Three handle characteristics to consider
Instrument weight
Handle diameter
Texture
Pinch Force refers to
force used to grasp the handle during instrumentation
More pinch force = muscle cramping
Handles to avoid
Heavy, solid metal handle
Small diameter
No texturing or nonraised texturing
A periodontal instrument is balanced if
the working-ends are aligned with the long axis of the handle.
Hold a simple shank so that the
working-end tip or toe is facing you.
Simple shank will appear to be STRAIGHT
Hold a complex shank so that the
working-end tip or toe is facing you.
Simple shanks are used for
Anterior teeth
Complex shanks are used for
posterior teeth ( 11/12 explorer)
Front-to-back complex shank bends allow you to reach the
Facial and lingual surfaces on the root.
Side-to-side complex shank bends allow you to reach the
mesial and distal surfaces of the root.
Rigid (thick) shanks remove
heavy deposits. (calculus)
Flexible shanks remove
small to medium deposits.
Flexible shanks enhance
amount of tactile information transmitted to clinician's fingers
Functional shank
the portion of the shank that allows the working-end to be adapted to the tooth surface.
Begins below the working-end, and extends to the last bend in the shank nearest the handle
Lower shank
the portion of the functional shank that is nearest to the working-end; also called the "terminal" shank.
The portion of the functional shank nearest to the working-end
Simple shank with short functional shank length used....
SUPRAgingival use on anterior teeth
- may go subgingivaly, but stays above CEJ
Simple shank with long functional shank length used...
subgingival use on anterior teeth
Complex shank with short functional shank length used...
supragingival use on posterior teeth
Complex shank with long functional shank length used...
subgingival use on posterior teeth
An instrument's function is determined by
the design of its working-end.
Parts of the working-end
Face
Back
Lateral surfaces
Cutting edges
Toe or tip
Tip=
Scalers
ex. 204S
Toe=
Curet
ex. SC 13/14
The cross section of a working-end is
exposed by cutting through the working-end at right angles to its longest dimension
The cross section of a working-end determines
whether the instrument can be used subgingivally, or is restricted to supragingival use.
Working-ends that are triangular in cross section are
limited to supragingival use.
- Scalers
Working-ends that are semi-circular in cross section
may be used supragingivally and subgingivally.
-Curets
Internal angles of a curet (shown by cross section)
70- to 80-degree internal angles at the cutting edges
Instruments used for Assessment
Periodontal Probes
Explorers
Instruments used for calculus removal
Sickle scalers
Curets
Periodontal Files
11/12 explorer (ODU 11/12) correct working end for ANTERIOR teeth
Tip "wraps/hugs" surface.
11/12 explorer (ODU 11/12) correct working end for POSTERIOR teeth
Terminal shank is parallel to teeth
Universal Curet examples
Columbia 13/14
Barnhart 5/6
4R/4L
Universal Curet features
Rounded back, Rounded toe, Semi-circular cross section, 2 cutting edges, face is at a 90d. angle
Universal Curet Indications
Removal of supra and subgingival small and medium deposits.
Universal Curet correct working end on Anterior teeth
Terminal shank "wraps" - not parallel.
Universal Curet correct working end on posterior teeth
Terminal shank is parallel
Posterior Sickle Scaler examples
204S
Nevi CN2
Posterior Sickle Scaler features
Pointed back, Pointed tip, Triangular cross section, 2 cutting edges, Face perpendicular to shank
Posterior Sickle Scaler indications
Removal of medium to large sized deposits. Removal of calculus on the crowns of the teeth. -not to be used on root surfaces.
Posterior Sickle Scaler correct working end
Terminal shank parallel to distal
Anterior Gracey Curet examples
Gracey 1/2
Gracey 3/4
Anterior Gracey Curet features
face tiled at 70d. to lower shank, Rounded toe, Rounded back, Semi-circular cross section.
Anterior Gracey Curet indications
removal of light calculus.
Used a a finishing/root planing curet- following ultrasonic/universal instrumentation.
Anterior Gracey Curet correct working end
Face tilts toward the tooth surface
Posterior Gracey Curet examples
Gracey 11/12, 13/14, 15/16, 17/18
Posterior Gracey Curet features
Face tilted at 70d. to lower shank, Rounded toe, Rounded back, Semi-circular cross section.
Posterior Gracey Curet indications
Removal of light calculus.
Used as a finishing/root planing curet - following ultrasonic/universal instrumentation.
Posterior Gracey Curet correct working end
Terminal lower shank is parallel
Use of Simple shank with short functional length
SUPRAgingival use on anterior teeth
Use of Simple shank with long functional length
SUBgingival use on anterior teeth
Use of Complex shank with short functional length
SUPRAgingival use on posterior teeth
Use of Complex shank with long functional length
SUBgingival use on posterior teeth
Assessment instruments
Periodontal probes & Explorers
Calculus removal instruments
Sickle scalers, Curets, Periodontal files
Explores have what type of shank
flexiable, and are circular in cross section