The document details the classification and functions of periodontal instruments used in dentistry, focusing on their specific purposes for scaling, curettage, and probing. It describes various types of instruments, including periodontal probes, explorers, scaling instruments, and ultrasonic devices, along with their designs and intended uses. Additionally, it covers advanced technologies such as digital probes and ultrasonic scalers, enhancing the diagnosis and treatment of periodontal disease.

1. CLASSIFICATION OF
PERIODONTAL INSTRUMENTS
DEPARTMENT OF
PERIODONTOLOGY
SUBMITTED BY:
ANUSHKA DUBEY
BDS 4TH
YEAR

2. CONTENTS
○ Introduction
○ Parts of Instruments
○ Classification
○ Periodontal probes
○ Explorers
○ Scaling and Curettage Instruments
○ Ultrasonic and Sonic Instruments
○ Dental Endoscopes
○ Cleaning and polishing Instruments

3. Periodontal instruments are
designed for specific
purposes such as :
• Removing calculus
• Planing root surfaces
• Curetting the gingiva, and
• Removing diseased tissue.
INTRODUCTION

4. THE PARTS OF EACH INSTRUMENT ARE
REFERRED TO AS THE WORKING END,
SHANK, AND HANDLE

5. Classification of
periodontal
instruments
Periodontal instruments are classified according to the purposes
they serve, as follows:
○ Periodontal probes
○ Explorers
○ Scaling, root-planing, and curettage instruments :Sickle
scalers, Curettes, Hoe, chisel, and file scalers, Ultrasonic and
sonic instruments
○ Periodontal endoscopes.
○ Cleansing and polishing instruments

6. PERIODONTAL PROBES
○ The typical probe is a tapered, rodlike
instrument calibrated in millimeters, with a
blunt, rounded tip
○ Periodontal probes are used to measure the
depth of pockets
○ When measuring a pocket, 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

7. CLASSIFICATION OF PROBE
○ 1st generation probe
○ 2nd generation probe
○ 3rd generation probe
○ 4th generation probe
○ 5th generation probe
Pihlstrom
Watts

8. First Generation probe
Manual and handheld.
They rely on tactile sense and visual markings.
Used to measure pocket depth
Most common type of probe.
Typically made of stainless steel.

9. Second generation PROBE
Second generation probes are
manual.
Equipped with a built-in
mechanism.
Regulates probing force to 20
grams.

10. Third Generation PROBE
Electronic probes.
Measure pocket depth.
Display results on a digital screen.
Built-in mechanism to regulate probing
force.

11. Fourth generation probe
Fourth generation probes are three-
dimensional (3D).
They create detailed maps of periodontal
tissues.
Currently under development.
Potential to revolutionize diagnosis and
treatment of periodontal disease.

12. Fifth-generation probes
Fifth-generation probes are in
development.
Expected to be more advanced than
fourth-generation.
May utilize artificial intelligence for data
analysis.
Aimed at providing more accurate and
personalized diagnoses.

14. Curved #2 Nabers probe for detection of furcation areas,
with color-coded markings at 3, 6, 9, and 12 mm.

15. EXPLORERS
○ Purpose: ○ Detect subgingival deposits
(plaque, calculus).
○ Identify carious areas
(decayed tooth surface).
○ Check the smoothness of
root surfaces after root
planing.

16. EXPLORERS
ARE
DESIGNED
WITH
DIFFERENT
SHAPES AND
ANGLES,
WITH
VARIOUS
USES

17. Limitations: In deep
pockets, the curved design
of the pigtail explorer
can restrict access to
deeper areas, resulting
in missed deposits and
inadequate assessments..
A. Pigtail Explorer shows limitations
B. #3 Explorer insertion
C.#3 Explorer limitations
D. Periodontal probe insertion

18. SCALING AND CURETTAGE
INSTRUMENTS
The five basic scaling instruments. A, Curette; B,
sickle; C, file; D, chisel; E, hoe.

