PERIODONTAL INSTRUMENTS & INSTRUMENTATION

PERIDONTAL INSTRUMENTS
PERIODONTAL PROBES EXPLORERS SCALING, ROOT-PLANING & CURETTAGE PERIODONTAL ENDOSCOPE CLEANSING & POLISHING INSTRUMENTS

CLASSIFICATION
PERIODONTAL PROBES- to locate, measure and mark pockets as well as determine their course on individual tooth surfaces EXPLORERS- to locate calculus deposites and caries SCALING, ROOT-PLANING AND CURETTAGE INSTRUMENTS- for removal of plaque and calcified deposites from crown and root of tooth, removal of altered cementum from the subgingival root surface, and debridement of the soft tissue lining the pocket. Sickle scaler- to remove supragingival calculus Curettes- for subgingival scaling, root planing and removal of the soft tissue lining

the pocket Hoe, chisel and file scaler- to remove tenacious calculus and altered cementum Ultrasonic and sonic instruments- for cleansing and polishing tooth surface and curetting the soft tissue wall of the periodontal pocket CLEANSING & POLISHING INSTRUMENTSeg: rubber cups, brushes, dental tape, air-powder abrasive system.

PARTS OF INSTRUMENT PERIDONATAL PROBES

TAPERED ROD LIKE INSTRUMENT CALIBERATED IN MILLIMETERS, WITH A BLUNT ROUND TIP FUFCATION AREAS BEST EVALUATED BY THE CURVED BLUNT NABERS PROBE PLASTIC PROBES IN CASE OF IMPLANTS PROBE IS INSERTED WITH A FIRM GENTLE PRESSURE TO THE BOTTOM OF THE POCKET. SHANK SHOULD ALLIGN WITH THE LONG AXIS OF THE TOOTH

EXPLORERS SICKEL SCALERS SICKLE SCALERS / SUPRAGINGIVAL SCALERS

USED TO REMOVE LARGE CALCULUS DEPOSITS FROM THE ENAMEL SURFACE

 USED WITH A PULL STROKE. LATERAL SURFACE:- STRAIGHT, MEET IN A POINT TIP NO OF CUTTING EDGE:- 2 CUTTING EDGE WORKING END IN CROSS SECTION:TRIANGULAR SICKLE SCALERS WITH STRAIGHT SHANKS ARE DESIGNED FOR USE ON ANTERIOR TEETH SICKLE SCALERS WITH CONTRA ANGLED SHANKS ADAPT TO POSTERIOR TEETH
U15/30 & UNIVERSITY SICKLE SCALER ARE LARGE JAQUETTE SICKLE SCALERS HAVE MEDIUM SIZE

HOE SCALERS

HOE SCALERS ARE USED FOR SCALING OF LEDGES OR RINGS CALCULUS BLADE IS BENT AT 99 ANGLE CUTTING EDGE BEVELED AT 45 DEGREE BLADE IS SLIGHT BOWED SO THAT IT CAN MAINTAIN TWO CONTACT AT TWO POINTS ON A CONVEX SURFACE THE BLADE IS INSERTED TO THE BASE OF THE PERIDONTAL POCKET SO THAT IT MAKES TWO POINT CONTACT WITH THE TOOTH .THIS STABLIZES THE INSTRUMENT AND PREVENT NICKING OF THE ROOT.

 THE INSTRUMENT IS ACTIVATED WITH A FIRM PULL STROKE TOWARD THE CROWN,

CHISEL SCALERS

IT IS DESIGNED FOR THE PROXIMAL SURFACE OF TEETH TOO CLOSELY SPACED TO PERMIT THE USE OF OTHER SCALERS IT IS USUALLY USED IN ANTERIOR PART OF THE MOUTH CHISEL INSERTED FROM FACIAL SURFACE INSTRUMENT IS ACTIVATED WITH A PUSH MOTION WHILE THE SIDE SIDE OF THE BLADE IS HELD FIRMLY AGAINST THE ROOT.

