Instrumentation of the subgingival area is aimed at removing as much as possible of the bacterial biofilm and subgingival calculus.However,thorough subgingival scaling is technically demanding as access to and visibility of the area are limited,so that complete subgingival plaque and calculus removal is rarely achieved.Although calculus has been shown not to be a factor in the causation of inflammatory periodontal disease,most studies evaluated instrument efficiency by eatimating residual calculus,whereas the estimation of residual subgingival plaque world actually be more meaningful.The effectiveness of residual subgingival debridement procedures by a variety of assessment methods shows that a wide range of approximent 5% to 80% of treated roots have residual plaque or calculus deposits.Up to 30% of the total surface area of these roors may be covered with residual calculus following subgingival scaling.Scaling efficacy is reduced with increading pocket depth and furcation involvement.Maximum instrumentation accessibility has shown to be limited to approximately 10mm of probing depth.Instrument effectiveness in terms of the mean depth of a pocket completely debrided after therapy has been found to vary greatly.

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