Principles of scaling & root planing dr alaa attia

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Associate prof, periodontology, Umm Alqura University, Saudi arabia, And Al-Azhar University, Egypt

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Principles of scaling & root planing dr alaa attia

  1. 1. Principles of scaling and root planing By Associate professor Dr. Alaa Moustafa Attia
  2. 2. Scaling: It is the process by which plaque and calculus are removed from both supragingival and subgingival tooth surfaces. Root planing: It is the process by which residual embedded calculus and portions of cementum are removed from the roots to produce a smooth, hard, and clean surface. Scaling & root planing means phase 1 therapy
  3. 3. Objective of scaling and root planing The primary objective of scaling and root planing is to restore gingival health by completely removing elements that provoke gingival inflammation (i.e. , plaque, calculus , and bacterial toxins).
  4. 4. Before scaling & root planing
  5. 5. After scaling & root planing
  6. 6. Radiograph before & after scaling & root planing
  7. 7. Detection skills Detection skills that required for the accurate initial assessment of the extent and nature of deposits and root irregulities on root surface before scaling and root planing: includes -Visual examination -Tactile exploration
  8. 8. Supragingival scaling procedures : By means of scalers, sonic and ultrasonic scalers, they were activated in obliaque and vertical direction. Subgingival scaling and root planing procedures: By means of curettes {(universal & Gracy (area spesific)} and sometimes Hoe scalers
  9. 9. Subgingival scaling procedures A= Curette inserted with the face of the blade flush against the tooth. B=Working angulation (45-90) is established at the base of the pocket. C= Lateral pressure is applied, and the scaling stroke is activated in the coronal direction.
  10. 10. Instrumentation for calculus removal A= Calculus is removed by engaging the apical or lateral edge of the deposits with cutting edge of scaler; vertical movement of the instrument will remove the fragment of the calculus. B= The instrument is moved lateraly and again engages the edge of the calculus. C=The final portion of the deposit is engaged and removed.
  11. 11. Shank position for scaling proximal surface A= Correct shank position, parallel with the long axis of the tooth. B= Incorrect shank position, titled away from the tooth. C= Incorrect shank position, titled too far toward the tooth.
  12. 12. The body position of the operator and the location of the finger rest must be frequently adjusted or changed to allow the following: - Parallism - Wrist-arm motion Notice
  13. 13. Approaches of scaling and root planing
  14. 14. 1- Maxillary anterior sextant: facial aspect, surface toward the operator Front positionO. Position DirectIllumination DirectVisibility Index finger of non operating handRetraction Intraoral, palm down. Fourth finger on the incisal edges or the occlusal or facial surfaces of adjacent maxillary teeth. Finger rest
  15. 15. 2- Maxillary anterior sextant: facial aspect, surface away from the operator Front positionO. Position DirectIllumination DirectVisibility Index finger of non operating handRetraction Intraoral, palm up. Fourth finger on the incisal edges or the occlusal or facial surfaces of adjacent maxillary teeth. Finger rest
  16. 16. 3- Maxillary anterior sextant: lingual aspect, surface away from the operator Back positionO. Position IndirectIllumination IndirectVisibility NoneRetraction Intraoral, palm up. Fourth finger on the incisal edges or the occlusal or facial surfaces of adjacent maxillary teeth. Finger rest
  17. 17. 4- Maxillary right posterior sextant: premolar region only: facial aspect Side or back positionO. Position DirectIllumination DirectVisibility Mirror or Index finger of non operating handRetraction Intraoral, palm up, Fourth finger on the occlusal surfaces of the adjacent maxillary posterior teeth. Finger rest
  18. 18. 5- Maxillary right posterior sextant: facial aspect Side positionO. Position DirectIllumination Direct (indirect for distal surfaces of molars).Visibility Mirror or index finger of non operating handRetraction Extra oral, palm up. Back of the middle and fourth fingers on the lateral aspect of the mandible on the right side of the face. Finger rest