FILES
THEIR PRIMARY FUNCTION IS TO FRACTURE OR CRUSH LARGE DEPOSITE OF TENACIOUS CALCULUS FILES CAN EASILY ROUGHEN ROOT SURFACES WHEN USED IMPROPERLY THEREFORE, THEY ARE SUITABLE FOR FINE SCALING MINI BLABE CURETTE ARE NOW PREFERRED

SCALING STROKE

SHORT, POWERFUL PULL STROKE THAT IS USED FOR THE REMOVAL OF BOTH SUPRAGINGIVAL & SUBGINGIVAL CALCULUS

CURETTES
CURETTES ARE OF TWO TYPES 1. UNIVERSAL 2. AREA SPECIFIC

UNIVERSAL CURETTES
-USED IN ANY AREA -BOTH CUTTING EDGES USED -CURVED IN ONE PLANE -FACE OF BLADE AT 90 DEGREE TO SHANK

AREA SPECIFIC
-USED IN SPECIFIC AREAS -ONE CUTTING EDGE USED -CURVED IN TWO PLANE OFFSET BLADE

GRACEY CURETTES

1-2 & 3-4 ANTERIOR TEETH 5-6 ANTERIOR TEETH & PREMOLARS 7-8 & 9-10 FACIAL & LINGUAL- POSTERIORS 11-12 MESIAL- POSTERIORS 13-14 DISTAL- POSTERIORS

EXTENDED SHANK CURETTES

-MODIFICATION OF GRACEY CURETTES -TERMINAL SHANK IS 3mm LONGER, ALLOWING EXTENSION INTO DEEPER PERIODONTAL POCKET OF 5mmOR MORE -THINNED BLADE FOR SMOOTHER INSERTION Eg HUFRIEDY AFTER FIVE CURETTES CHICAGO AFTER FIVE CURETTES

MINI BLADED CURETTES

-MODIFICATIONS OF AFTER FIVE CURETTES -BLADES ARE HALF THE LENGTH OF AFTER FIVE OR STANDERD GRACEY CURETTES -SHORTER BLADES ALLOWS EASIER INSERTION AND ADAPTATION IN

DEEP,NARROW POCKETS;FURCATIONS eg HU-FRIEDY MINI FVE CURETTES

SCHWARTZ PERIOTRIEVERS
A SET OF DOUBLE ENDED HIGHLY MAGNETISED INSTRUMENTS DESIGNED FOR THE RETRIEVEL OF BROCKEN INSTRUMENT TIPS

PLASTIC INSTRUMENTS
FOR IMPLANTS TO AVOID SCARRING AND PERMANENT DAMAGE TO IMPLANTS

DIAMOND COATED FILES

UNIQUE INSTRUMENTS USED FOR FINAL FINISHING OF ROOT SURFACES

QUETIN FURCATION CURETTES

HOES WITH A SHALLOW, HALF MOON RADIOUS THAT FITS INTO ROOF OR FLOOR OF FURCATION & DEVELOPMENTAL DEPRESSIONS OF ROOT SURFACE

DIAMOND COATED FILES QUETIN FURCATION CURETTES ULTRASONIC INSTRUMENTS

USED FOR REMOVING PLAQUE, STAINS, FOR SCALING & CURETTAGE 2 TYPES-MAGNECTOSTRICTIVE & PIEZOELECTRIC ALTERNATING ELECTRIC CURRENTS GENERATES OSCILLATIONS THAT CAUSES SCALER TIP TO VIBRATE 20,000-45,000 CYCLES PER SEC

 IN MAGNETOSTRICTIVE, PATTERN OF VIBRATION IS ELLIPTICAL- ALL SIDES OF THE TIP ARE ACTIVE IN PIEZOELECTRIC, VIBRATION IS LINEARTWO SIDES OF TIP ARE ACTIVE

SONIC INSTRUMENTS

CONSISTS OF A HAND PIECE THAT ATTACHES TO A COMPRESSED AIR LINE. 2000-6500 cps LESS POWER FOR CALCULUS REMOVAL THAN ULTRASONIC UNITS SONIC AND PIEZOELECTRIC- NO HEAT GENERATED- MAGNETOSTRICTIVEHEAT IS GENERATED- WHICH REQUIRE WATER FOR COOLING

SONIC AND ULTRASONIC MAGNETOSTRICTIVE ULTRASONIC UNIT

EVA SYSTEM
MOST EFFICIENT AND LEAST TRAUMATIC INSTRUMENTS FOR CORRECTING OVERHANGING OR OVERCONTOURED PROXIMAL ALLOY OR RESIN RESTORATION THESE FILES ARE MADE OF ALUMINIUM IN THE SHAPE OF A WEDGE PROTRUDING FROM A SHAFT ONE SIDE OF THE WEDGE IS DIAMOND COATED AND THE OTHER SIDE IS SMOOTH

PERIDONTAL ENDOSCOPY

CLEANSING & POLISHINING

RUBBER CUPS:- CONSIST OF A RUBBER WITH OR WITHOUT WEBBED CONFIGURATIONS IN THE HOLLOW INTERIOR USED IN HANDPIECE WITH A SPECIAL PROPHYLAXIS A GOOD CLEANSING & POLISHING PASTE THAT CONTAIN FLOURIED SHOULD BE USED & KEPT MOIST TO MINIMIZE FRICTION HEAT

