5 Instruments

PERIODONTAL
INSTRUMENTARIUM
J A FA R N A G H S H B A N D I D . D . S ; M . S
D I P L O M AT E O F T H E A M E R I C A N B O A R D O F
PERIODONTOLOGY
SPECIAL THANKS
WHOEVER TAUGHT ME A WORD MADE ME HIS SERVANT.
Dr. Jim Simon

Dr. Raul Caffesse
PERIODONTAL INSTRUMENTS
• Periodontal instruments are designed for specific purposes, such as

removing calculus, planing root surfaces, curetting the gingival wall or
removing diseased tissue.
• Periodontal instrument is composed of:
a. Blade
b. Shank
c. Handle
C L A S S I F I C AT I O N
OF
P E R I O D O N TA L
INSTRUMENTS
DIAGNOSTIC INSTRUMENTS
• Periodontal probes are used to locate,

measure mark pockets.
• Explorers are used to locate calculus
deposits and caries.
PERIODONTAL PROBES
• A typical probe is a tapered rod-like instrument calibrated in millimeters

with a blunt, rounded tip. Periodontal probes are used to measure the
depth of the pocket and to determine their configuration.
• When measuring a pocket, the probe is inserted with a firm gentle
pressure to the base of the pocket. The shank should be aligned with the
long axis of the tooth surface to be probed. Furcation areas can be best
evaluated with the curved, blunt Naber’s probe .
TYPES OF
PERIODONTAL • Color-coded
PROBES • Noncolor-coded
TYPES OF PERIODONTAL PROBES
SCALING AND ROOT PLANING,
AND
CURETTAGE INSTRUMENTS
Scaling and root planing instruments are classified as follows:

a. For supragingival scaling:
• Sickle scalers, cumine universal scaler, posterior Jacquette scaler, Morse scaler, surface scaler, cingulum
scaler.
b. For subgingival scaling:
Hoe scaler, chisel and file scalers are used to
remove tenacious subgingival deposits.
Curettes are used to plane the root surfaces by removing altered cementum and also, for scraping
the soft tissue wall of the pocket. c. Sonic and ultrasonic instruments.
SICKLE SCALERS
• Sickle scalers: Sickle scalers have a

flat surface and two cutting edges that
converge in a sharply-pointed tip. The
arch-shape of the instrument makes
the tip so strong that it will not break
off during use. They appear triangular
in cross-section. The sickle scaler is
inserted under ledges of calculus no
more than 1 mm below the gingival
sulcus. It is used with a pull stroke.
MORSE SICKLE
• The Morse sickle has a very small,

miniature blade; it is useful in the
mandibular, anterior area where
there is narrow, interproximal
space. Sickles with straight shanks
are designed for use on anterior
teeth and premolars. Sickle scalers
with contra-angled shanks adapt to
posterior teeth.
CURETTES
• The curette is the instrument of choice for removing deep subgingival calculus,
altered cementum, for root planing and for removing the soft tissue lining the
periodontal pocket.
• Curette can be adapted to provide good access to deep pockets, with minimal soft
tissue trauma. There are cutting edges on both sides of the blade. Both single and
double-ended curette may be obtained depending upon the preference of the
operator. The curved blade and rounded toe of the curette allows the blade to adapt
better to the root surface. In cross- section the blade appears to be semicircular with
a convex base.
• There are two basic types of curettes:
• Universal
• Area-specific
UNIVERSAL CURETTES:
• Universal curettes have cutting edges
that may be inserted in most areas of
the dentition by altering and adapting
the finger rest, fulcrum and hand
position of the operator.
• The face of the blade of every universal
curette is at a 90 degree angle to the
lower shank, when seen in cross section
from the tip.
• Example of universal curettes: Barnhart
curettes # 1-2 and 5-6 and Columbia
curettes # 13-14, 2R-2L and 4R-4L.
AREA-SPECIFIC CURETTES:
• Gracey curettes: They are area-specific curettes, designed and

