used with polishing paste in proximal surfaces
• Kept at right angle to long axis & activated with
firm labiolingual motion
120. Air Powder Polishing:
• A handpiece delivers an air-
powder slurry of warm water
& sodium bicarbonate
(Prophy-Jet)
• Effective in removal of extrinsic
stains & soft deposits
121. • Polishing powders containing glycine is used
for subgingival biofilm removal from root
surfaces. Air-powder polishing can be used
safely on titanium implant surfaces
• In patients with medical histories of respiratory
illnesses and hemodialysis the air-powder
polishing device cannot be used
122. Porte polisher:
• A hand instrument with a wooden point attached
• It is used to rub an abrasive agent over tooth surface
& remove stains
• A modified pen grasp is used with a circular motion
123. A. Excisional & Incisional:
1. Periodontal knives
2. Interdental knives
3. Surgical blades
B.Surgical curettes & sickles
C. Periosteal elevators
D. Surgical Chisels & Hoes
E. Surgical Files
F. Scissors,Nippers
G. Needle Holders
Surgical Instruments(classification)
124. Kirkland knives:
• Gingivectomy
• Either double/single ended
• Entire periphery is cutting edge
Interdental knives
eg. Orban’s knife no 1-2
Merrifield knife no.1,2,3
• Used in interdental area
• Spear shaped, cutting edge on both sides
• Double/single ended
Periodontal Knives
125. • 12-D: beak shaped,cutting edge both sides,allows operator to engage narrow restricted areas with
both pushing & pulling motions
• 15: used for thinning flaps
• Design of no.15 allows incision into narrow interdental portion of flaps
• 15-C:narrower version of no.15,used for making initial scalloping type incision
Surgical Blades
126. • For removal of granulation
tissue, fibrous interdental
tissue & tenacious gingival
deposits
• Curettes- The kramer heavy
surgical curettes #1
2and 3
• Sickle: Ball scaler #B2-B3
Surgical Curettes & Sickles
128. Ochsenbein chisels are paired, with the cutting edges in
opposite directions. Used in push stroke
chisel with a semicircular indentation on both sides of the
shank that allows the instrument to engage around the
tooth and into the interdental
area
129. Hoe:
• Pull stroke, used to detach
pocket walls after
gingivectomy
• Curved shank with
flattened fishtail shaped
blade
• Cutting edge bevelled with
rounded edge
130. Surgical Files
• To smooth the rough bony ledges all areas
of bone
Eg. Schulger & sugarman files
• Push / Pull stroke
• Primarily in interdental area
131. Scissors & Nippers
• For removing tabs of tissue during gingivectomy,
trimming margins of flaps, enlarging incisions in
periodontal abscess, removing muscle attachments
during mucogingival surgery
• Eg.Golmanfox no.16 with curved bevelled blade
132. • Used to suture flap at desired position after surgical
procedure is complete
• Castroviejo needleholder is used for delicate, precise
techniques that require quick and easy release and
grasp of the suture .
Needle Holders
135. Sharpening stones can be categorized by their method of use
• Mandrel-Mounted Rotary Stones – used in motor driven
slow speed handpiece
• Unmounted Stones – come in various sizes and shapes and
are hand held during use. May be flat and rectangular, have
grooved surfaces or be cylindrical or conical
136. Technique:
Angle 100-110° b/w the
face of blade sharpening
stone
• Downward Stroke
• Sharpening can be tested
by visual inspection –
under light
• Tactile discrimination :
plastic test stick
137. • Effective treatment requires clinical skill and
sound knowledge of periodontal
armamentarium.
• Thorough understanding of various
instruments is therefore, necessary for
successful periodontal treatment outcomes.
Conclusion