BRISTLE
AVAILABLE IN WHEEL & CUP SHAPES USED IN PROPHYLAXIS ANGLE WITH A POLISHING PASTE

DENTAL TAPE

DENTAL TAPE WITH POLISHING PASTE IN USED FOR POLISHING PROXIMAL SURFACE THAT ARE INACCESSIBLE TO OTHER POLISHING INSTRUMENTS

AIR POWDER POLISHING PERIDONTAL KNIVES

USED FOR GINGIVECTOMY

SURGICAL BLADES
USED IN PERIDONTAL SURGERY

PERIOSTEAL ELEVATOR
NEEDED TO REFLECT & MOVE THE FLAP AFTER THE INCISION HAS BEN MADE FOR FLAP SURGERY

TISSUE FORCEPS

 USED TO HOLD THE FLAP DURING SUTURING USED TO POSITION & DISPLACE THE FLAP AFTER THE FLAP HAS BENN REFLECTED (DEBAKEY TISSUE FORCEPS)

SCISSORS AND NIPERS

USED TO REMOVE TABS OF TISSUE DURING GINGIVECTOMY, TRIM THE MARGIN OF FLAP, ENLARGE INCISION IN PERIDONTAL ABSCESES ,REMOVE MUSCCHMENT IN SURGERY

NEEDLE HOLDER
USED TO SUTURE THE FLAP AT THE DESIRE PORTION AFTER SURIGAL PROCEDURE HAS BEEN COMPLETE. CASTROVEJO NEDDLE HOLDER

PERIDONTAL INSTRUMENTATION
ACCESSIBILITY:POSITIONING OF PATIENT AND OPERATOR VISIBILITY, ILLUMINATION &RETRACTION CONDITION AND SHARPNESS OF INSTRUMENT MAINTAINING A CLEAN FIELD INSTRUMENT STABILISATION INSTRUMENT ACTIVATION

ACCESSIBILITY
ACCESSIBILTY FACILITATES THOROUGHNESS OF INSTRUMENTATION POSITION OF PATIENT & OPERATOR SHOULD PROVIDE MAXIMAL ACESSIBILITY

 INADEQUATE ACCESSIBILITY IMPEDES THROUGH INSRUMENTATION, PREMATURELY TIRED THE OPERATOR DIMINISHES EFFECTIVENESS OF CLINICIAN CLINICIAN SHOULD DE SEATED COMFORTABLELY ON A OPERATING STOOL, SO THAT CLINICIANS FEET ARE ON THE FLOOR WITH THE THIGHS TO THE FLOOR BE IN A STRAIGHT & HEAD ERECT POSITION PATIENT SHOULD BE IN SUPINE POSITION & PLACED SO THAT THE MOUTH CLOSE TO THE RESTIG ELBOW OF THE CLINICIAN FOR INSTRUMENTATUON OF THE MAXILLARY ARCH, THE PATIENTS CHIN SHOULD BE RISE SLIGHTLY FOR MANDIBULAR ARCH, LOWER CHIN UNTILL MADIBLE IN PARALLEL TO FLOOR.

VISIBILITY, ILLUMINATION AND RETRACTION

DIRECT VISION WITH DIRECT ILLUMINATION FROM DENTAL LIGHT INDIRECT VISION BY USING MOUTH MIRROR RETRACTION PROVIDES VISIBILITY, ACESSIBILITY & ILLUMINATION MIRROR ALSO USED FOR RETRACTION CHEEKS OR TONGUE

 INDEX FINGER IS USED FOR RETRACTION OF THE LIP CONDITION AND SHARPNESS OF INSTRUMENT MAKE SURE THAT ARE CLEAN, STERILE & IN GOOD CONDITION WORKING END OF POINTED OR BLAED INSTRUMENT MUST BE SHARP TO BE EFFECTIVE SHARP INSTRUMENTS ENCHANCE TACTILE SENSITIVITY & ALLOW YHE CLINICIAN TO WORK MORE PRECISELY

