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The scaling and root planing of the mandibular teeth are accomplished in much the same matter
as used in the maxillary quadrants.
The sub-gingival surfaces of tooth number 19 is surveyed by a number three explorer
to determine the extent of sub-gingival calculus.
The mesial surface is then scaled with a number six Bunting curette. Notice the powerful lever
action used to dislodge the hard sub-gingival calculus.
Scaling is extended to the buccal and distal buccal surfaces.
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A relatively clear operative field is maintained by intermittent suctioning.
The scaled areas are now explored for residual calculus. Note that the explorer tip is passed
gently over the cementoenamel junction in an apical direction.
A number 16 periodontal file is used to smooth the cementoenamel junction, the mesial, and
the buccal root surfaces.
After clearing the operative field, the distal and distal-buccal surfaces are filed. It is
not enough just to remove the calculus, the root surface must also be planed until it
is smooth.
Rechecking with the explorer revealed residual calculus in the deep mesial pocket.
A number 11 hoe is effective for removal of this deposit.
After complete removal of calculus has been assured, the surface must be planed. A number
14 Columbia curette is utilized for this purpose.
The lingual surfaces of this tooth are now surveyed.
Scaling in this area is accomplished with a number 13 Columbia curette.
Notice the secure finger support that is employed; short, well-controlled strokes are used to
dislodge the tenacious sub-gingival calculus.
A mild amount of hemorrhage is unavoidable.
The scaled surfaces are again surveyed with an explorer for residual deposits.
The rough cementoenamel junction is smoothed with a number 15 periodontal file.
After checking the surface with an explorer, final planing is accomplished with a number
13 curette.
Prior to scaling and root planing tooth number 25, iodine solution is applied because vigorous
instrumentation will be necessary to remove the hard sub-gingival calculus in the deep
periodontal pockets. The number one Bunting scaler is used in this area.
This is a strong instrument which can withstand the powerful strokes required to dislodge
the inherent deposits of calculus. Extreme care must be exercised to avoid traumatizing
the soft tissues.
The tooth surfaces are checked for residual calculus with a number 17 explorer.
The cementoenamel junction at root surfaces are removed with a number 16 periodontal file.
Short, well-guided, apical strokes are used.
After checking the root surfaces with the explorer final smoothness is ensured by planing
with a number one sickle scaler.
Dense, hard calculus deposits are readily apparent on the lingual surface of the tooth.
Due to the vigorous instrumentation required to remove these heavy accumulations, the strong,
number one Bunting scaler is employed. If a more delicate instrument was used, time
would be wasted and the instrument might be broken.
Careful clearing of the operative field to include removal of dislodged calculus particles
must be maintained. The operator must constantly be aware of the necessity for proper finger
bracing and support.
After each scaling, filing, and planing procedure, the surfaces are checked with an explorer.
A number 18 periodontal file is used to smooth the cementoenamel junction and root surface.
Finally surface planing is accomplished with a number one sickle scaler.
In order to demonstrate instrumentation and finger positions for the right mandibular
segment, tooth number 28 will be scaled and planed. The initial exploring of tooth surfaces
is performed.
A number 15 Bunting curette dipped in iodine solution is used to scale the mesial-buccal,
buccal and distal-buccal surfaces.
Notice finger positions and the firm instrument support that is employed.
After scaling, the surfaces are checked with a number one explorer.
Roughness detected at the cementoenamel junction is smoothed with a number 16 periodontal file.
Again note the finger bracing and the short deliberate strokes.
Difficult access to the distal-buccal surface dictates the use of a number 18 file.
Final smoothness is accomplished with a number five curette.
Sub-gingival deposits are detected on the lingual surface and the number 14 Columbia
curette is employed to remove them.
Short, well-guided strokes are used. Some of these deposits can be extremely tenacious.
A residual piece of calculus is found on the distal-lingual surface. This is removed with
a curette.
Finally the cementoenamel junction is smoothed with number 16 and number 18 periodontal files.
The number 18 file is used on the distal-lingual surface which presents an access problem.
The tooth surfaces are explored and no areas of roughness can be detected.
Post-operatively, after all teeth were scaled and planed, the gingiva regained its normal
color, consistency, and surface texture. All forms of local irritation must be eliminated
in order to obtain satisfactory results from this treatment.
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