advanced instrumentation

used to dislodge heavy supramarginal calculus deposits

used to crush and remove heavy calculus deposits

used to dislodge brides of calculus on anterior mandibular teeth

• 1. single, straight cutting edge
• 2. cutting edge beveled at a 45 degree angle to the end of the blade
• 3. blade turned at 99-100 degree angle to the shank
• 4. strong, straight, rigid shank used for adaptation in anterior
• 5. curved shank used for adaptation in posterior sextants
• 6. paired instrument; set of 4 working ends of 4 areas

1. removal of heavy, tenacious SUPRAgingival calculus

2. removal of heavy, tenacious SUBgingival calculus in easily accessible areas, above the junctional epitherlium

3. most effective on the facial and lingual surfaces OR on proximal surfaces next to edentulous areas.

only in easily accessible areas

VERTICAL PULL STROKE toward the incisal/occlusal

hold instrument in a modified pen grasp utilizing a fulcrum near the tooth surface to be instrumented

full width

parallel

1. NOT for use on proximal surfaces EXCEPT in edentulous areas

2. Can gouge cemental surface

3. NOT adaptable to curved root surfaces

4. NOT to be used subgingivally unless tissue is SPONGY and FLEXIBLE bc blade size and shape will tear pocket wall

5.ALL instrumentation must be followed by curets

1. Multiple cutting edges, like a series of hoe scalers

2. each blade is at a 90-105 degree angle to the shank

3.shank comes in various angles. curved shanks are designed for the posterior and straight shanks are for the anterior

4. base can be round, rectangular or oval

1. calculus removal through crushing or fragmentation prior to definitive scaling with curets

2. SUBgingival use of the file must be away from the junctional epithelium

3. most effective on the facial /buccal and lingual surfaces OR on proximal surfaces next to edentulous areas

4. Smooth overhanging restorations

only in easily accessible areas

FLAT

parallel

a two-point contact between the instrument shank and the cutting edge to provide stability

VERTICAL PULL STROKE toward the incisal/occlusal.

Pressure applied allows cutting edge to grasp surface

1. Can gouge tooth surface and traumatize tissue

2. Inaccessible areas

3. lack of tactile sensitivity

4. Base of pocket inaccessible without trauma

5. Proximal use is difficult

FILE

1. single, straight, flat cutting edge

2. Blade is continuous with slightly curved shank

3. Cutting edge is bevealed at a 45 degree angle

1. extremely limited to areas where interdental papilla are missing

2. Removal of heavy supragingival calculus that bridges mandibular anteriour teeth and premolars where the lip allows access.

on the facial surface of teeth adjacent to tooth being instrumented

perpendicular

full width

HORIZONTAL PUSH (thrusting) motion from facial to lingual

1. must utilize entire cutting surface or sharp corners will gouge tooth surface

2. all instrumentation must be followed by curets

• ^{stationary stone, moving instrument}
• 1. maintain 45 degree bevel, establish finger rest on stone

2. PULL toward the cutting edge, use a short stroke

3. Round the corners by gently rolling stone across corner

1. use professional sharpening service or BUY a new one

2. too difficult and time-consuming with limited results

• ^{stationary stone, moving instrument}
• 1Maintain 45 degree bevel

2. PUSH instrument foward, toward the cutting edge

3. round corners by gently rolling stone over corners

*Root surfaces are broad and flat in faciolingual direction

*longitudinal groove possible, more common on distal surface

*concavity exists with longitudinal groove

roll handle to direct toe third of cutting edge into concavity

most commonly bifurcated in apical or middle third, forming facial and lingual roots

2 kinds BIfurcated and SINGLE rooted

mesial surface has deep developmental groove running from bifucation to crown, causing a concave mesial surface.



distal surface has a groove reduced in depth and length, causing a convex or flat distal surface at the cervical third

mesial and distal surfaces have longitudinal grooves similar to the grooves on the root trunk of a two rooted tooth.