19. SICKLE SCALERS
○ Design: Sickle scalers feature
a flat surface with two cutting
edges that converge into a
sharply pointed tip.
○ This design provides strength,
making the tip resistant to
breakage during use.
○ Use: removing supragingival
calculus.
Triangular shape,
double-cutting edge,
and pointed tip

20. BLADE
DESIGN
Straight Curved

22. Straight Blade
Excellent for broad facial and lingual surfaces
and can also be used interproximally.

23. CURVED BLADE
○ Two cutting edges on a curved blade that
end in a sharp point.

24. CURVED BLADE
Excellent for the removal of interproximal
deposits.

25. REMOVAL OF SUPRAGINGIVAL
CALCULUS.

26. Subgingival adaptation around the root is
better with the curette than with the sickle;
f, facial; l, lingual.

27. TYPES OF SICKLE SCALERS:
Large Blades: U15/30, Ball, and Indiana University
sickle scalers.
Medium Blades: Jaquette sickle scalers #1, 2, and 3.
Curved Blades: The 204 posterior sickle scalers are
available in large, medium, or small sizes.
Thin Designs for Subgingival Use: Montana Jack, Nevi
2, Nevi 3, and Nevi 4 curved posterior sickle scalers can
be inserted several millimeters subgingivally for
removing light to moderate calculus ledges

28. • Straight
Shanks: Designed
for anterior teeth
and premolars.
• Contra-Angled
Shanks: Adapted
for posterior teeth.
○ The selection
of these
instruments
should be
based on the
area to be
scaled.

29. HOE SCALERS
○ For scaling of ledges or rings of calculus
○ The blade is bent at a 99-degree angle
○ The cutting edge is beveled at 45 degree.
The back of the blade is rounded, and the blade has been reduced to
minimal thickness to permit access to the roots without interference
from the adjacent tissues

30. A, Hoe scalers designed for different
tooth surfaces, showing “two-point”
contact.
B, Hoe scaler in a periodontal pocket.
The back of the blade is rounded for
easier access. The instrument contacts
the tooth at two points for stability
• The instrument is
activated with a
firm pull stroke
toward the crown
• McCall’s #3, 4, 5, 6,
7, and 8 are a set of
six hoe scalers
designed to provide
access to all tooth
surfaces.

31. FILES
○ Files have a series of blades on a base
○ Their primary function is to crush large
deposits of tenacious calculus or burnished
sheets of calculus.
○ For removing overhanging margins of
dental restorations.

32. DIAMOND-COATED FILES
○ Final finishing of root surfaces.
Diamond files. A, #1,2 (Brasseler, Savannah, GA);
B, #3,4 (Brasseler);
C, SDCN 7, SDCM/D 7. Source: (HuFriedy, Chicago

33. CHISEL SCALERS
○ Designed for the proximal surfaces
of teeth too closely spaced to
permit the use of other scalers, is
usually used in the anterior part
of the mouth.
○ The chisel is inserted from the facial
surface.
○ The instrument is activated with a
push motion while the side of the
blade is held firmly against the root.

34. CURETTES
○ Curettes are used for:
○ Removing deep subgingival
calculus
○ Root planing altered
cementum
The curette is the
instrument of choice for
subgingival scaling and
root planing.

35. ○ Design Features:
● Cutting edges on both sides of
the blade and a rounded toe.
● Finer than sickle scalers; lacks
sharp points or corners.
○ Advantage: Provides good
access to deep pockets
while reducing the risk of
damaging surrounding soft
tissues.
Basic characteristics of
a curette: spoon-
shaped blade and
rounded tip allow the
blade to adapt better
to the root surface

36. THERE ARE TWO BASIC TYPES OF
CURETTES: UNIVERSAL AND AREA
SPECIFIC.
Universal curettes
○ Designed to access most areas of the dentition
by adjusting the finger rest, fulcrum, and
hand position of the operator.
○ The face of the blade is perpendicular (90
degrees) to the lower shank in cross-section
○ Blade is curved in one direction from
the head to the toe.

37. A, Double-ended curette for the
removal of subgingival calculus.
B, Cross-section of the curette
blade (arrow) against the cemental
wall of a deep periodontal pocket.
C, Curette in position at the base of a
periodontal pocket on the facial
surface of a mandibular molar.
D, Curette inserted in a pocket with
the tip directed apically.
E, Curette in position at the base of a
pocket on the distal surface of the
mandibular molar.

