Associate prof, periodontology, Umm Alqura University, Saudi arabia, And Al-Azhar University, Egypt

1. Principles of scaling and
root planing
By
Associate professor Dr. Alaa Moustafa Attia

2. Scaling:
It is the process by which plaque and
calculus are removed from both
supragingival and subgingival tooth
surfaces.
Root planing:
It is the process by which residual
embedded calculus and portions of
cementum are removed from the roots to
produce a smooth, hard, and clean surface.
Scaling & root planing means phase 1 therapy

3. Objective of scaling and root
planing
The primary objective of scaling and root
planing is to restore gingival health by
completely removing elements that provoke
gingival inflammation (i.e. , plaque, calculus ,
and bacterial toxins).

4. Before scaling & root planing

5. After scaling & root planing

6. Radiograph before & after scaling &
root planing

7. Detection skills
Detection skills that required for the
accurate initial assessment of the extent
and nature of deposits and root irregulities
on root surface before scaling and root
planing: includes
-Visual examination
-Tactile exploration

8. Supragingival scaling procedures :
By means of scalers, sonic and ultrasonic
scalers, they were activated in obliaque and
vertical direction.
Subgingival scaling and root planing
procedures:
By means of curettes {(universal & Gracy
(area spesific)} and sometimes Hoe scalers

9. Subgingival scaling procedures
A= Curette inserted with the face of the blade flush against the tooth.
B=Working angulation (45-90) is established at the base of the pocket.
C= Lateral pressure is applied, and the scaling stroke is activated in the
coronal direction.

10. Instrumentation for calculus removal
A= Calculus is removed by engaging the apical or lateral
edge of the deposits with cutting edge of scaler; vertical
movement of the instrument will remove the fragment of
the calculus.
B= The instrument is moved lateraly and again engages the
edge of the calculus.
C=The final portion of the deposit is engaged and removed.

11. Shank position for scaling proximal surface
A= Correct shank position, parallel with the long axis
of the tooth.
B= Incorrect shank position, titled away from the
tooth.
C= Incorrect shank position, titled too far toward the
tooth.

12. The body position of the operator and the
location of the finger rest must be frequently
adjusted or changed to allow the following:
- Parallism
- Wrist-arm motion
Notice

13. Approaches of
scaling
and root planing

14. 1- Maxillary anterior sextant: facial aspect,
surface toward the operator
Front positionO. Position
DirectIllumination
DirectVisibility
Index finger of non operating handRetraction
Intraoral, palm down. Fourth finger on the incisal edges or the
occlusal or facial surfaces of adjacent maxillary teeth.
Finger rest

15. 2- Maxillary anterior sextant: facial aspect, surface
away from the operator
Front positionO. Position
DirectIllumination
DirectVisibility
Index finger of non operating handRetraction
Intraoral, palm up. Fourth finger on the incisal edges or the
occlusal or facial surfaces of adjacent maxillary teeth.
Finger rest

16. 3- Maxillary anterior sextant: lingual aspect,
surface away from the operator
Back positionO. Position
IndirectIllumination
IndirectVisibility
NoneRetraction
Intraoral, palm up. Fourth finger on the incisal edges or the
occlusal or facial surfaces of adjacent maxillary teeth.
Finger rest

17. 4- Maxillary right posterior sextant: premolar
region only: facial aspect
Side or back positionO. Position
DirectIllumination
DirectVisibility
Mirror or Index finger of non operating handRetraction
Intraoral, palm up, Fourth finger on the occlusal surfaces of the
adjacent maxillary posterior teeth.
Finger rest

18. 5- Maxillary right posterior sextant: facial aspect
Side positionO. Position
DirectIllumination
Direct (indirect for distal surfaces of molars).Visibility
Mirror or index finger of non operating handRetraction
Extra oral, palm up. Back of the middle and fourth fingers on the
lateral aspect of the mandible on the right side of the face.
Finger rest

19. 6- Maxillary right posterior sextant: lingual aspect
Side or front positionO. Position
Direct and indirectIllumination
Direct or indirectVisibility
NoneRetraction
Extraoral, palm up. Back of the middle and fourth fingers on the
lateral aspect of the mandible on the right side of the face.
Finger rest

