Periodontal probe and explorer

A description and explanation of different periodontal probes and explores used in Periodontics

2. PERIODONTALINSTRUMENTSAREDESIGNED
FORSPECIFICPURPOSES, SUCHAS
REMOVINGCALCULUS, PLANNINGROOT
SURFACES, CURETTINGTHEGINGIVA,
ANDREMOVINGDISEASEDTISSUE.

3. Periodontal probe
Explorers
Scaling, root-planning, and curettage
instruments
The periodontal endoscope
Cleansing and polishing instruments

5. PERIODONTAL PROBE
•

6. •ITSHOULDBETISSUEFRIENDLYANDNOTTRAUMATIZETHE
PERIODONTALTISSUES
DURINGPROBING.
•ITSHOULDBESUITABLEASAMEASURINGINSTRUMENT.
•ITSHOULDBESTANDARDIZEDTOENSUREREPRODUCIBILITY,
PARTICULARLYWITHRESPECTTORECOMMENDED
PRESSURE.
•ITSHOULDBESUITABLEBOTHFORUSEINCLINICALSETTING
WHEREPRECISEDATA
DOCUMENTATION ISREQUIREDANDONINDIVIDUALPATIENT
BASIS, ANDFORSCREENING
PURPOSES, ASINEPIDEMIOLOGY.
•ITSHOULDBEEASYANDSIMPLETOUSEANDREAD.

7. •TOMEASURESULCUSANDPOCKETDEPTH
•TOMEASURECLINICALATTACHMENTLEVEL
•TODETERMINEWIDTHOFATTACHEDGINGIVA
•TOASSESSTHEPRESENCEOFBLEEDINGORPURULENT
EXUDATE
•TODETECTANDQUANTIFYFURCATIONINMOLARTOOTH
SPECIALLYBYNABERSPROBE.
•TODETERMINETHEBIOTYPEOFGINGIVA
•TOMEASURETHESIZEOFORALLESIONS
•TODETECTGINGIVALRECESSION
•TODETECTEDEMA.

9. Conventional Manual Probe
Composed of either stainless
steel or plastic. The design of the
working ends of manual probes
are eithertapered, round, flat, or
rectangular with smooth rounded
ends and are calibrated in
millimetres at variousintervals.
Probes have either straight or
curved working ends.

10. Tactile sensitivity
Easily available and inexpensive.
Even in presence of sub gingival calculusprobe
can be inserted with little navigationby the
operator.
Tip is rounded to avoid tissue trauma.
Color coded for faster and easieridentification of
readings.
Probes are heavy
Probing force is not
controlled.
Errors during
visualization

11. • A.Marquis color-coded probe.Calibrations are in3,6,9,12mm sections.
• B. UNC-15 probe,a 15-mm long probe with millimetermarkings and color
coding at the fifth, tenth, and fifteenthmillimeters.
• C.University of Michigan “O” probe, with Williamsmarkings (at 1, 2, 3, 5, 7, 8,
9, and 10 mm).
•D. Michigan “O”probe with markings at 3, 6, and 8 mm.
•E. World Health Organization(WHO)probe, which has a0.5-mm ball at the
tip and millimeter markings at 3.5, 8.5,and 11.5 mm and color coding from 3.5
to 5.5 mm

12. CHARLESH.M. WILLIAMSIN1936 INTRODUCED
GRADUATEDPERIODONTALPROBE.
• ITISSTAINLESSSTEELPROBEWITHDIAMETER1MM,LENGTH13MMAND
BLUNTTIPEND.
• THEPROBETIPANDHANDLESAREENCLOSEDAT130.8 DEGREE
• 4 AND6 MMMARKINGSAREMISSINGWHICHMINIMIZECONFUSION
DURINGREADINGDUETOSMALLSIZEOFMARKINGS.
4 MMISTHEUPPERLIMITOFMODERATEPERIODONTITISAND6 MMIS
CONSIDEREDADVANCED(≥ 5 MM) PERIODONTITIS.

13. •• 15MMMARKING
•• MARKINGAT5,10,AND15 MM
•• PROBETIPDIAMETER0.6MM
•• THINSHANKALLOWSACCESSINTO
TIGHTFIBROTICSULCI. SUITABLEFORUSEIN
DEEPPERIODONTALPOCKETS.
•• ITISPREFERREDFORCLINICALTRIALS
WHERECONVENTIONAL PROBEISREQUIRED.

14. •CALIBRATIONSAREIN3MMSECTIONSTOFACILITATE
EASYREADOUTOFPOCKETDEPTH.
•• MARKINGSARE3,6,9,12MM.
•• ITISAVAILABLEINBOTHSTRAIGHTANDCURVED
DESIGNSANDHASTHESLIMMESTTIP.