38. ○ Examples:
• Barnhart curettes
#1-2 and #5-6
• Columbia
curettes #13-14,
#2R-2L, and #4R-
4L
• Younger-Good
#7-8
• McCall’s #17-18
• Indiana
University #17-18

39. AREA-SPECIFIC CURETTES
• Instruments designed and angled to
adapt to specific anatomic areas
• Best instruments for subgingival
scaling and root planing
○ Gracey
curettes
#1-2 and #3-4: Anterior teeth
A, #5-6 :Anterior teeth and premolars
B #7-8 and 9-10: Posterior teeth: facial and lingual
C #11-12:Posterior teeth: mesial
D #13-14:Posterior teeth: distal

40. Gracey #13-14 curette. For distal
surfaces.
Gracey #11-12 curette. For mesial
surfaces

41. ○ Single-Ended Gracey Curette
○ Typically consists of a set of 14 instruments.
○ Area-Specific Use
○ An experienced operator can adapt each instrument
for use in several different areas by altering the
position of his or her hand and the position of the
patient
○ Blade Angulation: Blade is angled 60–70 degrees
from the lower shank
○ Subgingival Scaling: Unique angulation allows for
precise placement
○ Curved Blade from head to toe and along the
cutting edge, allowing only a pull stroke.

43. Gracey #17-18 is a modification of
the #13-14.
• Terminal shank elongated by 3
mm
• provide complete occlusal
clearance and better access to all
posterior distal surfaces.
• Shorter Blade: Blade is 1 mm
shorter for improved adaptation to
distal tooth surfaces.
Gracey #15-16. New Gracey
curette
Designed for mesioposterior
surfaces, combines a Gracey
#11-12 blade with a Gracey #13-
14 shank. Source: (Copyright A.
Pattison.)
Improved angulation allows
better adaptation to mesial
surfaces,

44. After Five curette. Note the
extra 3 mm in the terminal
shank of the After Five curette
compared with the standard
Gracey curette. A, #5-6; B, #7-
8; C, #11-12; D, #13- 14.)
Comparison of After Five curette with
standard Gracey curette. Rigid Gracey
#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 extralong
shank of the After Five curette, which
allows deeper insertion and better
access
▪ All standard Gracey numbers except #9-10 (includes #1-2, #3-4,
#5-6, #7-8, #11-12, #13-14).
After Five Curette

45. Comparison of After Five curette and Mini
Five curette. The shorter Mini Five blade
(half the length) allows increased
access and reduced tissue trauma.
The shorter blade allows easier insertion
and adaptation in deep, narrow pockets;
furcations; developmental grooves; line
angles; and deep, tight, facial, lingual, or
palatal pockets.’
Area in which root morphology or tight
tissue
Comparison of standard rigid Gracey #5-
6 with rigid Mini Five #5-6 on the palatal
surfaces of the maxillary central incisors.
used with a straight vertical stroke.
Standard Gracey or After Five
curette usually cannot be inserted
vertically in this area because the
blade is too long.
Mini Five curette

46. Micro Mini Five
Gracey curettes. A, #1-
2; B, #7-8; C, #11-12; D, #13-14.
• 20% thinner and smaller
than the Mini Five
curettes
• Provide exceptional
access and adaptation to
tight, deep, or narrow
pockets; narrow
furcations; developmental
depressions; line angles;
and deep pockets on
facial, lingual, or palatal
surfaces.

47. Comparison of Gracey curette designs. Left
to right, Standard #1-2, After Five #1-2,
Mini Five #1-2, Micro Mini Five #1-2.

48. ○ Gracey Curvettes are another
set of four mini-bladed
curettes
○ The Sub-0 and the #1-2 are
used for anterior teeth and
premolars, the #11-12 is used
for posterior mesial surfaces,
and the #13-14 for posterior
distal surfaces.
○ Adapt more closely to the
tooth surface
Gracey Curvettes

49. PERIODONTAL MAINTENANCE
CURETTES.
○ The most recent Gracey curette innovation is a
category called periodontal maintenance Gracey
curettes, introduced in November 2015.
○ Specifically designed for patients with tight tissue,
recession, and residual pocket depth following
initial periodontal therapy or periodontal surgery
○ Length: 1 mm shorter than standard blades.
○ Thickness: 20% thinner, allowing easier insertion
and access.
○ Blade-to-Shank Angle: Offset at 60 degrees
(standard is 70 degrees) for better adaptation to tight
tissue.