MAINTAINING A CLEAN FIELD

INSTRUMENTATION CAN BE HAMPERED IF THE OPERATIVE FIELD IN OBSCURED BY SALIVA, BLOOD & DEBRIS

INSTRUMENT STABILISATION INSTRUMENT GRASP

MODIFIED PEN GRASP STANDARD PEN GRASP PALM AND THUMB GRASP

FINGER REST
CONVENTIONAL CROSS ARCH OPPOSITE ARCH FINGER ON FINGER

INSTRUMENT GRASP
PEN GRASP THE THUMB, INDEX FINGER, & MIDDLE FINGER ARE USED TO HOLD INSTRUMENT AS PEN IN HELD

 MODIFIED PEN GRASP:-ENSURE GREATEST CONTROL IN PERFORMING INTRAORAL PROCEDURES

PALM AND THUMB GRASP

FOR STABILIZING INSTRUMENTS DURING SHARPENING AND FOR MANIPULATING AIR AND WATER SYRINGES

FINGER REST
CONVENTIONAL FINGER REST IS ESTABLISHED ON TOOTH SURFACE IMMEDIATELY ADJACENT TO WORKING AREA CROSS ARCH FINGER REST IS ESTABILISHED ON TEETH SURFACE ON THE OTHER SIDE OF THE SAME ARCH OPPOSITE ARCH FINGER REST IS ESTABLISHED TOOTH SURFACE ON THE OPPOSITE ARCH FINGER ON FINGER REST IS ESTABLISHED ON THE INDEX FINGER OR THUMB OF THE NONOPERATING HAND

EXRA ORAL FALCRUM

FOR EFFECTIVE INSTRUMENTION OF SOME ASPECTS OF THE MAXILLARY POSTERIOR TEETH PALM UP:- FULCRUM IS ESTABLISHED BY RESTING THE BACKS OF THE MIDDLE & FOURTH FINGER ON THE SKIN OVERLYING THE LATERAL ASPECTS OF THE MANDIBLE ON THE RIGHT SIDE OF THE SIDE THE PALM DOWN FULCRUMM IS ESTABLISHED

BY RESTING THE FRONT SURFACE OF THE MIDDLE & FOURTH FINGER ON THE SKIN OVERLYING THE LATER ASPECT OF THE MANDIBLE ON THE LEFT SIDE OF THE MAXILLA

INSTRUMENT ACTIVATION ADAPTATION

ADAPTATION REFERS TO THE MANNER IN WHICH THE WORKING END OF THE INSTRUMENT IS PLACED AGAINST THE TOOTH TO THE ANGLE BETWEEN THE FACE OF A BLADED INSTRUMENT AND THE TOOTH SURFACE -ALSO CALLED TOOTH-BLADE RELATIONSHIP DURING INSERTION0 SCALING & ROOT PLANING 45-90

ANGULATION : REFERS

LATERAL PRESSURE : IT REFERS

TO

THE PRESSURE CREATED WHEN FORCE IS APPLIED AGAINST THE SURFACE OF THE TOOTH WITH THE CUTTING EDGE OF A BLADED INSTRUMENT MAY BE FIRM, MODERATE OR LIGHT UNCONTROLLED APPLICATION OF HEAVY FORCES SHOULD BE AVOIDED

STROKES : 3 TYPES

-EXPLORATORY /

SCALING / ROOT PLANING ANY OF THESE STROKES MAY BE ACTIVATED BY A PULL OR PUSH MOTION IN VERTICAL OBLIQUE OR HORIZONTAL DIRECTION

 EXPLORATORY STROKE : LIGHT

FEELING STROKE USED WITH PROBES AND EXPLORERS TO EVALUATE THE DIMENTION OF POCKET & TO DETECT CALCULUS & IRREGULARITIES ON TOOTH SURFACE

SCALING STROKE : SHORT

POWERFULL

PULL STROKE USED WITH BLADED INSTRUMENTS FOR THE REMOVAL OF BOTH SUBGINGIVAL & SUPRAGINGIVAL CALCULUS. SCALING MOTION SHOULD BE INITIATED IN THE FORE ARM &TRANSMITTED TO THE WRIST TO THE HAND WITH A SLIGHT FLEXION OF FINGERS PUSH SCALING MOTION IS RARELY USED

ROOT PLANING STROKE :MODERATE

TO LIGHT PULL STROKE USED FOR FINAL SMOOTHENING & PLANING OF THE ROOT SURFACE HOES, FILES, CURETTES & ULTRA SONIC INSTRUMENTS CAN BE USED

INSTRUMENT SHARPENING MOUNTED ROTARY STONES

MOUNTED ON A METAL MANDRILL. CYLINDRICAL CONICAL OR DISC SHAPED DIFFICULT TO CONTROL, CREATES HEAT, TENDS TO WEAR THE INSTRUMENT EASILY

UNMOUNTED STONES

RECTANGULAR, CYLINDRICAL OR CONE SHAPED, EITHER INSTRUMENT STABLIZED & STONE DRAWN ACROSS IT OR STONE STABLIZED & INSTRUMENT DRAWN ACROSS STONE Eg INDIA STONE / ARKANAS STONE / CERAMIC STONE