scaling instruments

8/13/2019 Scaling Instruments

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Periodontal ScalingInstruments


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Scaling and Root planning

Scaling is a procedure which aims atthe removal of plaque and calculusfrom tooth surfaceSupragingival: on the clinical crown

Subgingival: below the gingival margin

Root planning: removal of softenedcementum and making root surfacehard and smooth.

Subgingival scaling and root planningare either closed or open procedureunder local anaethesia.


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Scaling and Root Planning

Before After

After

Before


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Instruments

Instruments used for scaling and

root planning are classified as:

Hand instruments

Ultrasonic and sonic

Rotating

Reciprocating


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Hand Instruments

Hand instrument: composed of three parts:

Working part (blade); carbon steel,stainless steel, or tungsten carbide

Shank

Handle

Cutting edge: centered over the long axis ofthe handle for proper balance

Groups: Curettes, Sickles and Hoes


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Curettes

Used for both scaling and root planning

Blade is spoon shaped with two curvedcutting edges united by rounded toe

Length, angulation of shank and dimensions

of blade differ according to brand


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Gracey Curettes Developed in the 1930's by

Dr. Clayton Gracey

Designed to provide better

access to root surfaces in

deep pockets

Long shanks and unique

blades

Bends improving access

to complex root surface

morphology

G C


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Gracey Curettes The original series: 7 double-ended

instruments (1/2; 3/4; 5/6; 7/8; 9/10; 11/12;

13/14)

The opposing ends of the instruments havemirror image blades

In the 1980's, 2 modified instruments wereadded (15/16; 17/18)

Dr. Gracey's concept: to properly accessdifferent areas of the dentition, differentshank and blade designs were required

(Area Specific Curettes).


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Gracey curettes

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racey curettes Gracey curettes 1/2, 3/4, and 5/6 are used

to scale all tooth surfaces in the anterior

sextants.

7/8 and 9/10 are used for scaling the

buccal and lingual aspects of teeth in theposterior sextants.

11/12 and 15/16 are used to scale the

mesial aspects of the teeth in the posteriorsextant

13/14 and 17/18 are used to scale the distalaspects


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Gracey curettes

Gracey curettes: stainless steel, carbonsteel or different combinations of metals;some stronger or more rigid than others

Carbon steel; rusts and wears away more

quickly. solid one-piece instrument (usually

stainless steel)

cone socket instrument (usually carbonsteel); shank and blade can be replaced


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Gracey curettes

Unique design:

each end had only one

cutting edge

is designed to adapt

closely to the specific

tooth surface


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Gracey curettes The cutting or useable edge of the

blade is the lower outer aspect of theblade

cutting edge exhibits a curve longer

(convex) in relation to the "non-

working" edge

The blade of the curette

is machined at a 70

degree angle


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Gracey curettes

Adapting the Gracey instruments tothe teeth to perform scaling;

Identify the cutting edge

Place it against the surface to be scaledTerminal shank parallel to tooth surface;

ideal working angulation for calculus

removal


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Gracey curettes

Place it against the surface to be scaled

Terminal shank parallel to tooth surface


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Sickle Scaler Used for supragingival or

shallow pocket scaling Very useful instrument;

first instrument used to

remove large, heavydeposits

improving access tosubgingival area for otherinstruments.


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Sickle Scaler

A number of different sickle scalers are

available in a variety of shapes and

sizes:

Towner H-15

Jacquette

204 S; 204 SDMorse

USC - 128


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Sickle Scaler

Common features making them

suited to the removal of heavy

calculus deposits and working

interproximally, around the contact

areas of teeth.

C F


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Common FeaturesFlat blade cut at a 90 degree angle to the shank.

Cutting edges on both sides of the blade.The face of the blade is triangular tapering to a

strong, sharp point at the toe.

The face of the blade may be straight or curved.

LateralLateral

Facial

SICKLE SCALER


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Sickle Scaler

Flat blade, cutting edgeson both sides, triangular,straight or curved


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Sickle Scaler

The sharp pointed toe & The first 1-2 mm of the

lateral cutting edges perform the work.


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Hoe Used for supragingival scaling, but is also

useful in root planning during surgery

Has only one cutting edge

Blade is turned 100 degree angle to shank with

cutting edge beveled at a 45 degree

Blade can be positioned at four different

inclinations in relation to shank: facial, lingiual,

distal and mesial.


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Instrument Handle

Another aspect in choosing an instrument isthe thickness of the handle.

Research has shown that a thicker handle is

easieron our hands and wrists than athinner instrument.


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Essentials of Instrumentation

Grasp

Fulcrum

Wrist and Arm Motion

Adaptation

Angulation

Insertion

Strokes


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Grasp

Grasp: the firm light hold of dental clinicians

on their instruments.

Enables the clinician to maneuver the

scaling instrument around the tooth and

correctly direct pressure application for

calculus removal without damaging the

periodontal tissues.

Three specific grasps are used; the pen

grasp, the modified pen grasp, and thepalm-thumb grasp.


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Modified Pen Grasp


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Fulcrum

The resting of the third fingeron a firm

intra- or extraoral site acts as a fulcrum.

Improves control of the instrument andapplication of forces by the working end

against the tooth.


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Wrist and Arm Motion

The instrument/wrist/ forearm complex

must act as a unit rocking firmly but

smoothly on the fulcrum.Avoid wrist twisting or independent finger

movement; to avoid pain, muscle fatigue,

and inflammation of the ligaments andnerves of the wrist.


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Adaptation

The placement of the working end of the

instrument in the correct relationship to the

tooth.


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Angulation The angle formed by the plane of the tooth surface

and the plane of the face of the blade. Ideal: most efficient cutting between 45 & 90

Less than 45 degrees is considered "closed

More than 90 degrees is considered "open" .


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Insertion

To avoid damaging the soft

tissues when entering the sulcus

with a large, sharp instrument, the

working end is inserted into the

sulcus with the face of the blade"closed" or f lattened to the tooth

surface.

Once in the depth of the pocket orsulcus, the blade is opened 45 to

90 degrees for working strokes.


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Strokes

The action of the working end of aninstrument as it is moved across a tooth

surface.

Exploratory strokesWorking strokes

Scaling strokes

Root planning


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Exploratory strokes

Exploratory strokes provide light tactile

feedback from the instrument tip


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Working strokes

Working strokes provide controlled

pressure against a tooth surface using an

appropriate cutting angulation Working strokes are ideally a series of

overlapping strokes covering the entire

tooth surface


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Scaling strokes

Scaling strokes are short pulling strokes

made with firm pressure to remove

increment from root and enamel surfaces


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Rotating Instruments

Different burs


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Reciprocating Instruments


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Finishing and Polishing

Eva System


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scaling instruments

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