PERIODONTAL

INSTRUMENTS

Dr. APEKSHA KAMBLE

1st YEAR MDS
DEPARTMENT OF
PERIODONTOLOGY
 CONTENTS

1. INTRODUCTION

2. CLASSIFICATION
 Introduction
• Periodontal intruments are designed for specific purposes

•  Removing calculus
•  Root Planing
•  Curetting
•  Removing dead tissue
CLASSIFICATION
PARTS OF AN INSTRUMENT
Used to grasp the instrument

connects the handle to the working end

extends between the blade and the first

bend

carries out the function of the instrument

and is unique to each instrument type.
 PERIODONTAL PROBES
• They are tapered rod like instruments,calibrated in millimeters.

Purpose:
• They are used to locate,mark,measure the depth of periodontal pockets.
• When measuring a pocket, the probe is inserted with a firm gentle
pressure to the bottom of the pocket.
• Shank should be aligned with long axis of the tooth surface to be
probed.
 TYPES OF PROBES
•  First Generation
•  Second Generation
PHILSTROM
•  Third Generation
•  Fourth Generation
•  Fifth Generation ------- WALTZ
 FIRST GENERATION PROBES
• Do not control for probing pressure and are not suited for
automatic data collection.
• These probes most commonly are used by general dental
practitioners as well as periodontists.
 WILLIAM’S PROBE
• Invented in 1936 by Charles H.M. Williams.
• These probes have a thin stainless steel tip of 13 mm
in length and a blunt tip end with a diameter of 1 mm.

• 4-mm and 6-mm markings are absent

to improve visibility and avoid
confusion in reading the markings.
• Probe tips and handles are enclosed
at 130 degrees.
 CPITN PROBES
The Community Periodontal Index of Treatment Need (CPITN)
was designed by Professors George S. Beagrie and Jukka
Ainanio in 1978.

Screening and monitoring patients with the

CPITN index.
CPITN-E (epidemiologic) CPITN-C (clinical)
Have 3.5-mm and 5.5-mm Have 3.5-mm, 5.5-mm, 8.5
markings mm, and 11.5-mm markings.
• CPITN probes have thin handles and are
lightweight (5 gm).
• The probes have a ball tip of 0.5 mm, with a
black band between 3.5 mm and 5.5 mm. as
well as black rings at 8.5 mm and 11.5 mm.
 MICHIGAN ‘O’ PROBE
• Markings at 3 mm. 6 mm, and 8 mm.
• A modification of this probe with Williams‘ markings also is
available.
 UNC 15 PROBE
• University of North Carolina-15.

• Color-coded at every 5 millimeter

demarcation.

• They are the preferred probe in clinical

research if conventional probes are

required.
 NABER’S PROBE

Used to detect and measure the

involvement of furcal areas by the

periodontal disease process in

multirooted teeth.

Can be color-coded or without demarcation.

 SECOND GENERATION (CONSTANT PRESSURE)
PROBES
• Pressure sensitive, allowing for improved standardization of probing
pressure.
• The True Pressure Sensitive (TPS) probe is the prototype for second-
generation probes.
• Introduced by Hunter in 1994, these probes have a disposable probing
head and a hemispheric probe tip with a diameter of 0.5 mm.
• A controlled probing pressure of 20 gm is usually applied.
• These probes have a visual guide and a sliding scale where two indicator
lines meet at a specified pressure.
 THIRD GENERATION (AUTOMATED)

• This generation includes computer-

assisted direct data capture to reduce
examiner bias and allows for greater
probe precision.
• These probes require computerization
of the dental operatory and can be
used by periodontists and academic
institutions for research.
1. FOSTER - MILLER PROBE

2. FLORIDA PROBE

3. TORONTO AUTOMATED PROBE

 1. FOSTER - MILLER PROBE

• Prototype of third-generation probes.