50. • Reduced tissue
distention increases
patient comfort.
• Improved access to root
surfaces and furcation
areas.
• Helps prevent spanning
across root depressions.
Blade Size: Three-
quarter length, between
standard and mini-bladed
Gracey curettes for better
adaptation.

51. LANGER AND MINI-LANGER
CURETTES
○ A set of three combining shank
designs of standard Gracey #5-6, #11-
12, and #13-14 with universal blades
honed at 90 degrees.
○ Can adapt to mesial and distal
surfaces without changing
instruments.
○
Langer #5-6: For anterior teeth
○ Langer #1-2: Adapted for
mandibular posterior teeth with
Gracey #11-12 shank.
○ Langer #3-4: Adapted for maxillary
posterior teeth with Gracey #13-14
shank.

52. QUÉTIN FURCATION
CURETTES
○ The Quétin furcation curettes are actually hoes
with a shallow, halfmoon radius that fits into the
roof or floor of the furcation.
Quétin furcation curettes: BL2 (larger)
and BL1 (smaller).
• These instruments
remove burnished
calculus from recessed
areas of the furcation
• Lessen the likelihood of
root damage.

53. SCHWARTZ
PERIOTRIEVERS
• Design:Set of two double-
ended instruments.
• Highly magnetized for
effective retrieval
• Function: Retrieving
broken instrument tips from
periodontal pockets.
• They are indispensable
when the clinician has
broken a curette tip in a
furcation or deep pocket.

54. PLASTIC AND TITANIUM
INSTRUMENTS FOR IMPLANTS
(A) Plastic probe: Colorvue. (B) New
Implacare II Barnhart #5-6 cone
socket plastic curette tips that screw
into an autoclavable stainless steel
handle.
Used to avoid scarring
and damage to imlants

55. Types Available: come in both
universal and Gracey curette
designs.
Blade Design: Smaller blades
allow easier insertion under tight
tissue and better adaptation
around implants and restorations.
Mini-bladed titanium implant
instruments

56. Usage: Suitable for implant
maintenance; designed for
biofilm and light calculus
removal.
Precautions: Avoid moderate or
heavy-pressured strokes to
prevent scratching or roughening
of implant surfaces.
Limitations: Not intended for
heavy calculus or cement
removal; such cases (e.g., peri-
implantitis with bone loss)
require different instrumentation
and possible surgical
intervention.

57. ULTRASONIC AND SONIC
INSTRUMENTS
○Used for removing plaque and
stain, scaling, root planing,
curetting, and surgical
debridement.
○Key factors :frequency, stroke,
and water flow.

58. ○Frequency: Frequency is defined as
the number of times per second an
insert tip moves back and forth
during one cycle in an orbital,
elliptic, or linear stroke path.
○Stroke: Stroke is the maximum
distance the insert tip travels during
one cycle or stoke path

59. Water Flow in Ultrasonic Scalers:
○ Types: Ultrasonic scalers can be manually or
automatically tuned.
○ Manual-Tuned Units: Feature three control
knobs (water, tuning, power) allowing clinicians
to adjust frequency.
○ Auto-Tuned Units: Have two knobs (water,
power) and maintain a stable frequency through
feedback that adjusts the insert's vibration
automatically.

60. ○ Water contributes to three physiologic effects that enhance
the efficacy of power scalers: acoustic streaming, acoustic
turbulence, and cavitation.
○ Acoustic streaming is the unidirectional fluid flow caused
by ultrasound waves.
○ Acoustic turbulence is created when the movement of the
tip causes the coolant to accelerate, producing an intensified
swirling effect.
○ This turbulence continues until cavitation occurs. Cavitation
is the formation of bubbles in water caused by the high
turbulence.
○ In vitro, the combination of acoustic streaming, acoustic
turbulence, and cavitation has been shown to disrupt
microflora.