15. •INANEFFORTTOINCREASETHEACCURACY
ANDREPRODUCIBILITYOFREADINGSANDTO
IMPROVEEFFICIENCY,MICHIGAN“O” PROBEWAS
INTRODUCEDBYRAMFJORD.
•• ITWASATTEMPTEDTOMAKETHISPROBEASTHIN
ASPOSSIBLEANDTOGIVEITTHEMOSTVERSATILE
ANGULATIONFORUNIVERSALPROBINGOF
PERIODONTALPOCKETS
•• MARKINGSAREAT3 ,6, AND8 MM

16. •• THEREWILLBEMARKINGSAT1,2,3,5,7,8,9,10 MM.
•THEREWILLBENOCOLOURCODING(BLACKBANDS) .
FLATWORKINGENDFOREASIERINSERTIONINFACIAL
ANDLINGUALSURFACES.
•• ITISUSEDTOASSESSPERIODONTALPOCKET
DEPTHS,ATTACHMENTLEVELS, ANATOMY
CONFIGURATIONS ANDGINGIVALBLEEDING.
•• FLATSHANKDOESNOTALLOWEASYACCESS
INTOTIGHTFIBROTICPOCKETS.

17. •FIRSTDESCRIBEDBYWHO ANDFDI IN1978 ANDINTRODUCEDBYJUKKA
AINAMO, DAVIDBARMES, GEORGEBEAGRIEIN1982. ITISRECOMMENDED
FORSCREENINGANDMONITORINGPATIENTSUSINGCPITN INDEX.
•PURPOSES-1.MEASUREMENTOFPOCKETDEPTH2.DETECTIONOFSUBGINGIVAL
CALCULUS
•THEFDI /WHO JOINTWORKINGGROUPHASADVISEDTHEMANUFACTURERS
OFCPITNPROBESTOIDENTIFYTHEINSTRUMENTSASCPITN–E
(EPIDEMIOLOGIC) , WHICHHAVE3.5-MMAND5.5-MMMARKINGS, AND
CPITN–C(CLINICAL), WHICHHAVE3.5-MM, 5.5-MM, 8.5-MM, AND11.5-
MMMARKINGS.
•CPITN PROBESHAVETHINHANDLESANDARELIGHTWEIGHT(5GM). THE
PROBESHAVEABALLTIPOF0.5 MM, WITHABLACKBANDBETWEEN3.5
MMAND5.5 MM, ASWELLASBLACKRINGSAT8.5 MMAND11.5 MM.
•ADVANTAGES:-
•A. BALLTIPFORPATIENTCOMFORT.
•B. COLOURCODEDFROM3.5-5.5; EASYTOREADMARKINGS.
•C. THINSHANKALLOWSACCESSINTOTIGHTFIBROTICSULCUS.

18. •SOMEOTHER1STGENERATIONPROBESTHATAREUSEDAREFURCATIONPROBE,LL 20 PROBE(HU-
FRIEDYUSA),PLASTICPROBE, BIOTYPEPROBE.
FURCATION PROBE
(NABERS PROBE)
Advantages:-Ideal for
detection of mesial
and distal
furcationsin maxillary
molars.
LL 20 PROBE(HU-FRIEDY
USA)
• A conventional
manual probe marked
in
increments of 1 mm
upto20mm.
PLASTIC PROBE
Vivid yellow tip and
black markings
provide
increased intraoral
visibility for faster and
more accurate
assessments

19. •CONSTANTFORCECONTROLLEDPRESSUREPROBES
•• THEYAREPRESSURESENSITIVEPROBE.
•• SECONDGENERATIONPROBESWEREDEVELOPEDINANEFFORTTOSTANDARDIZE
ANDQUANTIFYTHEPRESSUREUSEDDURINGPROBING.
•• SCIENTIFICLITERATURETHATDEMONSTRATED PROBINGPRESSURESHOULDBESTANDARDIZED
ANDNOTEXCEED0.2 N/MM2 LEDTOTHEDEVELOPMENT OFTHESEPROBES.
•• ACCORDING TOHEFTIETAL., SOMERESEARCH“IDENTIFIEDAPOSITIVE
CORRELATIONBETWEENPROBINGFORCEANDDEPTHOFPROBEPENETRATION”.
•• WEINBERGETAL. STATEDTHATCONTROLLEDFORCEOF20 TO25 GRAMSPROBE
DURINGPROBINGREDUCEDEXAMINERERROR.
•• THESECONDGENERATIONPROBESDIDNOTHAVEELECTRONICDATACOLLECTION.

