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Instrument Design
and Classification
MODULE OVERVIEW
This module introduces the various design characteristics of periodontal
instruments. To select an appropriate instrument for a particular instrumentation
task, the clinician must have a thorough understanding of the design features of
the handles, shanks, and working-ends of periodontal instruments. With so many
instruments on the market and new designs introduced regularly, it is impossible
for any one clinician to recognize each instrument by name. Fortunately, a
clinician who understands the principles of design and classification can easily
determine the intended use of any unfamiliar instrument.
MODULE OUTLINE
SECTION 1
151
Shank Design
154
Working-End Design
158
161
Periodontal Probes
Explorers
Sickle Scalers
Curets
Periodontal Files
149
SECTION 5
Skill Application
163
Practical Focus
Skill Evaluation Module 7: Instrument Design and
Classification
KEY TERMS
Paired working-ends
Unpaired working-ends
Design name
Design number
Knurling
Balanced instrument
Simple shank
Complex shank
Proximal surfaces
Rigid shank
Flexible shank
Visual information
Tactile information
Tactile sensitivity
Functional shank
Lower shank
Terminal shank
Extended lower shank
Face
Back
Lateral surfaces
Cutting edge
Toe of working-end
Tip of working-end
Cross section
Classifications
Periodontal probe
Explorer
Sickle scaler
Curet
Periodontal file
LEARNING OBJECTIVES
1. Identify each working-end of a periodontal instrument by its design name and number.
2. Recognize the design features of instrument handles and shanks, and discuss how these
design features relate to the instruments use. Describe the advantages and limitations of
the various design features available for instrument handles and shanks.
3. Given a variety of periodontal instruments, sort the instruments into those with simple
shank design and those with complex shank design.
4. Given a variety of periodontal instruments, identify the face, back, lateral surfaces, cutting
edges, and toe or tip on each working-end.
5. Given a variety of periodontal instruments, determine the intended use of each
instrument by evaluating its design features and classification.
6. Given any instrument, identify where and how it may be used on the dentition (i.e.,
assessment or calculus removal, anterior/posterior teeth, supragingival or subgingival
use).
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151
SECTION 1
Unpaired and Paired Working-Ends. Instrument A has unpaired, dissimilar working-ends. Instrument
B has paired, mirror image working-ends.
INSTRUMENT IDENTIFICATION
Each periodontal instrument is identified by a unique design name and number.
1. Design nameidentifies the school or individual originally responsible for the
design or development of an instrument or group of instruments. Instruments often
are named after the designer or an academic institution. A well-known example is
the design name Gracey. In the late 1930s, Dr. Clayton H. Gracey designed the
14 original single-ended instruments in this series that bears his name.
2. Design numbera number designation that when combined with the design name
provides an exact identification of the working-end. Using an instrument from the
Gracey series as an exampleGracey 11Gracey is the design name and 11
is the design number that identifies a specific instrument in this instrument series.
3. The design name and number are stamped on the handle of the instrument.
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BASIC SKILLS
WORKING-END IDENTIFICATION
A double-ended instrument has two design numbers, one to identify each working-end of the
instrument. For example, the original Gracey series of instruments includes 7 double-ended
instruments, such as the Gracey 3/4, Gracey 5/6, Gracey 11/12, and Gracey 13/14.
G R AC EY 1 2
Name and Number Marked Along the Handle. In this case, each working-end is identified by the
number closest to it.
Name and Number Marked Across the Handle. In this case, the first number (on the left) identifies
the working-end at the top and the second number identifies the working-end at the lower end of
the handle.
INSTRUMENT HANDLES
Instrument handles are available in a wide variety of diameters and textures. Handle design is an
important component in the prevention of musculoskeletal injury during instrumentation (Table 7-1).
1. In selecting an instrument handle, there are three characteristics to consider: (1)
weight, (2) diameter, and (3) texture.
a. Weight. Lightweight handles place less stress on the muscles of the hand and
fingers.
b. Diameter.
1) Small-diameter handles (3/17 inch) are difficult to hold and tend to cause
muscle cramping.
2) Large-diameter handles (3/8 inch) are easier to hold and decrease muscle
strain.
c. Texture. Another term for texturing is knurling.
1) Handles with no texturing decrease control of the instrument and increase
muscle fatigue.
2) Handles with bumpy texturing maximize control of the instrument and
reduce muscle fatigue.
2. It may be helpful to select handles in a range of larger diameters, thus providing
some variety for the muscles of your fingers.
TABLE 7-1.
153
Recommended
Avoid
Bumpy texturing
INSTRUMENT BALANCE
Balanced instrumenta periodontal instrument that has working-ends that are aligned with the
long axis of the handle.
1. During instrumentation, balance ensures that finger pressure applied against the
handle is transferred to the working-end, resulting in pressure against the tooth.
2. An instrument that is not balanced is more difficult to use and stresses the muscles
of the hand and arm.
154
BASIC SKILLS
SECTION 2
Shank Design
SIMPLE AND COMPLEX SHANKS
The shanks of most periodontal instruments are bent in one or more places to facilitate placement
of the working-end against the tooth surface.
1. Simple shank designa shank that is bent in one plane (front-to-back).
a. Another term for a simple shank is a straight shank.
b. Instruments with simple shanks are used primarily on anterior teeth.
2. Complex shank designa shank that is bent in two planes (front-to-back and sideto-side) to facilitate instrumentation of posterior teeth.
a. Another term for a complex shank is an angled or curved shank.
b. The crowns of posterior teeth are rounded and overhang their roots. An
instrument with a complex shank is needed to reach around the crown and onto
the root surface.
