D NG C Nha Chu

School of Medicine Pharmacy
Faculty of Odonto - Stomachtology
PERIODONTAL INSTRUMENTS
Resident doctor: Do Thi Thu Huong

Content
1. Introduction
2. Assessment Instruments
3. Treatment handle instruments
4. Polishing instruments
5. Periodontal surgical instruments
6. Antiseptic solution
7. Periodontal Surgical Dressing
8. Dental Bio-material
I. History
The importance of removal of calculus and dental

plaque
Some astringent mouth rinses for gingival diseases
was used like Egyptian medicine
Susruta samhita is a great Indian doctor, lived in 6th
century B.C -> tooth mobility, periodontitis, proper
tooth brushing…
Celsus (25 B.C – 50 A.D) offered treatment for
periodontal diseases
Set of 14 double ended
instrument was used by
Albucasis (936-1013 A.D)
Assessment Instruments
Assessment Instruments
Periodontal Probes: Locate,
measure, mark pockets on
individual tooth surfaces
+ First time described in USA, 1925
+ Long, thin, tapered blunted at the end
+ 5 generation probes: conventional,
pressure – sensitive probes,
computerized, 3D probes, ultrasonic
probes.
+ 3 types: normal probes, furcation
probes, computer assisted probes
I. Normal Probes
Marqui color-coded probe: 3-6-9-12

I. Normal Probes
UNC 15 probe: 1,2,3,4,5,….,15, black colour in 5,

10,15
I. Normal Probes
Michigan O Probes: 3,6,8,10

I. Normal Probes
William Probes: 1,2,3,5,7,8,9,10

+ invented in 1936 by Charles H.M. Williams
+ Absent 4, 6
+ Angle 130 degree
I. Normal Probes
WHO Probe: 1978, assessment CPITN
(Community Periodontal Index for Treatment
Needs), 5g
+ Invented in 1978 by George S. Beagrie, Jukka
Ainanio
Naber’s Probes
To detect the furcation lesion, to assessment degree

of furcation lesion, may have marking or not
II, Pressure – sensitive probes
• Introduced by Hunter in 1994, Probing
pressure usually is 20 gm
• Have visual guide and sliding scale where
2 indicator line meet at a specified
pressure
II, Pressure – sensitive probes
Thermal probes
The difirent of temperature between pocket and gingival 0,1
- Pressure up to 30 g, the in tip seem into epithelium, up to 50g the tip in
osseous defects
- Advantage???
- + Precise
- + Constant force
- + Computer storage of data
- Disadvantages:
- + Tactile sensitivity
- +
Probes Techique Uses
The probes should be
inserted parrallel to the
vertical axis of the tooth
and “walked” around each
tooth to detect the areas
lession. The Naber’s
probe -> accurate
exploration furcation
lesion.
+ Forces : 0,75N
+ Shape and size of
probe tip
+ Degree of inflammaton
Finger rest in oral
Treatment handle instrument
- Handle: cone socket handle, fixed, avoided

smooth handle
- Shank: thick shank  heavy deposits, thinner 
tacile sensitivity, root debridement
- Worrking end: based on design and materials
used
Types of materials
- Stanless steel
- Carbon steel
- Non metal: Plastic, Nylon…
 for implants
Types based on design
+ Single ended type 1 working end
+ Double ended may have paired or complementary
working end
Treatment instrument
- Are Used to removal of plaque and calcified deposits from the crown
and root tooth, removal or altered cementum from the subgingival
root surface and debridement of soft tissue lining the pocket
- Are Classified:
+ Sickle scalers: used to remove supragingival calculus
+ Curettes: used to scaling, root planing and remove soft tissue lining
the pocket
+ Hoe, chisel and file scaler: used to remove tenacious subgingival
calculus and altered cementum, less use compared with currettes
+ Ultra sonic and sonic instrument: use for scalling, cleaning tooth
surfaces, curretting soft tissue wall of periodontal pocket
+ Periodontal endoscope: visual deeply into subgingival pockets and
furcation
+Cleaning, polishing instrument: rubber cup, brushes, dental tapes, air
– power abrasive systems …
SICKLE SCALER
- Have a flat
surface and two
cutting edges that
converga in a
sharply pointed
tip  strong
- Used to remove
supragingival
calculus
- A large blade 
difficult to insert
under gingiva
without tissue
damage.
TYPES OF SICKLE SCALER
- Blade size
- Design: curved or straight blade
- Shank: straight for anterior teeth and premolars, angled for
posterior tooth.
Contact with tooth surface
• 1/3 ending of blade must be keep contact
with the tooth while moving.
HOE SCALERS
• Scaling of ledges or rings of calculus