20. •ADVANTAGESOFSECONDGENERATIONPROBES:-
••STANDARDIZATIONOFPROBINGFORCES.
••COMFORTABLETOTHEPATIENT.
••CONSTANTPRESSURE.
•DISADVANTAGESOFSECONDGENERATIONPROBES:-
••PROBETIPMAYPASSBEYONDTHEJUNCTIONALEPITHELIUMININFLAMEDSITES.
••READINGHASTOBEPERFORMEDMANUALLY.
••NOCOMPUTERSTORAGEOFTHEDATA.
•EXAMPLESOF2NDGENERATIONPROBESAREPRESSUREPROBE,

21. •CONSTANTFORCEPLUSCOMPUTERASSISTEDPROBE
•ITMINIMIZESTHEERRORSOFSECONDGENERATIONBYUSINGNOTONLYSTANDARDIZED
PRESSURE, BUTALSODIGITALREADOUTSOFTHEPROBES’ READINGSANDCOMPUTERSTORAGE
OFDATA. THISGENERATIONINCLUDESCOMPUTER-ASSISTEDDIRECTDATACAPTURETO
REDUCEEXAMINERBIASANDALLOWSFORGREATERPROBEPRECISION. THESEPROBESREQUIRE
COMPUTERIZATION OFTHEDENTALOPERATORYANDCANBEUSEDBYCLINICIANSAND
ACADEMICINSTITUTIONSFORRESEARCH.THESEPROBESREDUCETHEERRORSINREADINGTHE
PROBE,RECORDINGDATA, ANDCALCULATINGATTACHMENTLEVEL.
•EXAMPLESAREFOST

22. •THESEARETHREEDIMENSIONALPROBESINWHICHSEQUENTIALPROBEPOSITIONS
AREMEASURED.
FIFTH GENERATION PROBE
PROBES ARE BEING DESIGNED TO BE 3D AND NON -INVASIVE: AN ULTRASOUND
OROTHER DEVICE IS ADDED TO THE FOURTH GENERATION PROBE. FIFTH -
GENERATION PROBES AIM TO IDENTIFY THE ATTACHMENT LEVEL WITHOUT
PENETRATING IT.

23. EXPLORERS
•EXPLORERSAREUSEDTOLOCATE
CALCULUSDEPOSITS, AND
CARIOUSAREASANDTOCHECKTHE
TOOTHSURFACEIRREGULARITIES, &
DEFECTIVEMARGINSON
RESTORATIONS.
•• EXPLORERSAREDESIGNEDWITH
DIFFERENTSHAPESANDANGLESFOR
AVARIETYOFUSES.
•• EXPLORERHAVEFLEXIBLESHANK&
CIRCULARCROSSSECTION.

24. •• USEDFORSUPRAGINGIVALEXAMINATION
OFMARGINSOFRESTORATIONORTOASSESSFOR
SEALANTRETENTION
•• NOTRECOMMENDED FORSUBGINGIVALUSEBECAUSE
POINTCOULDINJURETHESOFTTISSUE
•E.G. 23 & 54 EXPLORER

25. •USEDFORCALCULUSDETECTIONINNORMALSULCIOR
SHALLOWPOCKETS.
•CAREMUSTBETAKENNOTTOINJURESOFTTISSUEBASEOF
SULCUSORPOCKETIF
•WORKING-ENDISUSEDSUBGINGIVALLY.
•E.G. 3 & 3A EXPLORER

26. •CALCULUSDETECTIONINNORMALSULCIOR
SHALLOWPOCKETEXTENDINGNODEEPERTHAN
CERVICALTHIRDOFROOT.
•CURVEDLOWERSHANKCAUSES
CONSIDRABLESTRETCHINGAWAYFROMROOTSURFACE
•E.G. 3ML, 3CH & 2A EXPLORER

27. •TIPISBENTAT90˚ ANGLETOLOWERSHANK.
•STRAIGHTLOWERSHANKALLOWSINSERTIONINNARROW
POCKETSWITHSLIGHTSTRETCHINGOFSOFTTISSUE
•USEDINASSESSMENTOFANTERIORROOTSURFACE
&FACIAL& LINGUALSURFACEOFPOSTERIORTEETH, TO
CHECKCARIES
•E.G. 17, 20F &TU17

28. •TIPAT90˚ ANGLETOLOWERSHANK
•USEDINANTERIOR& POSTERIORTEETHEQUALLYBECAUSE
OFLONGCOMPLEXSHANK
•USEDINDEEPPERIODONTALPOCKETS, & SULCI
•E.G. ODU 11/12 & 11/12A EXPLORER

29. •USEDFORSUPRAGINGIVALEXAMINATIONOFMARGINSOF
RESTORATION& TOASSESSFORSEALANTRETENTION
•CALCULUSDETECTIONINSHALLOWPOCKETS
•E.G. 6, 6A, & 6XL EXPLORER