• Devised by Jefficoat et al in 1986, this probe has controlled
probing pressure and automated detection of the
cementoenamel junction (CEJ).
 • Main mechanism of action is by
detection of the CEJ.
• The ball tip moves or glides over the
root surface at a controlled speed
and preset pressure.
1. A pneumatic cylinder, • Abrupt changes in the acceleration
2. A linear variable
of the probe movement (recorded
3. Differential transducer (LVDT),
4. A force transducer, on a graph) indicate when it meets
5. An accelerator the CEJ and when it is stopped at
6. A probe tip
the base of the pocket
Advantage -
Automatic detection of the CEJ

Disadvantage -
It cannot deem root roughness or root surface irregularities as

the CEJ.
 2. FLORIDA PROBE
• Gibbs et al. in 1988.
• This probe consists of a -
1. Probe handpiece and sleeve;
2. A displacement transducer;
3. A foot switch; and
4. A computer interface/personal computer.
• The hemispheric probe tip has a diameter of 0.45 mm, and
the sleeve has a diameter of 0.97 mm .
• Constant probing pressure of 15 gm is provided by coil
springs inside the handpiece.
• They also can record missing teeth, recession, pocket depth, bleeding,
suppuration, furcation involvement, mobility, and plaque assessment.
• Each measurement is recorded with potentially 0.2-mm accuracy.
 3. TORONTO AUTOMATED PROBE

• Devised by McCulloch and Birek in 1991 at University of Toronto,

used the occlusoincisal surface to measure relative clinical
attachment levels.
• The sulcus is probed with a 0.5-mm nickel titanium wire that is
extended under air pressure.
• It controls angular discrepancies by means of a mercury tilt sensor
that limits angulation within ± 30°.
• Has the advantage of an incorporated electronic guidance system to

improve precision in probe angulation.

• It also estimates the biophysical integrity of the dentogingival junction

by measuring intrapocket probing velocity.

• The disadvantages are associated with positioning :

It is difficult to measure second and third molars, and patients have to

position their heads in the same place to reproduce readings.

 FOURTH GENERATION PROBES

• Three dimensional (3D) probes.

• Aimed at recording sequential probe positions along the
gingival sulcus.
• They are an attempt to extend linear probing in a serial
manner to take into account the continuous and 3D pocket
being examined.
 FIFTH GENERATION PROBES

• Fifth-generation probes aim to identify the attachment level without

penetrating it.
• The only fifth-generation probe available, the UltraSonographic (US)
probe (Visual Programs, Inc), uses ultrasound waves to detect,
image, and map the upper boundary of the periodontal ligament and
its variation over time as an indicator of the presence of periodontal
disease.
 EXPLORERS
• Used to locate subgingival deposits and carious areas.
• To check the smoothness of root surfaces after root planing..
Shepherd Hook Explorer - Straight Explorer - for Curved Explorer: Pigtail and Cowhorn
for supragingival supragingival for calculus Explorer:
examination of caries and examination of detection and For calculus detection and
irregular restoration caries and irregular shallow pockets. shallow pockets
margins. restoration margins. not extending deep than
cervical third of root.
SCALING AND CURETTAGE INSTRUMENTS
SICKLE SCALERS (SUPRAGINGIVAL SCALERS)

• Have flat surface and two cutting edges

that converge in a sharply pointed tip.
• Used to remove supragingival calculus.
• Used with a pull stroke.

Scalers with straight shank: anterior teeth and premolars.

Scalers with contra-angle shank: posterior teeth.
• U15/30 scalers: large.

• Jacquette sickle scalers #1,2,3 : medium sized blades.

• Curved 204 sickle scaler: large, medium or small blades.

• Nevi 2 posterior scaler: thin enough, can be inserted few mm

subgingivally
 CURETTES
• For removing deep subgingival calculus, root planing, altered
cementum and removing soft tissue lining the pocket.
• Each working end has cutting edge on both sides and a
rounded toe.
• Finer than sickle scalers.
• Can be adapted and provide good access to deep pockets,
with minimal soft tissue trauma.
 UNIVERSAL CURETTES
• Have cutting edges that may be inserted in most areas of
dentition by altering, adapting the finger rest, fulcrum and
hand position of operator.
• Face of blade is 90-degree angle to the lower shank.
• Blade is curved in one direction from head of the blade to toe.

Examples :
Banhart curettes #1-2 and 5-6
Columbia curettes #13-14, 2R-2L. 4R-4L
Younger-Good #7-8
The McCall’s #17-18
Indiana University #17-18
AREA-SPECIFIC CURETTES
• Offset blade: they are angled approx. 60-70 degrees from lower

shank. This allows the blade to be inserted in precise position

necessary for subgingival scaling and root planing.

