Instrumentation for Achieving the Gold Standard of Non-Surgical Periodontal Therapy

Cooke, Ashley, Jessica Lobaido, Kristie Jakubik, Michelle Peterson, and rebecca Raftery


             To determine if a gold standard for periodontal instrumentation exists by evaluating and comparing, based on current evidence, different aspects of periodontal instrumentation using hand instruments, ultrasonic scalers, and lasers.


                The gold standard for non-surgical periodontal therapy is to create a gain in clinical attachment level (Cobb). The main purpose to non-surgical therapy is the removal of plaque and reduction of bacterial load. There are many different modalities used in non-surgical therapy, but a major component is the use of instruments.  Each type of periodontal instrumentation has the potential to 1) promote a gain in attachment level, 2) reduce bleeding, 3) affect bacteria, and 4) achieve periodontal health. In this review, conventional hand instruments, ultrasonic scalers and lasers will be compared and contrasted. Overall each instrumentation type can be used alone or in adjunct based on the case of the patient and treatment needed. Evidence based studies have shown that there are advantages and limitations to each type of instrumentation type but all are beneficial to achieving periodontal health.



          All types of instrumentation have their limitations and advantages based on current

evidence. With this knowledge it can be concluded that all instruments used for periodontal debridement can be used to achieve the gold standard for non-surgical therapy.