The mesial surface groove is more pronounced than the distal and therefore more concave on mesial surface.

three roots are lingual, mesiobuccal, distobuccal

short root trunk

grooves ar epresent from trifurcation to cervical line on mesial, distal, and facial surfaces

lingual surface of lingual root has longitudinal groove more pronounced at cervical third

maxillary first molar

longitudinal groove usually present on mesial and distial surfaces, making them concave in the faciolingual direction

sometimes this root is bifurcated in the apical third

bifurcation in cervical third forms mesial and distal roots

developmental depression on facial and lingual root trunk extends from bifurcation to CEJ, becoming more shallow toward CEJ

each root has longitudinal grooves on the mesial and distal root surfaces, which are more prominent on mesial roots

extension to the midline of proximal surfaces

and longevity is limited by sharpening often

after-five mini gracey curet

for narrow facial and lingual surfaces of anterior teeth

light to moderate calculus

fine scaling, root planing, debridement

adjuction to ultrasonic scaling

more flexible shank that bends under pressure

heavy scaling

does not dissipate the power used in generating a working stroke

does not diminish tactile sensitivity

enhances control and energy needed

available in mini, traditional, and after five series

moderate to heavy calulus

scaling and debridement

periodontal surgery

wider shank

same shank angulation as standard Gracey Curette

same blade width as standard Gracey Curette

to smooth root surfaces and remove small residual deposits after ultrasonic scaling

O'hehir curettes

SOH 1/2, SOH 3/4 SOH 5/6 SOH 7/8

SOH (o'hehir)

360- degree diamond coating

thin tips and unique bends

active in both push and pull motion

medical grade diamond coating

scaling efficiency

superior access

provides accessto scale in small and narrow pockets

ensures consistency of coated surface

paried ends R/L

universal application

access for class III furcations

extended shank and pronounced curvature

large diameter handle

Barbara Long RDH from Saskatchewan

perpendicular


parallel

50% shorter blade

straight shank permits insertion into narrower deeper pockets especially anterior.

improved adaptation at line angles, and for removal of deposit once it had been dislodged

long shank, facial and lingual line angles on anterior and premolars

anteriors, premolars, and interproximal surfaces

mesial of molars and furcations

distals of molars and furcations

small "X"

5 mm

10 mm

helps clinician visually assess pocket depth during instrumentation, to compare with perio charting and tactile sensation

1. short working end limits extension to midline of proximal surfaces

2. upward curve could gouge if not adapted properly

Dr. Burton Langer

periodontist

combines best features of the gracey and universal curette blade


allows you to scale the mesial and distal surfaces with the same instrument

langers have a slightly shorter, thicker terminal shank making them less flexible

shank is not parallel to long axis of tooth when a good working blade angulation is achieved

similar to 11/12

mandibular posterior mesial and distal

maxillary posterior

similar to 13/14

but suitable for both mesial and distal of surfaces of maxiallary teeth

anterior and premolar teeth

similar to gracey 5-6

posterior

advantageous when scaling 2nd and 3rd molars

angled shank allows for a more horizontal hand position

scaler has a miniature sickle with a straight shank

has a straight shank with miniature curet

used to gain additional stability and control

non-dominanthand is used for additional support, additional lateral pressure, and longer pull strokes

designed for scaling root concavities and furcations:

available in: buccal-lingual or mesial-distal

• blade width is 2 sizes either
• .9mm 1.3 mm

• 1. extraoral palm up hand rest
• 2. extraoral palm-up reinforced hand rest
• 3. intraoral finger on finger rest
• 4. intraoral opposite arch finger rest
• 5. intraoral opposite arch reinforced finger rest
• 6. cross arch finger rest
• 7. horizontal strokes in anterior and using an 11/12 on the distal of most posterior tooth
• 8. opposite end of 13/14 for horizontal strokes with toe down