angled to adapt to specific anatomic areas of the dentition. These
curettes and their modifications are probably the best instruments
for subgingival scaling and root planing because they provide the
best adaptation to complex root anatomy.
• The term offset blade is used to describe Gracey curettes, because
they are angled approximately 60–70 degrees from the lower shank.
Double-ended Gracey curettes are paired in the following manner:
Gracey # 1-2 and 3-4 : Gracey # 5-6 :
Gracey # 7-8 and 9-10 :
Gracey # 11-12 : Gracey # 13-14 :
for anterior teeth
for anterior teeth and premolars
posterior teeth; facial and lingual
posterior teeth; mesial posterior teeth; distal
Recent additions to Gracey set are:
Gracey # 15-16 and 17-18
: #15-16 is a modification of #11-12; # 17-18 is a modification of #
13-14. It has a shank elongated by 3 mm.
ULTRASONIC AND SONIC INSTRUMENTS
• Used for removing plaque, scaling,

curetting and removing stains
Two types of ultrasonic units are:

• Magnetostrictive: Vibration of the tip
is elliptical; hence all the sides can be
used.
• Piezo-electric: Pattern of vibration of
the tip is linear;
only two sides of the tip are active.
• Ultrasonic vibrations range from
20,000 to 45,000 cycles/second. They
operate in a wet field and have
attached water outlets.
THE PERIODONTAL
ENDOSCOPE
• Used to visualize
deep pockets and
furcations during
scaling and root
planing.
CLEANSING AND POLISHING
INSTRUMENTS
• Rubber cups, brushes, dental tapes

• Air-powder abrasive system.
SURGICAL INSTRUMENTS
• Excisional and incisional

instruments, surgical
curettes and sickles,
periosteal elevators,
surgical chisels, Hoes
files, scissors and nippers.
1. EXCISIONAL AND INCISIONAL INSTRUMENTS:
• Periodontal knives (Gingivectomy knives): Example
• Kirkland knife.
• Interdental knives: Example, Orban knife #1-2,
• Merrifield knife #1,2,3 and 4
• Surgical blades: Example, # 12D, 15 and 15C.
• Electrosurgery (Radiosurgery) techniques and instrumentation:
– Electrosection used for incisions, excisions and tissue planing.
– Electrocoagulation, coagulation or hemorrhage control
– Electrofulguration not in general use in dentistry
– Electrodessication not in general use in dentistry
2. SURGICAL CURETTES AND SICKLES:
• Required for the removal of granulation tissue, fibrous

interdental tissue, and tenacious subgingival deposits.
• Examples:
– Kramer curettes # 1, 2, 3 and Langer curettes.
– Kirkland surgical instruments.
– Ball scaler # B2-B3.
3. PERIOSTEAL ELEVATORS:
• Necessary to reflect and move

the flap after the incision has
been made for flap surgery.
• Example: Goldman Fox #14.

4. SURGICAL CHISELS AND HOES:
• They are used during periodontal surgery for

removing and reshaping bone. Chisels are
used with a push stroke whereas surgical hoes
are used with a pull stroke.
Example:
• • Ochsenbein #1-2, chisel.
• Rhodes chisel.
5. SURGICAL FILES:
• They are used primarily to smoothen

rough, bony, ledges and to remove all
areas of necrotic bone.
• Example: Schluger and Sugarman
files.
6. SCISSORS AND NIPPERS
• Used for removing tabs of tissue

during gingivectomy, trimming the
margins of flaps, enlarging
incisions in periodontal abscesses
and removing muscle attachments
in mucogingival surgery
• Example: Goldman – Fox # 16
scissors.
7. NEEDLE HOLDERS:
• They are used to suture the flap at

• the desired position.
Example: Castroviejo needle holder.

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PERIODONTAL

WHOEVER TAUGHT ME A WORD MADE ME HIS SERVANT.

Dr. Jim Simon

• Periodontal instruments are designed for specific purposes, such as

• Periodontal probes are used to locate,

• A typical probe is a tapered rod-like instrument calibrated in millimeters

Scaling and root planing instruments are classified as follows:

• Sickle scalers: Sickle scalers have a

• The Morse sickle has a very small,

• Gracey curettes: They are area-specific curettes, designed and

• Used for removing plaque, scaling,

Two types of ultrasonic units are:

• Rubber cups, brushes, dental tapes

• Excisional and incisional

• Required for the removal of granulation tissue, fibrous

• Necessary to reflect and move

• Example: Goldman Fox #14.

• They are used during periodontal surgery for

• They are used primarily to smoothen

• Used for removing tabs of tissue

• They are used to suture the flap at

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