Periodontal Probe Types

Shank

Shank

Fig. 41-1 Parts of a typical periodontal instrument.

Fig. 41-2 The periodontal probe is composed of the handle, shank, and calibrated working end.

tested,1 18 but specifications vary among manufacturers. n Stainless steel is used most commonly in instrument manufacture. Migh-carhon steel instruments are also available and are considered by some clinicians to be superior.

I.ach group of instruments has characteristic features; individual therapists often develop variations with which they operate most ellectively. Small instruments are recommended to lit into pockets without injuring the soft tissues. '- :s

I he parts ot eac h instrument, referred to as the working end, shank, and handle, are shown in I ig. 41-1.

Periodontal Probes

Periodontal probes are used to measure the depth of pockets and to determine their configuration. The typical probe is a tapered, rodlike instrument calibrated in millimeters, with a blunt, rounded tip iltg. 41-2). there are several other designs with various millimeter calibrations. I he World Health Organization (Wilt)) probe has millimeter markings and a small round hall at the tip il ig. 41-*). Ideally, these probes are thin, and the shank is angled to allow easy insertion into the pocket. Furcation areas can best be evaluated with the curved, blunt Nabcrs probe (I ig. 41-4).

When measuring a pocket, the probe is inserted with a firm, gentle pressure to the bottom ot the pocket. The shank should be aligned with the long axis of the tooth surface to be probed. Several measurements are made to determine the level ol attachment along the surface of the tooth.

Marquis Color Coded Probe

Fig. 41-3 lypes of periodontal probes. A, The Marquis color coded probe. Calibrations are in Vmm sections B, The UNC-15 probe, <\ I 5-mm-long probe with millimeter markings at each millimeter and color coding at the 5"', 10", and IS'" mm. C, The University ol Michigan "O" probe, with Williams markings (at 1. ?, 3. 5, 7, 8, 9, and 10 mm) D, The Michigan "O" probe with markings at 3, 6, and 8 mm E, The WHO (World Health Organization) probe, which has a 0.5 mm hall at the tip and millimeter markings at 3.5, 8.5, and 11.5 millimeters and color coding from 3.5 to 5 5 mm

Fig. 41-3 lypes of periodontal probes. A, The Marquis color coded probe. Calibrations are in Vmm sections B, The UNC-15 probe, <\ I 5-mm-long probe with millimeter markings at each millimeter and color coding at the 5"', 10", and IS'" mm. C, The University ol Michigan "O" probe, with Williams markings (at 1. ?, 3. 5, 7, 8, 9, and 10 mm) D, The Michigan "O" probe with markings at 3, 6, and 8 mm E, The WHO (World Health Organization) probe, which has a 0.5 mm hall at the tip and millimeter markings at 3.5, 8.5, and 11.5 millimeters and color coding from 3.5 to 5 5 mm

Fig. 41-4 The curved Nabers probe for detection of furcation areas.

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Explorers

Explorers arc used In locale subgingival deposits and carious areas and to check the smoothness of the root surfaces alter root planing. I \plorers are designed with different shapes and angles for a variety ol uses. Some of the most commonly used explorers are shown in lig. 41-5, and their uses and limitations are shown in lig. 41-6. Hie periodontal probe can also be useful in the detection of subgingival deposits (see Pig. 11-6».

Scaling and Curettage Instruments

Scaling and curettage instruments are illustrated in Fig. 41-7.

Sickle Scalers (.Stipragingival Scalers). Sickle scalers have a ilat surface and two cutting edges that converge in a sharply pointed tip. I he shape ol the instrument makes the tip strong so that il will not break off during use (l ig, 41-8). The sickle is used primarib to remove supragingival calculus il ig. 4l-(>). Because of the design of Ibis instrument, it is difficult to inseit a large sickle blade under the gingiva without damaging the surrounding gingival tissues (lig. 41-Kb Small, curved sickle scaler blades such as the 204SI) can be inserted under ledges of calculus a few mm below the gingiva Sic kle scalers are used with a pull stroke.

It is important to note that sickle scalers with the same basic design can be obtained with different blade si/es and shank types to adapt to specific uses. I lie 1115/30 d ig. 41-11), Ball, and Indiana University sickles are large. Ihe lacjuette sickles tf I, 2, and 3 have medium-size blades. The curved 204 sickles «ire available with large, medium, or small blades. I he Nevi 2 posterior

Cross Calculus Probe

Fig. 41-6 Insertion ol Iwo lypes of explorers and a probe in a pocket lor calculus detection. A, The limitations of the pigtail explorer in a deep pockei B, Insertion ol the # i explorer C, Limitations ol the 43 explorer D, Insertion ol the probe.

Periodontal Hoe

Ficj. 41-7 Ihe live basic scaling instruments. A, Curette B, sickle; C, lile; D, chisel; E, hoe.

Fig. 41-5 Five typical explorers. A, n 1 7; B, t>2S; C, EXD II 12; D, <»3; E, »3CH Pigtail.

Fig. 41 8 Basic characteristics ol a sickle scaler: triangular shape, double-cutting edge, and pointed tip.

Fig. 41-6 Insertion ol Iwo lypes of explorers and a probe in a pocket lor calculus detection. A, The limitations of the pigtail explorer in a deep pockei B, Insertion ol the # i explorer C, Limitations ol the 43 explorer D, Insertion ol the probe.