• These have curved blade (curved from head to toe and along the

side of cutting edge).

• Only pull stroke can be used.

 GRACEY CURETTES
• Designed and angled to adapt specific anatomic areas of dentition.
• Double ended curettes paired in this manner: 
1. Gracey #1-2 and 3-4: Anterior teeth
2. Gracey #5-6: Anterior teeth and premolars.
3. Gracey #7-8 and 9-10: Posterior teeth: Facial and lingual.
4. Gracey #11-12 : Posterior teeth: Mesial
5. Gracey #13-14: Posterior teeth: Distal
 Modifications of Gracey Curettes
• Gracey #15-16 : consists of Gracey #11-12 combined with more acutely
angled #13-14 shank.
Allows better adaptation to posterior mesial surfaces from a front position
with intraoral rests.
• Gracey #17-18: modification of #13-14.
Has a terminal shank elongated by 3mm and a more accentuated angulation of
the shank to provide complete occlusal clearence and better access to all
posterior distal teeth.
 EXTENDED SHANK CURETTES
AFTER-FIVE CURETTES.
• Terminal shank is 3mm longer, allowing extensions into the pockets of 5mm or more.
• Thinned blade for smoother subgingival insertion and reduced distention.
• Large-diameter, tapered shank.
• All standard Gracey numbers except #9-10 are available in After Five curettes.
 MINI BLADED CURETTES
• Half the length of After-Five or standard Gracey curettes.
• Shorter blade allows easier insertion and adaptation in deep, narrow pockets;
furcations; developmental grooves; line angles; and deep pockets.
• Can be used in areas where root morphology or tight tissue prevents full
insertion of other curettes.
• Used with vertical strokes.
 GRACEY CURVETTES
Another set of four Mini-bladed curettes:
Sub-0 and #1-2: Anterior teeth and premolars
#11-12: posterior mesial surfaces.
#13-14: posterior distal surfaces.

• Blade length is 50% shorter than conventional Gracey curette, and blade has
been curved slightly upward.
• Has a precision balanced tip in direct alignment with the handle, a blade tip
perpendicular to the handle, and a shank closer to parallel with the handle.
LANGER AND MINI-LANGER CURETTES

• These combine the shank design of the standard

gracey #5-6, 11-12 and 13-14 curettes with a
universal blade honed at 90 degrees

• Langer #1-2: mesial and distal surfaces of

mandibular posterior teeth.
Langer #3-4: mesial and distal surfaces of
maxillary posterior teeth.
• Langer #5-6: mesial and distal surfaces of anterior
teeth.
 SCHWARTZ PERIOTRIEVERS
• Set of two double-ended, highly magnetized instruments.
• Retrieval of broken instrument tips from periodontal pockets.
PLASTIC INSTRUMENTS FOR IMPLANTS

• Instruments for use on

titanium and other implant
abutment materials.
• Used to avoid scarring
and permanent damage
to the implants.
 HOE SCALERS

• Used for scaling of ledges or rings of

calculus.
• The blade is bent at 99-degree angle
• Cutting edge is formed by the
junction of flattened terminal surface
with the inner aspect of the blade.
• Cutting blade is beveled at 45
degrees.
• The blade is inserted to the base of the pocket so that it makes a

two point contact with the tooth.

• This stabilizes the instrument and prevents the nicking of the root.

• The instrument is activated with a firm pull stroke towards the

crown, with every effort being made to preserve the two point

contact with the tooth.

• McCall’s #3,4,5,6,7 and 8 : access to all tooth surfaces.

 FILES
• Have series of blades on a base.
• Function: to fracture or crush large deposits
of tenacious calculus or burnished sheets of
calculus.
• Can easily gauge and roughen root surfaces
when used improperly.
• Not suitable for fine scaling and root planing.
• Sometimes used for removing overhanging
margins of dental restoration.
 CHISEL SCALERS
• Double ended instrument with a curved shank at
one end and a straight shank at other end.
• The blades are slightly curved and have a straight
cutting edge beveled at 45 degrees. 
• Inserted from facial surface.
• Curve of the blade allows it to stabilize against the
proximal surface, whereas the cutting edge
engages the calculus.
• Activated by push motion.
 QUETIN FURCATION CURETTES

• Actually hoes with a shallow, half moon radius that

fits into the roof or floor of furcation.
• Curvature of the tip fits into the developmental
depressions of the inner aspects of the root.

