Instrumentation: Improve Your Scaling and Root Planing Skills

The Bane of Burnished Calculus
By Linda Brookman, RDH, BSDH, MSHS and Donna Smith, BSDH, MSEd, RDHAP

One of the more challenging aspects of closed periodontal therapy is complete removal of subgingival calculus. According to Carranza, the composition of subgingival calculus is 70% to 90% inorganic components that originate from the plasma. Two-thirds of the inorganic components are crystalline in structure. Subgingival deposits attach to the root surfaces in different ways and may affect the ease or difficulty encountered when trying to remove the deposit. Subgingival calculus may mechanically lock into root surface irregularities or it may attach to unaltered cementum surfaces.

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