By Kathleen O. Hodges, RDH, MS
Extended shank instruments are indicated for deep periodontal pocket depths greater than 5 mm as measured with a periodontal probe. Deep periodontal pocket depth can be complex in regard to shape; however, for simplification, deep periodontal pockets can be thought of as narrow or wide topography, ie, shape and surface area (Figure 1). The topography of the periodontal pocket includes its circumference defined by the tooth surface (root), sulcular epithelium of the free gingiva, and the junctional epithelium (Figure 1). Critically thinking about periodontal pocket depth topography helps the clinician choose the appropriate hand-activated instruments and techniques.
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