61. TYPE AND BENEFIT OF POWER
INSTRUMENTS
○ Sonic units work at a frequency of 2000–6500
cycles per second and use a high- or low-speed air
source from the dental unit.
○ Water is delivered via same tubing used to deliver
water to a dental handpiece.
○ A sonic scaler tip travels in an elliptical or orbital
stroke pattern.
Magnetostrictive ultrasonic devices work in a
frequency range of 18,000–50,000 cycles per second.
Tips move in an elliptical or orbital stroke pattern.
This allows the tip four active working surfaces.

62. Magnetostrictive ultrasonic
devices
Piezoelectric ultrasonic units

63. ○ Piezoelectric ultrasonic units work in a frequency
range of 18,000– 50,000 cycles per second
○ Piezoelectric tips move in a linear pattern, giving the
tip two active surfaces
○ Efficiency Power
Instrumentation has the potential to make scaling less
demanding, more time efficient, and more
ergonomically friendly.

64. TIP DESIGNS
○ Large diameter tips are created in a universal
design and are indicated for the removal of large,
tenacious deposits
○ Thinner diameter tips may be site specific in
design.
○ The straight tip design is ideal for use in treating
patients with gingivitis and deplaquing
maintenance patients.
○ The right and left contra-angled instruments
allow for greater access and adaptation to root
morphology.

65. DENTAL ENDOSCOPE
○ Use subgingivally in the diagnosis
and treatment of periodontal
disease
○ The Perioscopy system (Perioscopy,
Inc., Oakland, CA) consists of a 0.99-
mm diameter, reusable fiberoptic
endoscope over which is fitted a
disposable, sterile sheath.
○ The fiberoptic endoscope fits onto
periodontal probes and ultrasonic
instruments that have been designed
to accept it
○ Sheath delivers water irrigation that
flushes the pocket , keeping the field
clear.

66. ○ The fiberoptic endoscope connects to a medical-
grade CCD video camera and light source.
○ Produces images on a flat-panel monitor for
real-time viewing during subgingival
exploration and instrumentation.
○ Enables operators to detect the presence and
precise location of subgingival deposits.
○ Assists in the thorough removal of
subgingival deposits.
○ Magnification: Provides magnification ranging
from 24 to 48 times for detailed observation of
minute plaque and calculus deposits.

67. ○ Facilitates higher levels of root debridement and
cleanliness, achieving results that are difficult or
impossible without the device.
○ The Perioscopy system can also be used to
evaluate subgingival areas for caries, defective
restorations, root fractures, and resorption
Perioscopic
instrumentation
permits deep
subgingival
visualization in
pockets and
furcations.

68. CLEANSING AND POLISHING
INSTRUMENTS
Rubber cups
They are used in the handpiece with a special
prophylaxis angle.

69. A good cleansing and polishing paste that
contains fluoride should be used and kept moist
to minimize frictional heat as the cup revolves
Disposable plastic
prophylaxis angle with
rubber cup and with
brush.

70. BRISTLE BRUSHES
○ Bristle brushes are available in wheel and cup
shapes
○ The brush is used in the prophylaxis angle with a
polishing paste.
○ Use of the brush should be confined to the crown to
avoid injuring the cementum and the gingiva.

71. DENTAL TAPE
○Dental tape with
polishing paste is
used for polishing
proximal surfaces
that are inaccessible
to other polishing
instruments.

72. AIR-POWDER POLISHING
○ This device, called the Prophy-Jet (Dentsply
International, York, PA), is very effective for the
removal of extrinsic stains and soft deposits
○ It is used with a specially designed handpiece

73. CONCLUSION
○ Advancements in instrument making and dental
practice have led to a wide variety of instrument
designs.
○ Modern instruments can effectively access nearly
all areas of the teeth and gums.
○ Many efficient instruments from historical sets
have proven durable and continue to be included
in new sets.

74. REFERENCES
○ Newman and Carranza's Clinical Periodontology
THIRD SOUTH ASIA EDITION

75. THANKYOU