periodontal instrumentation2013b [compatibility mode]

8/13/2019 Periodontal Instrumentation2013b [Compatibility Mode]

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Periodontal Instrumentation

(Scaling and Root Planing)

Malik Hudieb, BDS, PhD

Department of Preventive Dentistry

Faculty of Dentistry

Jordan University of Science and Technology

Academic/Research

Clinical

Classification of Diseasesand Conditions Affecting

the Periodontium

Periodontal Examination &Periodontal Indices

Plaque Control & OralHygiene instructions.

Anatomy, Histology andPhysiology ofPeriodontium

Plaque

PeriodontalInstrumentation

Treatment of Periodontal

Diseases

Non-surgical Surgical

Objectives of Nonsurgical

Periodontal Therapy

Eliminate inflammation by physical removal of

Plaque and Calculus (supra and sub gingival).

Controls plaque-induced gingivitis, slight to

moderate chronic periodontitis

Precedes periodontal surgery


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Non-surgical periodontal therapy:

Oral hygiene measures

Periodontal instrumentation

Chemical agents

Periodontal debridement: Disruption ofbacterial plaque and calculus from the crownand root surfaces

Deplaquing: Disruption of subgingival microbial

plaque from cemental surfaces and the pocket

space

Gross debridement: to enable an examination

and diagnosis

Emerging TerminologyCLASSIFICATION OF PERIODONTAL

INSTRUMENTS (non-surgical)

Periodontal Probes

Explorers

Scaling & Root planing Instruments

Cleansing & Polishing Instruments


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Parts of Periodontal Instrument

Handle

Shank

Working end/ Blade


Handle


Shank: -- Functional

-- Terminal/ Lower

CLASSIFICATION OF PERIODONTALINSTRUMENTS (non-surgical)

Periodontal Probes

Explorers




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Periodontal Probes Examination and Detection Skills

Use of the Probe

Measures sulcus depth

Periodontal pockets

Gingival recession

Attachment loss

Angulation

Probe is parallel to long axis of tooth


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Readings

Six readings

Distal (DB & DL)

Buccal (B) or Lingual(L)

Mesial (MB & ML)

Deepest reading withinthe designated areas

Periodontal Probes

Nabers probe

CLASSIFICATION OF PERIODONTALINSTRUMENTS (non-surgical)

Periodontal Probes

Explorers



Explorers


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Insertion & use Explorers CLASSIFICATION OF PERIODONTALINSTRUMENTS (non-surgical)

Periodontal Probes

Explorers

Scaling & Root planingInstruments


Scaling & Root PlaningInstruments


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Types of Curettes

UniversalCurette

Types of Curettes

Gracy or Area SpecificCurettes

Differences between UniversalCurettes & Gracy Curettesa

A. Universal Curette

B. Gracy Curette

General Principles ofInstrumentation

Accessibility

Visibility, Illumination & Retraction

Condition of the Instruments

Mainting a Clean Field

Instrument Stbilization

Instrument Grasping

Finger Rest

Instrument Activation

Adaptation

Angulation

Lateral Pressure


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Gracey Curettes

The original seriescontained 7 double endedinstruments (1/2; 3/4; 5/6;7/8; 9/10; 11/12; 13/14).

In the 1980's, 2 modified

instruments were addedto the collection (15/16;17/18).

Curettes for SubginbivalSC & RP

Universal Curettes

Technique for SC & RP

Adaptaion

Angulation

Activation

General principles ofInstrumentation(746)

1- Accessibility: facilitate thoroughness ofinstrumentation. Position of patient &operator should provide maximal

accessibility.

2- Visibility: whenever possible direct

vision with direct illumination


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Principles of Instrumentation

3- Condition and sharpness of Instruments

4- Maintaining clean field

5- instrument stabilization:

A- Instrument grasp

B-Finger restC- Instrument Activation

A-Instrument Grasp

Modified pen grasp

Instrument Grasp

Standard pen grasp Palm& thumb

B-Finger Rest

Conventional finger rest


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Intra-oral

Cross arch opposite archExtra oral rest

Palm up Palm down

C-Instrument Activation

1-Adaptation: manner of which instrumentend is placed against surface of the tooth

2-Angulation

1-o degree angle 2- 45 degreeangle


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Strokes

Exploratory stroke: light, feeling stroke todetect calculus, roughness or smoothnessof root

Scaling stroke

Scaling strokes

A-Vertical B-Oblique C-Horizontal

5- Grasp in light modified pen grasp, applyrest

6-Use short, light, vertical, horizontal, oroblique strokes

7-Working end should be kept in constantmotion, parallel to the tooth

8-Swich off periodically

9- Finish remaining manually

Blade Adaptation to ToothSurface

insertion

0

90

Tissue

Trauma


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Sickle Scaler

Supragingival calculus

Stain

Slightly subgingival (1-2mm)

Different Designs

Anterior teeth

Posterior teeth

Modified shank

Blade can vary in size & design

Design Characteristics

Straight rigidshank

Two cuttingedges

Straight orslightlycurved

Back of theinstrument

Pointed orrounded

Visual Guide to Instrumentation

Anterior Teeth

Handle extendsupward/parallel to longaxis of teeth wheninterproximal

Does not apply to Facialor Lingual surfaces

Oblique stroke is best

Alternative instrumentsare better than sickle

Prevent tissue trauma


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Universal Curets

Can adapt to all tooth surfaces

90 degree blade angulation

shank curvature allows adaptation

both cutting edges are used

blade curved on only one plane

periodontal instrumentation2013b [compatibility mode]

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