• Blade is bent at 90 degree
• 2 point contact with the tooth  stabilized
prevent nicking the root
FILES
• To fracture or crush large deposits/ calculus,
remove overhanging margins of restoration.
• An eassily gauge and roughen root surface if
use improperly not popular
• Diamon coated files: coated with fine grit
diamond, don’t have cutting edges  final
finishing of cleaning root
CHISEL SCALERS
• Double ended, 1 curved shank, 1 straight
shank, active by push motion
CURETTE
- Each working-end has cutting-edge on both side of the
blade and a rounded toe
- Design: rounded toe, no sharp points  insert into deep
pocket with minimal soft tissue trauma.
- Some type: + Universal curettes
+ Gracey curettes
Univeral curettes
• Useful: can be inserted in most areas of dentition
• Design: Blade size, angle, length of shank -> vary. The
blade is at 90 degree to the shank with 2 cutting edge
Universal curettes
• Some types that differ slightly in design.
• Columbia 13/14
• Columbia 4R/4L
• Columbia 2R/2L
• Barmhardt 5/6, 1/2
Gracey curettes
• Area-Specific curettes: design to adapt to
specific anatomic areas
• The best instrument for subgingival
scaling root planing ???
Gracey curettes
• Blade is at 70 degrees from lower shank
Gracey curettes
Gracey curetttes
• Small Gracey curettes: #5-6
#7-8
#11-12
#13-14
Finishing curettes
• Modification of Gracey curettes design:
1. Terminal shank is 3mm longer  deeper periodontal
pockets
2. Thinner blade: smoother, reduced tissue stretching
3. 1mm shorter blade
Traditional Gracey
After five Gracey
Mini Five
• Modifications of after five
curettes:
1. Blade are ½ length of
after five curettes
2. Extended shank
 deep, narrow pockets,
furcation, developmental
grooves
CURVETTE
Others curetttes
• Quentin Furcatin curettes:
Others curetttes
• O’Hehir curettes:
Others curetttes
• Periotrievers: retrieval of broken
instrument tips from periodontal pocket
• Files: used to crush calculus deposits
ULTRASONIC AND SONIC
INSTRUMENTS
• Removing plaque and stain, scaling,
curetting
• The vibrations in ultrasonic tip from 20000-
45000 c/s
• The vibrations in sonic tip from 2000-6500
c/s
• 2 types: Magnetostrictive / Pizeoelectric
ULTRASONIC AND SONIC
INSTRUMENTS
• Magnetostrictive:
vibration is elliptic  all
sides of tip are active
when adapted to the
tooth, required water for
cooling
• Pizeoelectric: vibration is
linear  just 2 sides of
the tip are most active,
less heat but need water
for cooling frictional heat
and flushing away debris
DENTAL ENDOSCOPE
• Diagnosis and
treatment periodontal
diseases
• Perioscopy system:
0,99mm diameter,
reuseable fibreoptic
endoscope with
disposable/sterile
sheath
DENTAL ENDOSCOPE
• The sheath delivers water irrigation while is used
• Magnification ranges from 24-64x
POLISHING INSTRUMENTS
• Goals: remove stains, smoothening tooth surfaces
• Content:
+ Rubber cup
+ Bristle cup
+ Dental tape
+ Air-power polishing
Rubber - Bristle cups
• Use in handpiece for prophylaxis
• Paste that contain F
• Keep moist to minimize friction heat
Dental tape
• Use with polishing paste, proximal surface
Uses:
1. Never be directed at soft tissue  severe
sloughing
2. never spray directly into sulcus or pocket 
emphysema, air in connective tissue  pain,
infection
Polishing paste
Periodontical surgical instruments
• 1. Excisional, incisional instrument
• 2. Surgical curettes and sickles
• 3. periosteal elevator
• 4. Surgical chisels
• 5. Surgical files
• 6. Scissors
• 7. Needle holders
Incisional, excisional instruments
• Gingivectomy knives (Kirkland knifes)
• Orban knife #1-2
• Merrifield knife #1-4
Surgical blades
• Use with bard parker handles
• # 11, #12, #12D, #15, #15C
Surgical blades
Periosteal elevator
Tissue forceps
Hemostatic clamp
• 40N
Scissors
Needle holder
Dental surgical burs
Sugarman periodontal file
antiseptic solution
• Periodontal diseasea use Chlorhexidine
(CHX) + Cetylpyridinium chloride (CPC) to
reduce the level of pathogens
Periodontal Surgical Dressing
• Benefits: minimizes post operative infection,
haemorrhage, prevent from trauma during mastication,
reduce pain because contact food or saliva
• But dressing in long time will delay the healing
Bio-materials
References
• C
Sharpening stones
• Unmounted
stones:
rectangular with
flat or grooved
surfaces, cone
shaped.

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School of Medicine Pharmacy

Faculty of Odonto - Stomachtology

Resident doctor: Do Thi Thu Huong

The importance of removal of calculus and dental

Marqui color-coded probe: 3-6-9-12

UNC 15 probe: 1,2,3,4,5,….,15, black colour in 5,

Michigan O Probes: 3,6,8,10

William Probes: 1,2,3,5,7,8,9,10

To detect the furcation lesion, to assessment degree

- Handle: cone socket handle, fixed, avoided

• Scaling of ledges or rings of calculus

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