  19. 19. 6- Maxillary right posterior sextant: lingual aspect Side or front positionO. Position Direct and indirectIllumination Direct or indirectVisibility NoneRetraction Extraoral, palm up. Back of the middle and fourth fingers on the lateral aspect of the mandible on the right side of the face. Finger rest
  20. 20. 7- Maxillary right posterior sextant: lingual aspect Front positionO. Position DirectIllumination DirectVisibility NoneRetraction Intraoral, palm up, finger on fingerFinger rest
  21. 21. 8- Maxillary left posterior sextant: facial aspect Side or back positionO. Position Direct or indirectIllumination Direct or indirectVisibility MirrorRetraction Extroral, palm down. Front surfaces of the middle and fourth fingers on the lateral aspect of the mandible on the left side of the face. Finger rest
  22. 22. 9- Maxillary left posterior sextant: facial aspect Back or side positionO. Position Direct or indirectIllumination Direct or indirectVisibility NoneRetraction Intraoral, palm up. Fourth finger on the incisal edges or the occlusal surfaces of adjacent maxillary teeth. Finger rest
  23. 23. 10- Maxillary left posterior sextant: lingual aspect Front positionO. Position DirectIllumination DirectVisibility NoneRetraction Intraoral, palm down, opposite arch, reinforced. Fourth finger on incisal or facial surfacs of mandibular teeth. Finger rest
  24. 24. 11- Maxillary left posterior sextant: lingual aspect Front positionO. Position Direct and indirectIllumination Direct and indirectVisibility NoneRetraction Extraoral, palm down. Front surface of middle and fourth fingers on the lateral aspect of the mandible on the left side of the face. Finger rest
  25. 25. 12- Maxillary left posterior sextant: lingual aspect Side or front positionO. Position DirectIllumination DirectVisibility NoneRetraction Intraoral, palm up. Fourth finger on the occlusal surfaces of adjacent maxillary teeth. Finger rest
  26. 26. 1- Mandibular anterior sextant: facial aspect, surfaces toward the operator Front positionO. Position DirectIllumination DirectVisibility Index finger of the non-operating handRetraction Intraoral, palm down. Fourth finger on the incisal edge or the occlusal surfaces of adjacent mandibular teeth. Finger rest
  27. 27. 2- Mandibular anterior sextant: facial aspect, surface away from the operator Back positionO. Position DirectIllumination DirectVisibility Index finger or thumb of the nonoperating handRetraction Intraoral, palm down. Fourth finger on the incisal edge or the occlusal surfaces of adjacent mandibular teeth. Finger rest
  28. 28. 3- Mandibular anterior sextant: lingual aspect, surfaces away from the operator Back positionO. Position Direct or indirectIllumination Direct and indirectVisibility Mirror retract the tongueRetraction Intraoral, palm down. Fourth finger on the incisal edge or the occlusal surfaces of adjacent mandibular teeth. Finger rest
  29. 29. 4- Mandibular anterior sextant: lingual aspect, surfaces toward the operator Front positionO. Position Direct and indirectIllumination Direct and indirectVisibility Mirror retract the tongueRetraction Intraoral, palm down. Fourth finger on the incisal edge or the occlusal surfaces of adjacent mandibular teeth. Finger rest
  30. 30. 5- Mandibular right posterior sextant: facial aspect Side or front positionO. Position DirectIllumination DirectVisibility Mirror or index finger of nonoperating handRetraction Intraoral, palm down. Fourth finger on the incisal edge or the occlusal surfaces of adjacent mandibular teeth. Finger rest
  31. 31. 6- Mandibular right posterior sextant: lingual aspect Front positionO. Position Direct and indirectIllumination Direct and indirectVisibility Mirror retracts the tongueRetraction Intraoral, palm down. Fourth finger on the incisal edge or the occlusal surfaces of adjacent mandibular teeth. Finger rest
  32. 32. 7- Mandibular left posterior sextant: facial aspect Side or back positionO. Position DirectIllumination Direct or indirectVisibility Index finger or mirror of the nonoperating hand.Retraction Intraoral, palm down. Fourth finger on the incisal edge or the occlusal surfaces of adjacent mandibular teeth. Finger rest
  33. 33. 8- Mandibular left posterior sextant: lingual aspect Front or side positionO. Position Direct and indirectIllumination DirectVisibility Mirror retracts the tongueRetraction Intraoral, palm down. Fourth finger on the incisal edge or the occlusal surfaces of adjacent mandibular teeth. Finger rest
  34. 34. Thank You

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