20. 7- Maxillary right posterior sextant: lingual aspect
Front positionO. Position
DirectIllumination
DirectVisibility
NoneRetraction
Intraoral, palm up, finger on fingerFinger rest

21. 8- Maxillary left posterior sextant: facial aspect
Side or back positionO. Position
Direct or indirectIllumination
Direct or indirectVisibility
MirrorRetraction
Extroral, palm down. Front surfaces of the middle and fourth
fingers on the lateral aspect of the mandible on the left side of
the face.
Finger rest

22. 9- Maxillary left posterior sextant: facial aspect
Back or side positionO. Position
Direct or indirectIllumination
Direct or indirectVisibility
NoneRetraction
Intraoral, palm up. Fourth finger on the incisal edges or the
occlusal surfaces of adjacent maxillary teeth.
Finger rest

23. 10- Maxillary left posterior sextant: lingual aspect
Front positionO. Position
DirectIllumination
DirectVisibility
NoneRetraction
Intraoral, palm down, opposite arch, reinforced. Fourth finger on
incisal or facial surfacs of mandibular teeth.
Finger rest

24. 11- Maxillary left posterior sextant: lingual aspect
Front positionO. Position
Direct and indirectIllumination
Direct and indirectVisibility
NoneRetraction
Extraoral, palm down. Front surface of middle and fourth fingers
on the lateral aspect of the mandible on the left side of the face.
Finger rest

25. 12- Maxillary left posterior sextant: lingual aspect
Side or front positionO. Position
DirectIllumination
DirectVisibility
NoneRetraction
Intraoral, palm up. Fourth finger on the occlusal surfaces of
adjacent maxillary teeth.
Finger rest

26. 1- Mandibular anterior sextant: facial aspect,
surfaces toward the operator
Front positionO. Position
DirectIllumination
DirectVisibility
Index finger of the non-operating handRetraction
Intraoral, palm down. Fourth finger on the incisal edge or the
occlusal surfaces of adjacent mandibular teeth.
Finger rest

27. 2- Mandibular anterior sextant: facial aspect,
surface away from the operator
Back positionO. Position
DirectIllumination
DirectVisibility
Index finger or thumb of the nonoperating handRetraction
Intraoral, palm down. Fourth finger on the incisal edge or the
occlusal surfaces of adjacent mandibular teeth.
Finger rest

28. 3- Mandibular anterior sextant: lingual aspect,
surfaces away from the operator
Back positionO. Position
Direct or indirectIllumination
Direct and indirectVisibility
Mirror retract the tongueRetraction
Intraoral, palm down. Fourth finger on the incisal edge or the
occlusal surfaces of adjacent mandibular teeth.
Finger rest

29. 4- Mandibular anterior sextant: lingual aspect,
surfaces toward the operator
Front positionO. Position
Direct and indirectIllumination
Direct and indirectVisibility
Mirror retract the tongueRetraction
Intraoral, palm down. Fourth finger on the incisal edge or the
occlusal surfaces of adjacent mandibular teeth.
Finger rest

30. 5- Mandibular right posterior sextant: facial aspect
Side or front positionO. Position
DirectIllumination
DirectVisibility
Mirror or index finger of nonoperating handRetraction
Intraoral, palm down. Fourth finger on the incisal edge or the
occlusal surfaces of adjacent mandibular teeth.
Finger rest

31. 6- Mandibular right posterior sextant: lingual aspect
Front positionO. Position
Direct and indirectIllumination
Direct and indirectVisibility
Mirror retracts the tongueRetraction
Intraoral, palm down. Fourth finger on the incisal edge or the
occlusal surfaces of adjacent mandibular teeth.
Finger rest

32. 7- Mandibular left posterior sextant: facial aspect
Side or back positionO. Position
DirectIllumination
Direct or indirectVisibility
Index finger or mirror of the nonoperating hand.Retraction
Intraoral, palm down. Fourth finger on the incisal edge or the
occlusal surfaces of adjacent mandibular teeth.
Finger rest

33. 8- Mandibular left posterior sextant: lingual aspect
Front or side positionO. Position
Direct and indirectIllumination
DirectVisibility
Mirror retracts the tongueRetraction
Intraoral, palm down. Fourth finger on the incisal edge or the
occlusal surfaces of adjacent mandibular teeth.
Finger rest

34. Thank You