• Shanks are slightly curved for better access.

• They remove burnished calculus from recessed areas of furcation.
 DIAMOND COATED FILES

• Used for final finishing of root.

• Donot have cutting edges.

• Coated with very fine grit diamond.

• Sharply abrasive and should be used with light, even pressure against the root

surface to avoid gouging or grooving.

• These can produce smooth, even, clean, highly polished surfaces.

 ULTRASONIC AND SONIC
INSTRUMENTS

ULTRASONIC :
• Used for removing plaque, scaling, curetting and
removing stain.
• Two types: MAGNETOSTRICTIVE AND PEIZOELECTRIC
• Alternating electric current generates oscillations in materials in the
handpiece that cause the scaler tip to vibrate.
• Vibrations range from 20,000 to 45,000 cycles per second.
MAGNETOSTRICTIVE UNITS: the pattern of vibration of the tip is
elliptical i.e. all the sides of tip are active and work when adapted to
the tooth.
Generate heat and require water for cooling.

PEIZOELECTRIC UNITS: the pattern of vibration is linear, or back and

forth i.e. two sides of the tips are most active.
Donot generate heat but still utilize water for cooling frictional heat and
flushing away debris.
Sonic Units:

• consists of a handpiece that attaches to a compressed air-line

and uses a variety of specially designed tips.
• Vibrations range from 2000-6500cps, which provides less power
for calculus removal than
• ultrasonic units.
• All tips are designed to operate in a wet field with a water spray
directed at the end of tip.
• Within water droplets of this spray mist are tiny vaccuum
bubbles that quickly collapse, releasing energy in a
process known as cavitation.

• The cavitation water sprays serve to flush calculus,

plaque, and debris dislodged by the vibrating tip from the
pocket.
 DENTAL ENDOSCOPE
• Used subgingivally for diagnosis and treatment of
periodontal disease.
• Consists of a 0.99mm diameter, reusable fibreoptic
endoscope over which are fitted a disposable, sterile
sheath.
• The fibreoptic fits onto the probes and instruments.
• The sheath delivers water irrigation that flushes the pocket
while the endoscope is being used.
• Allows clear visualization deeply into subgingival pockets and
furcations.
• Permits operators to detect the presence and location of subgingival
deposits.
• Magnification ranges from 24X to 46X. 
• Used to evaluate the subgingival areas for caries, defective
restorations, root fractures and resorption.
 CLEANING AND POLISHING
INSTRUMENTS
RUBBER CUPS
• Consists of a rubber shell with or without
webbed configurations in the hollow interior.
• Used in the handpiece with a special prophylaxis angle.
• A good cleansing and polishing paste that contains fluoride should be used and kept
moist to minimize frictional heat as the cup revolves.
BRISTLE BRUSHES

• Used in prophylaxis angle with a polishing paste.

• Use of brush should be confined to the crown to avoid injuring

the cementum and the gingiva.

 DENTAL TAPE

• Used for polishing proximal surfaces that are inaccessible to

other polishing instruments.
• The tape is passed interproximally while being kept at a right
angle to the long axis of the tooth and is activated with a firm
labiolingual motion.
• The area is cleansed with warm water to remove the remnants
of the paste.
 AIR-POWDER POLISHING

• Prophy-Jet: introduced first in early 1980s.

• Very effective for removal of extrinsic stains and soft
deposits.
• Uses the slurry of warm water and sodium bicarbonate.
• The slurry removes stains rapidly and efficiently by
mechanical abrasion and provides warm water for rinsing
and lavage.
Contraindications Disadvantages
• Patients with history of respiratory • Abrasion of tooth structure.
illness and hemodialysis. • Roughening of amalgam,
• Hypertensive patients on sodium composite resins, cements
restricted diet or patients on and nonmetallic restorations.
medications affecting electrolyte
balance.
• Patients with infectious disease.
THANK
YOU