Ficj. 41-7 Ihe live basic scaling instruments. A, Curette B, sickle; C, lile; D, chisel; E, hoe.

ABC DE

Fig. 41-5 Five typical explorers. A, n 1 7; B, t>2S; C, EXD II 12; D, <»3; E, »3CH Pigtail.

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Sickle And Pigtail ExplorerSickle Scaler

Fig. 41-9 Use ol <i sickle scaler for removal of supracjingival calculus.

Curette Columbia
Fig. 41 10 Subgingival adaptaUon around the root is better with the curette than with the sickle. I, facial; I, lingual.

sickle scaler is a new design that is thin enough to be inserted several mm subgingivally for removal of moderate ledges of calculus (Fig. 41-12). The selection of these instruments should be based on the area to be scaled. Sickles with straight shanks are designed lor use on anterior teeth and premolars. Sickle scalers with contra-angled shanks adapt to posterior teeth.

Curettes. I he curette is the instrument ol choice for removing deep subgingival calculus, root planing altered

Periodontal Probe Types
Fig. 41-11 Both ends of a U15/30 scaler
U15 Sickle Scaler
Fig. 41-12 Both ends of a NFVI ? posterior sickle scaler.

cementum. and removing the soft tissue lining the periodontal pocket d ig. 41-M). l ach working end has a cutting edge on both sides of the blade and a rounded toe. The curette is finer than the sickle scalers and does not have any sharp points or corners other than the cutting edges of the blade (1 ig. 41-14). I herelore curettes can be adapted and provide good access to deep pockets, with minimal soft tissue trauma (see Fig. 41-10). In cross section, the blade appears semicircular with a convex base. The lateral border of the convex base forms a cutting edge with the face ol the semicircular blade. There are cutting edges on both sides ol the blade. Both single-arid double-end curettes may be obtained, depending on the preference of the operator.

As shown in I ig. 41-10, the curved blade and rounded toe of the curette allow the blade to adapt better to the root surface, unlike the straight design and pointed end of a sickle scaler, which can cause tissue laceration and trauma. I here are two basic types of curettes: universal and area-specific.

Ficj. 41-15 Principal types of curettes as seen from the toe ot the instrument a, Universal curette. b, Gracey curette Note the offset blade angulation of the Ciracey curette.

Universal Curette And How Use

Fig. 41-14 Basic characteristics of a curette: spoon-shaped blade and rounded tip.

Ficj. 41 16 a, Double-ended curette lor the removal ot subginyi val calculus. b, Cross section ol the curette blade (arrow) against the cemental wall of a deep periodontal pocket. c, Curette in position at the base ol a periodontal pocket on the facial surface ol a mandibular molar d, Curette inserted in a pocket with the tip directed apically. e, Curette in position at the base ol a pocket on the distal surface ol the mandibular molar.

Fig. 41-13 The curette is the instrument of choice for subgingival scaling and root planing

Fig. 41-14 Basic characteristics of a curette: spoon-shaped blade and rounded tip.

Universal Curettes. I'niversal curettes have cutting edges that may be inserted in most areas of the dentition by altering and adapting the linger rest, tulcrum, and hand position of the operator. The blade size and the angle and length of the shank may vary, but the lace of I he blade of every universal curette is at a 1 JO-degrec angle (perpendicular) to the lower shank when seen in cross section from the tip (Fig. 41-15. A). Ihe blade of I he universal curette is curved in one direction from the head of the blade to the toe. I he Karnhart curettes #1-2 and 5-6

These curettes and their modifications are probably the best instruments lor subgingival scaling and root planing because they provide the best adaptation to complex root anatomy.

Ficj. 41 16 a, Double-ended curette lor the removal ot subginyi val calculus. b, Cross section ol the curette blade (arrow) against the cemental wall of a deep periodontal pocket. c, Curette in position at the base ol a periodontal pocket on the facial surface ol a mandibular molar d, Curette inserted in a pocket with the tip directed apically. e, Curette in position at the base ol a pocket on the distal surface ol the mandibular molar.

and the Columbia curettes #13-14, 2R-2I.. and 4R-4I (Figs. 41-16 and 41-17) are examples of universal curettes.

Arcii-Specific Curettes

GRACEV CURE I ThS. (iracev curettes are representative of the area-specific curettes, a set of several instruments designed and angled t<> adapt to spec ifu anatomic areas of the dentition (Fig. 41-18).

Ficj. 41-15 Principal types of curettes as seen from the toe ot the instrument a, Universal curette. b, Gracey curette Note the offset blade angulation of the Ciracey curette.

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Types CurettesGracey Curette

Fig. 41-18 Reduced sei ol Gracey curettes. From left, »5-6, P «11-12, and #13-14.

Fig. 41 17 Columbia MML universal curette.

Fig. 41-18 Reduced sei ol Gracey curettes. From left, »5-6, P «11-12, and #13-14.

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Responses

  • filmon
    How to determine Gracey 11 curette frome Gracey 12 curette?
    2 years ago
  • Hubert
    How to determine which working end to use on a h 6/7 sickle scaler?
    10 months ago

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