Basic periodontal instruments

Probes

Parodontologic probe

Periodontal Probe Examination

• To examine the depth of the periodontium (in healthy periodontium we insert the probe into the sulcus)
• At 4 sites - interbuccal, buccal, distobuccal, oral
• First visit - still mesiooral and distoral = six-point measurement
• Pressure - 0.25 N (gentle probing)

The supporting apparatus is very vulnerable, the probe easily penetrates the bottom of the paradontal socket further into the tissue.

• We are not talking about the depth of the paradontal socket, but the depth of the probing
• Usually greater than the histological depth of the paradontal socket (inflamed tissues do not resist)

WHO probe

• Calibrated by colour coding, blunt-tipped ball
• Pieces on the working part are separated from each other
  • 0.5/ 3.5/ 5.5/ 8.5/ 11.5 mm (for CPI-TN)

Williams-Fox probe

• Millimetre scale (division usually in 1 or 2 mm increments)

Florida-Probe, Interprobe

• Electronic, pressure-calibrated probes
• Measurement and results acquisition - in conjunction with a computer
• Improved resolution (depth of 0.1 mm)
• Result reproducibility comparable to manual probes

Tools used to clean teeth and remove tartar

Scalers

• For hard surface removal and rough depuration
• Pointed, large - cannot work subgingivally without damaging the gingiva
• Straight - entire maxillary and mandibular area
• Curved - to remove tartar from interdental spaces

Sickle

• Sickle - triangular cross-section, 2 cutting edges that converge into a tip
• Hoe-scaler

- Hoe-shaped or hook-shaped working end - Removal of tartar even subgingivally without uncovering the gingiva - Cannot reach the bottom of the gingival sulcus - Sharp edges - risk of scratching the root surface

Curettes

- Removal of subgingival deposits, necrotic and infected root cementum, granulation tissue and epithelium from the paradontal sockets - Tiny, rounded end

Curette set

Universal curettes

• Can be used in all quadrants of the dentition on all tooth surfaces
• Sharpened on both sides of the spoon-shaped working end
• Angle between shank and working edge = 80°
• Columbia, Langer...

Special curettes

• Sharpened on one side only - it is necessary to choose the right tool
• Angle between working edge and surface = 80°
• Angle between shank and working edge = 60-70°
• Gracey's curettes - numerical coding - selection of the tool specifically designed for the surface

Chisels

• Removal of interdental calculus in the frontal and anterior lateral sections
• E.g. Zerfing chisel

Ultrasonic tartar removers

• Removal of tartar and subgingival concretions (when the gingiva is uncovered)
• Do not use to remove soft plaque - risk of damage to hard dental tissues

Principle of magnetoconstriction - steel/nickel core vibrated longitudinally in a coil through which an alternating current passes

Ultrasound tip

Piezoelectric effect - deformation of silicon crystals in an alternating field, oscillations transmitted to the working end

• Conversion of electric current to microscopic beats at 25-50 kHz
• For tartar removal in the molars - special tips (SlimlineTM) - very thin, coolant supplied through the inside of the instrument to the tip - removal of concretions, reduction of bacteria and their toxins in the molar and on the root surface

Airscalers

• Connected to the unit via a quick coupler to a quick release elbow, powered by air
• Max 10000 oscillations/second - not UZ area
• Release of hard adherent coatings from tooth surface
• Cooling required - risk of overheating (up to 195 °C)
• Risk of cavitation ( even with UZ) - place tips flat on tooth, work intermittently with minimum pressure, use tips with rounded edges

Working technique when working with hand instruments

• Hold them like a writing pen, with the middle finger resting on the tooth row - exert sufficient force, prevent the instrument from slipping (injury to the patient or doctor)
• Chisel - gentle strokes away from you
• Scalers and curettes - pulling from the apex towards the coronal
• Grind after using the instrument

Sources

Related articles

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