Fundamentals of
“Universal” Instruments:
To date you’ve learned:
*#17 Explorer
To date you’ve learned:
-Gracey 1/2
-204s
2 Types of Universal Instruments:
1. Scalers-
(in cross-section)
pointed tip
pointed back
supragingival calculus removal
2. Curets -
(in cross-section)
rounded tip
rounded back
sub/supragingival calculus removal
Let’s first talk about the
Sickle Scalers
Types of Sickle Scalers:
 Anterior- ‘straight’ shank
instrument
 Posterior- ‘curved’ or multiple
shank instrument
– (actually can be used universally in the mouth)
Anterior Sickle
Top instrument (Unpaired) is an example of a
curet (on the left) and an anterior sickle on the (right)
Bottom instrument (paired) is an example of a
posterior sickle on both ends.
Design Characteristics:
Basically there are 2 cutting edges at each end.
The Face of the Sickle is at a 90 degree angle to the terminal shank.
Flat “face”
Terminal shank
Sickle instrument have two cutting edges on each
end of the instrument:
Terminal shank is at
a 90 degree angle to
the Face
Face
Face
 Your instrument casetes do not include the
Anterior Sickle.
 You will use the Posterior Sickle throughout
the mouth including the anterior teeth.
Let’s get prepared to
Initial scaling with the
Sickle Scaler
P. 210
p.290
In
Nield
Book
(mirror, sickle, etc.)
(mirror)
(sickle)
(fulcrum)
Keep In Mind:







Operator and Client Positioning
Instrument Blade Selection
Grasp
Fulcrum
Insertion
Adaptation
Angulation
Please remember:
The Sickle instrument is used
SUPRAGINGIVAL!
(You can go sub about 1-2 mm if necessary, but not
more than that!!!)
Anterior Scaler
Initial point of insertion is always at
the line angle
The above shows a straight shanked
sickle.
Since we will not use this type of
instrument, please focus instead on
the Terminal Shank and its cutting
edges and how it relates to the tooth.
Mandibular Anteriors: Buccal
Right Handed Clinician
5
6
#27
1.
2.
3.
4.
5.
#26
4
#25
3
#24
2
#23
1
#22
From a 12:00 position, insert at the Distal Buccal Line Angle of #22 (tip towards the col)
Initiate walking stroke towards and into the distal col. Remove at end of pull stroke
Reinsert at the Mesial Buccal Line Angle of #22 (tip towards the mesial col)
Initiate walking stroke toward and into the mesial col. Remove at end of pull stroke
Move onto #23 D and then #23 M, then #24D, #24 M, etc.
Mandibular Anteriors: Lingual
Right Handed Clinician
#22
1.
2.
3.
4.
5.
#23
#24
#25
#26
#27
From a 12:00 position, insert at the Distal Lingual Line Angle of #22 (tip towards the col)
Initiate walking stroke towards and into the distal col. Remove at end of pull stroke
Reinsert at the Mesial Lingual Line Angle of #22 (tip towards the mesial col)
Initiate walking stroke toward and into the mesial col. Remove at end of pull stroke
Move onto #23 D and then #23 M, then #24D, #24 M, etc.
Mandibular Anteriors: Buccal
Left Handed Clinician
5
6
#27
1.
2.
3.
4.
5.
#26
4
#25
3
#24
2
#23
1
#22
From a 12:00 position, insert at the Distal Buccal Line Angle of #27 (tip towards the col)
Initiate walking stroke towards and into the distal col. Remove instrument at upward stroke
Reinsert at the Mesial Buccal Line Angle of #27 (tip towards the mesial col)
Initiate walking stroke toward and into the mesial col. Remove instrument at upward stroke
Move onto #26 D and then #26 M, then #25D, #25 M, etc.
Mandibular Anteriors: Lingual
Left Handed Clinician
#22
1.
2.
3.
4.
5.
#23
#24
#25
#26
#27
From a 12:00 position, insert at the Distal Lingual Line Angle of #27 (tip towards the col)
Initiate walking stroke towards and into the distal col. Remove at end of pull stroke
Reinsert at the Mesial Lingual Line Angle of #27 (tip towards the mesial col)
Initiate walking stroke toward and into the mesial col. Remove at end of pull stroke
Move onto #26 D and then #26 M, then #25D, #25 M, etc.
Stroke Sequence for Posterior Teeth:
2
1
2
1
2
1
2 1
2
Notice that you will begin your working stroke at the
Distal Line Angle (1) and proceed into the distal col.
You will then reinsert tip at the Mesial Line Angle (2)
(tip now pointing towards the Mesial). Remember,
Terminal shank of instrument is parallel to the line angleproceed with walking stroke into the mesial col area.
Correct:
Auxiliary Shank
Terminal Shank
Incorrect:
Auxiliary Shank
Terminal Shank
Correct angulation
Incorrect angulation
Do Not use the
sickle on direct
buccal/lingual
surfaces!!!
Walking Sequence
(per quadrant):
Midline
(limited radius)
1.
2.
For Right
Handed Clinicians:
Area
Patient’s
Head
Clock Position
1. UR and LR
Buccal
Left
10:00-11:0012:00 (Anteriors)
2. UR and LR
Lingual
Right
11:00
12:00 (Anteriors)
-------------
------------------
Right
11:00
12:00 (Anteriors)
---------------2. UL Buccal
2. UL Lingual
1.
Right
11:00
12:00 (Anteriors)
2. LL Buccal
Right
10:00-11:00
12:00 (Anteriors)
1. LL Lingual
Left
10:00-11:00
12:00 (Anteriors)
2.
2.
1.
2.
2.
2.
2.
2.
2.
2.
2.
2.
Notice that operator position and the direction of the instrument
handle changes at the canine on the dominant side.
1.
2.
1.
1.
2.
2.
1.
1.
2.
1.
2.
1.
2.
2.
Walking Sequence
(per quadrant):
Midline
(limited radius)
1.
2.
2.
For Left
Handed Clinicians:
Patient’s
Head
Clock Position
1. UL and LL
Buccal
Right
2:00-1:00
12:00 (Anteriors)
2. UL and LL
Lingual
Left
2:00-1:00
12:00 (Anteriors)
------------
------------------
Area
---------------2. UR Buccal
2. UL Lingual
2.
Left
Left
1:00
12:00 (Anteriors)
1:00
12:00 (Anteriors)
2. LR Buccal
Left
2:00-1:00
12:00 (Anteriors)
1. LR Lingual
Right
2:00-1:00
12:00 (Anteriors)
2.
2.
2.
2.
1.
2.
2.
1.
2.
1.
2.
Notice that operator position and the direction of the
instrument handle changes at the canine on the dominant side.
2.
2.
1.
1.
2.
1.
2.
2.
1.
1.
2.
1.
2.
1.
So, what are we saying?
You will be using the Posterior Sickle on
ALL
proximal surfaces in the mouth.
When you are scaling only the anterior teethplease follow the sequence in slides (slides #20-23)
When scaling posterior and anterior teeth in a
single session- instrumentation sequence is:
quadrant at a time! (slides #35/36)
In Review You Should
ALWAYS Keep in Mind:





Lateral Pressure
Strokes
Stroke Direction
Stroke Length
Reinforcement
Now, Let’s take a look at the
Universal Curet
 The Universal curet is similar to the Sickle in
that it also has two cutting edges per end.
 The difference between them is that the tip
of the Universal curet is rounded- not
pointed like the Sickle.
 This allows you to use this instrument
SUBGINGIVAL!!!
Universal Curets:
Scalers

-
(in cross-section)
pointed tip
pointed back
supragingival calculus removal
Curets -
(in cross-section)
rounded tip
rounded back
sub & supragingival calculus removal
Universal Curets
 Columbia
 Barnhardt
 Younger Good
 Blade size, shank length and design will determine
preferred area usage.
So, Let’s Keep in Mind. . .
 Fulcrum rest must be near, but not directly over
the surface being scaled (fulcrum on same arch).
 Determine correct working end of instrument:
 Terminal shank parallel to MESIAL line angle of molar
 Foot of instrument curves towards the tooth
 Angle for insertion is 0-40 (closed blade)
Continued. . . .
 With closed blade, insert subgingival to JE- lateral
pressure should be fairly light.
 Open angle to 45-90° (subgingival) and initiate
exploratory stroke (pull stroke)
 Lateral pressure against tooth should remain fairly light unless a
‘bump’ is felt. Return back to JE and apply firmer pressure
during pull stroke to remove ‘bump’  calculus?
 Fulcrum pressure increases during pull stroke
Continued. . .
 Relax fingers during exploratory stroke
 Apply greater lateral pressure during pull stroke.
 Strokes should be short and controlled, with
moderate pressure from the base of the pocket,
toward the gingival margin.
 Stroke direction – vertical, oblique & horizontal
(overlapping) remaining primarily in the gingival
sulcus.
Please remember~
 You should ALWAYS scale a tooth to
completion!!!
 That means: Look at the clock and budget your
time!!!
 Quesstimate how long it will take you to scale a
lingual/buccal surface
 Dependant on : How ‘heavy’ the calculus is

How ‘tenacious’ the calculus is

How good is your technique?!?
 Then determine how many teeth you can scale
thoroughly and completely with the amount of time
you have. . .