155
Facial
view
Proximal
view
Proximal
view
Facial
view
156
BASIC SKILLS
SHANK FLEXIBILITY
An important characteristic of an instrument shank is its strength. During instrumentation, the
clinician applies pressure against the handle and shank to press the working-end against the tooth
surface. The type and diameter of metal used in a shank determine its strength. Instrument shanks
are classified as either rigid or flexible in design.
1. Rigid shankan instrument shank that is larger in diameter and thus will
withstand the pressure needed to remove heavy calculus deposits. A calculus
deposit can be removed more quickly and with less effort if the instrument has a
rigid shank.
2. Flexible shankan instrument shank that is thinner in diameter. When used against
a heavy calculus deposit, a flexible shank bends or flexes as pressure is applied
against the deposit. Flexible shanks enhance the amount of tactile information
transmitted to the clinicians fingers. For this reason, a flexible shank design is
desirable for instrumentssuch as explorersthat are used to locate calculus
deposits hidden beneath the gingival margin.
a. Visual information is of limited use when working subgingivally because the
clinician cannot see the working-end hidden beneath the gingival margin.
Instead of using visual information, the clinician must rely on tactile
informationhis or her sense of touchto locate the calculus deposits hidden
beneath the gingival margin.
b. Vibrations are created when the working-end quivers slightly as it moves over
irregularities on the surface of the tooth. These vibrations are transmitted from
the working-end, through the shank, and into the handle. This is similar to the
sensations felt in the soles of the feet when roller blading over a section of gravel
on an otherwise paved road surface. The rollers encounter the gravel patch and
transmit vibrations to the soles of the feet.
c. Tactile sensitivity is the clinicians ability to feel vibrations transmitted from the
instrument working-end with his or her fingers as they rest on the shank and
handle.
157
Functional
shank
Lower
(terminal)
shank
Functional and Lower Shanks. The functional shank begins below the
working-end and extends to the last bend in the shank nearest the handle.
The lower shank is the portion of the functional shank nearest to the
working-end. The lower shank is also termed the terminal shank.
TABLE 7-2.
Shank Design
Use
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BASIC SKILLS
SECTION 3
Working-End Design
PARTS OF THE WORKING-END
An instruments function is determined, primarily, by the design of its working-end. Some
instruments are used to assess the teeth or soft tissues, others are used to remove calculus deposits.
To determine an instruments use, you must recognize the design characteristics of the face, back,
lateral surfaces, and cutting edges of the working-end.
Face
Back
Lateral surface
Cutting edges
Toe
Tip
Curet
Sickle
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160
BASIC SKILLS
161
SECTION 4
Periodontal Instruments
Sickle
Scalers
Periodontal
Probes
Assessment
Instruments
Classification
Calculus
Removal
Instruments
Curets
Periodontal
Files
Explorers
Classification of Hand-Activated Periodontal Instruments
PERIODONTAL PROBES
The periodontal probe is a slender
assessment instrument used to evaluate the
health of the periodontal tissues. Probes
have blunt, rod-shaped working-ends that
are circular or rectangular in cross section.
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BASIC SKILLS
EXPLORERS
An explorer is an assessment instrument
used to locate calculate deposits, tooth
surface irregularities, defective margins on
restorations, and carious lesions. Explorers
have flexible shanks and are circular in
cross section.
SICKLE SCALERS
A sickle scaler is a periodontal instrument
used to remove calculus deposits from the
crowns of the teeth. The working-end of a
sickle scaler has a pointed back and
pointed tip and is triangular in cross
section.
CURETS
A curet is a periodontal instrument used
to remove calculus deposits from the
crowns and roots of the teeth. The
working-end of a curet has a rounded
back and rounded toe and is semi-circular
in cross section. Two curet sub-types are
the universal curet and area-specific curet.
PERIODONTAL FILES
A periodontal file is an instrument used to
crush large calculus deposits. Each workingend of a periodontal file has several cutting
edges.
SECTION 5
Skill Application
PRACTICAL FOCUS
1. Use nail polish to identify the design elements of several periodontal instruments.
Equipment: Ask your instructor to help you assemble the following instrumentsa
sickle scaler, a universal curet, and an area-specific curet.
Materials: Four bottles of nail polish in different colors and nail polish remover or
orange solvent (to remove nail polish from your instruments at the completion of
this activity).
a. Paint the lateral surfaces of each working-end with one color of nail polish.
b. Use a contrasting color of polish to paint the face of each instrument.
c. Paint the functional shank on each instrument. Compare the functional shank
lengths on the various instruments.
d. Use a contrasting color of polish to paint the lower shank on each instrument.
e. Ask an instructor to check your work.
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BASIC SKILLS
TABLE 7-3.
Instrument
A
B
C
D
E
F
G
H
I
J
K
L
M
N
Shank
Simple or complex?
Short or long?
Working-End
Rounded toe?
Pointed tip?
Classification
Instrument Use
Assessment?
Calculus removal?
165
Student:
Evaluator:
Date:
Instrument
Instrument
Instrument
Instrument
Instrument
1
2
3
4
5
DIRECTIONS FOR STUDENT: Use Column S, evaluate your skill level as: S (satisfactory) or U (unsatisfactory).
DIRECTIONS FOR EVALUATOR: Use Column I. Indicate: S (satisfactory) or U (unsatisfactory). Each S equals 1 point,
each U equals 0 points.
1
CRITERIA:
2
I
3
I
4
I
5
I
Instrument
Identifies each working-end by its design name and number
Determines whether the instrument is balanced
Working-End
Identifies the classification of each working-end
Identifies parts of the working-end (face, back, lateral surfaces,
tip or toe, cutting edges)
States the shape of the working-end in cross section
Shank
Identifies the functional shank
Identifies the lower shank
Identifies the shank as simple or complex
OPTIONAL GRADE PERCENTAGE CALCULATION
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BASIC SKILLS
Student:
EVALUATOR COMMENTS