Instrumentation and Patient/Operator Positioning (POHS I)

Adaption

relationship between the working end and tooth surface

Angulation

angle formed by the working end with tooth surface

Stroke

motion from an instrument, unbroken during assessment or debridement

Terminal shank

working end to first bend

Functional shank

working end to last bend

blade

working end of an instrument

curet

curved, rounded instruments (universal or area specific)

lateral pressure

pressure with an instrument

scaling

method in removing calculus and biofilm

Neutral work position

position in which the normal curve of the spine is maintained; muscles and joints are naturally aligned

Ergonomics

study of human performance and workplace design to maximize health, comfort, and effciency

supine

flat position; for maxillary arch; chin is UP

semi-supine

raised 15 from supine; mandibular arch

trendelenberg

modified supine where head is lower than heart

postural hypotension

low-blood pressure from lying down; lightheadedness and fainting

modified pen grasp

method for holding periodontal instruments; three-finger combo

handle

part of instrument used for holding

shank

metal between handle and working end

working end

carries out function of the instrument

fulcrum

provides stability during instrumentation; ring finger

indirection vision

use of dental mirror to see teeth that cannot be directly seen

retraction

use of mirror head to hold cheek, lip or tongue out of the way

indirect illumination

use of mirror surface to reflect light onto tooth in dark areas

transillumination

directing light off of the mirror and through the teeth

Why do we do neutral working position?

decrease risk of musculoskeletal injuries

efficacy and endurance of performance

Eyes are _-_ away from oral cavity

15-22

can tilt head forward to _

15 degrees

can raise elbows to __

20

dont raise elbows above

60

semi-upright position

reclined 45; for pt with congestive heart failure, vertigo, emphysema, asthma and pregancy

light is angled _ to _ in supine position

60 to 90

light is angled _ to _ in semi-supine position

90

position of trendelenburg

back extra 10-15

positioning sequence

1. me

2. patient

3. equipment

4. non-dominant hand

5. dominant hand

clock positions for right-handed

8-12 o clock

clock positions left-handed

12-4 o clock

divide dentition into _ sextants

6

section and are anterior sextants

2 and 5

sections _,_,_, and _ are posterior sextants

1,3,4, and 6

anterior sextants are for __surfaces

facial and lingual

posterior sextants are for __ aspects

buccal and lingual

8-9 o clock (and 3-4) are ___ surfaces ___

anterior surfaces towards

12 o clock are surfaces __

anterior surfaces away

9 o clock (and 3 o clock) are ___ surfaces __

posterior surfaces towards

10-11 o clock (1-2 o clock) are surfaces _

posterior surfaces away

mirror types

front, concave, and plane

front surface

most common, reflects surface on front of glass

concave

reflects surface on front of mirror; distorted

flat surface

reflects surface to back of mirror; double-image

4 functions of dental mirror

indirect vision, retraction, and indirect illumination and transillumination

3 types of fulcrums

intraoral → max fulcrum; palms are up

extraoral → mand fulcrum; palms are down

alternative → finger on finger or non-dominant hand

intraoral fulcrum is used for ___ arch

maxillary; palms are up

extraoral fulcrum is used for __arch

mandibular; palms are down

two types of Instrument strokes

1. Assessment stroke

2. scaling or working stroke

assessment stroke

light, use with all explorers, use with curets and scalers when looking for calc

purpose of scaling or working stroke

used for calculus removal

instrument stroke characteristics

1. grasp →light for calc, firm for removal

2. hand stability → pivots on fulcrum

3. motion → action of shoulder, arm, wrist and hand

4. length → 2-3mm

vertical stroke

up and down

all anterior surfaces, posterior mesial and distal surfaces

oblique stroke

diagonal (like this /)

posterior buccal and lingual surfaces

horizontal strokes

side to side

anterior facial/lingual surfaces and posterior around line angles, deep pockets and furcations

common musculoskeletal disorders

carpal tunnel syndrome

ulnar nerve entrapment

tenosynovitis

tendinitis

3 instrument design components

handle, shank, and working end

properties of handle

thickness → 10mm

weight → <15.0g

texture → ribbed

others → design name, number, and manufacturer

shank connects _ to _

working end to handle

two types of shanks

function or terminal shank

type of shank SHAPE

simple or complex

simple shank shape

anterior teeth

complex shank shape

posterior teeth/universal

single-ended instrument has ___

one working end and shank (mirror)

double-ended instrument are __

mirrored on both sides of handle (11/12 exp)

unpaired instruments are __

different on each side (TU17/23)

What instruments are single-ended?

mirrors, pliers, UNC12 probe

What instruments are double-ended?

11/12 exp, nabers, 204SD, L3/4 and gracey

what instruments are unpaired?

Tu17/23 and nevi1/H33 (anterior sickle)

_and _ are assessment instruments

explorers and probes

example of explorer

TU17/23 and Exp 11/12

example of probes

NUC 12 probe and naber probe

_, _, and _ are debridement instruments

sickle scalers, universal curets, and area-specific curets

example of sickle scalers

anterior sickle Nevi1/H33 and posterior sickle 204 SD

examples of universal curtes

barnhart 5/6 and langer 3/4

example of area-specific instruments

graceys 1/2, 11/12, 13/14 and 15/16

Assessments are used for _

detect changes from tactile sense (calc, caries, defective restorations)

Characteristics of explorers

thin and adapt 1-2mm

Design of explorers

1. stepherd hook (23 end)

2. Pigtal cowhorn

3. Orban-type

4. 11/12 type

stepherd hook (23 end)

1. crown only

2. caries detection

pigtail and cowhorn

1. limited cal detection

2. caries detection

orban-type (17 end)

tip bend 90 to the shank

simple shank

anterior shank/calculus detection

11/12 type

tip bent 90

complex shank

uni calc detection

Debridement instrument is used for _

removal of hard/soft depositis (calc, materia alba, biolfim, and staining)

Debridement instruments has what types of working ends?

tip or toe

Sickle scaler has what kind of working end?

tip, two cutting edges, triangular, 90 degrees

universal curets have what kind of working end?

toe, two cutting-edge, semi-circular, 90 degrees

area-specific curets have what kind of working end?

toe, ONE cutting edge per working end, semi-circular, 70 degrees

gracey ½ is used on ___ teeth

anterior

gracey 11/12 and gracey 15/16 are used on ___ teeth

posterior, medial

gracey 13/14 is used on __ teeth

posterior, distal

type and function of instrument TU-17

assessment; explore for calculus

type and function of instrument 23

assessment; caries detection

type and function of instrument UNC12 Probe

assessment; measurement

type and function of instrument nabers probe

assessment; measurement