1. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Mirror

2. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Mirror The working-end of a dental mirror has a reflecting mirrored surface.

3. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Dental Mirrors

4. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Three Common Types 1.Front Surface 2.Concave 3.Plane (Flat) Surface

5. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Front Surface Produces a clear mirror image with no distortion Most commonly used type because of good image quality

6. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Concave Produces a magnified image Not recommended because magnification distorts the image

7. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Plane (Flat) Surface Produces a double image (ghost image) Durable, resists scratching because the reflecting surface is on the back of the mirror lens Not recommended because double image is distracting

8. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Uses of Dental Mirror

9. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Uses of Dental Mirror 1.Indirect Vision 2.Retraction 3.Indirect Illumination 4.Transillumination

10. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins 1. Indirect Vision The use of a mirror to view a tooth surface or intraoral structure that cannot be seen directly

11. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Use of the mirror to hold the patient’s cheek, lip, or tongue so that the clinician can view tooth surfaces that are otherwise hidden from view by these soft tissue structures 2.Retraction

12. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Retraction of Tongue

13. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Retraction of Lip The index finger is used to retract the lip away from the teeth More comfortable for patient than using a mirror for retraction of the upper or lower lip

14. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Retraction of Cheek

15. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins 3. Indirect Illumination Use of the mirror to reflect light onto a tooth or soft tissue structure in a dark area of the mouth

16. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins 4. Transillumination The technique of directing light off of the mirror surface and through the anterior teeth

17. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Uses of Dental Mirror The dental mirror has four important functions during periodontal instrumentation: 1.Indirect Vision 2.Retraction 3.Indirect Illumination 4.Transillumination

18. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Characteristics of Periodontal Instruments

19. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Topics Paired and unpaired instruments Instrument identification Working-end identification Instrument handles Instrument balance

20. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Paired and Unpaired Instruments

21. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Paired and Unpaired Unpaired working-ends : instrument with two dissimilar working- ends Paired working-ends : instrument with working-ends that are mirror images of each other

22. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Unpaired vs. Paired

23. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Instrument Identification

24. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Design Name Design Name : school or person who designed instrument (for example: Gracey)

25. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Design Number Design Number : identifies the working-ends (example: 1 and 2)

26. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Working-End Identification

27. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Number Along Handle Each working-end is identified by the number closest to it.

28. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Number Across Handle The first number (on the left) identifies the working-end at the top. The second number is the working-end on the lower end of the handle.

29. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Instrument Handles

30. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Examples of Handle Designs

31. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Choosing the Right Handle RECOMMENDED Large diameter Lightweight handle Bumpy texturing AVOID Small diameter Heavy, solid metal handle Smooth or flat texturing

32. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Instrument Balance

33. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins A periodontal instrument is balanced if the working-ends are aligned with the long axis of the handle.

34. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Balanced? Balanced if the working- ends are centered with the midline of the handle A = Not balanced B = Balanced

35. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Significance of Balance Ensures that finger pressure applied against the handle is transferred to the working-end for calculus removal An instrument that is not balanced is difficult to use and stresses the muscles of the hand.

36. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Summary: Recognize Design Features Paired or unpaired working-ends Instrument identification Working-end identification Handle design Instrument Balance

37. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

38. Shank Design

39. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Topics Simple and complex shank designs Functional and lower shank portions The best instrument for a task Specialized instruments with extended lower shanks

40. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Shank Bends The shanks of most periodontal instruments are bent in one or more places to facilitate placement of the working-end against the tooth surface.

41. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Simple Shank Design Hold the instrument so that the working-end tip or toe is facing you Simple shank will appear to be straight

42. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Complex Shank Design Hold the instrument so that the working-end tip or toe is facing you Complex shank has side-to-side bends

43. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Comparison of Shank Designs Simple shanks : for use on anterior teeth Complex shanks : for use on posterior teeth

44. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Selecting the Right Shank for the Task Should I select an instrument with a simple shank design or a complex shank design?

45. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Simple Shank: Anterior Tooth Anterior teeth are wedge-shaped. A simple shank is adequate to reach along the crown and onto the root.

46. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Posteriors: Complex Shank Posterior teeth have large, bulky crowns that are larger in diameter than the roots. A complex shank is needed for posterior teeth.

47. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Complex Shank: Facial and Lingual The illustration shows a molar when viewed from the mesial aspect. Front-to-back shank bends allow you to reach the facial and lingual surfaces of the root.

48. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Complex for Proximal Surfaces The illustration shows a molar when viewed from the facial aspect. Side-to-side bends allow you to reach the mesial and distal surfaces of the root.

49. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Regions of the Shank

50. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Functional and Lower Portions Functional shank : the portion of the shank that allows the working-end to be adapted to the tooth surface Lower shank : the portion of the functional shank that is nearest to the working-end; also called the “terminal” shank

51. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Functional Shank Begins below the working-end, and extends to the last bend in the shank nearest the handle

52. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Lower Shank The portion of the functional shank nearest to the working-end

53. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Selecting the Best Instrument for a Task

54. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Instrument Use: Simple Shank Simple shank with short functional shank length— supra gingival use on anterior teeth Simple shank with long functional shank length— sub gingival use on anterior teeth

55. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Complex Shank Use Complex shank with short functional shank length— supra gingival use on posterior teeth Complex shank with long functional shank length— sub gingival use on posterior teeth

56. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Specialized Instruments with Extended Lower Shanks

57. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Extended Lower Shanks Instrument A has a standard lower shank. Instrument B has an extended lower shank.

58. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Use: Extended Lower Shank Instruments with extended lower shanks can reach the middle- and apical-third of the root surface.

59. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Important Shank Characteristics Determine if shank is simple or complex Recognize the functional shank Recognize the lower shank Recognize an extended lower shank

60. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Working-End Design

61. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Topics Parts of the working-end Working-end in cross section Introduction to Instrument Classification

62. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Working-End Design An instrument’s function is determined, primarily, by the design of it’s working- end. To determine an instrument’s use, you must recognize the design characteristics of the working-end

63. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Overview: Parts of Working-End Face Back Lateral surfaces Cutting edges Toe or tip

64. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Face and Back The shaded surface on this illustration is the face. The surface opposite the face is the back of the working-end.

65. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Lateral Surfaces The surfaces on either side of the face are called the lateral surfaces of the working-end.

66. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Cutting Edge The cutting edge is a sharp edge formed where the face and lateral surfaces meet. Most working-ends have 2 cutting edges.

67. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Toe This is a bird-eye view, looking down on the face. On some working- ends the cutting- edges meet to form a rounded toe.

68. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Tip This is a bird-eye view, looking down on the face. On some working- ends the cutting- edges meet to form a pointed tip.

69. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins The Working-End in Cross Section

70. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins The cross section of a working-end is exposed by cutting through the working-end at right angles to its longest dimension.

71. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Significance of Cross Section The cross section of a working-end determines whether the instrument can be used sub gingivally—beneath the gingival margin—or is restricted to supra gingival use.

72. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Instrument Use Working-ends that are triangular in cross section are limited to supragingival use. Working-ends that are semi-circular in cross section may be used supragingivally and subgingivally.

73. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Creating a Cross Section Saw a pencil into two parts by cutting it in the middle perpendicular to the long axis of the pencil.

74. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Hexagonal Cross Section The pencil is hexagonal in cross section. A hexagon is a six- sided figure.

75. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Working-End Cross Section Imagine cutting the working-ends of these instruments in half to reveal the cross section.

76. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Shape of Cross Section One working-end is semi-circular in cross section The other is triangular in cross section

77. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Triangular Cross Sections Sickle scalers are instruments with triangular cross sections. Sickle scalers are limited to supragingival use.

78. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Semi-Circular Cross Section Curets are instruments that are semi-circular in cross section. Curets may be used supragingivally and subgingivally.

79. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Introduction to Instrument Classification

80. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Periodontal instruments are divided into types, or classifications, based on the specific design characteristics of the working-ends.

81. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

82. Periodontal Probe A slender instrument used to evaluate the health of the periodontal tissues Blunt, rod-shaped working-ends

83. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Explorer Used to locate calculus deposits, tooth irregularities, carious lesions Circular in cross section

84. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Sickle Scaler Used to remove supra gingival calculus deposits Triangular in cross section Pointed tip Pointed back

85. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Curet Used to remove calculus deposits Semi-circular cross section Rounded toe Rounded back

86. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Periodontal File Used to crush large calculus deposits Each working-end has several cutting edges

87. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Skill Application Practice identifying the parts of the working- end and shank. Use various colors of nail polish to paint and identify the following on several instruments: Face and lateral surfaces of working-end Functional and lower shanks

88. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Summary An instrument’s function is determined, primarily, by the design of it’s working- end. To determine an instrument’s use, you must recognize the design characteristics of the working-end.