Advanced Periodontal Instrumentation

What are the explorer strokes?

assessment

contact with surface of tooth but without pressure application

fluid stroke, medium length

What are the root planing strokes?

light to moderate pressure

medium length strokes

What are the calculus removal strokes?

powerful (biting) strokes

moderate to firm pressure

short stroke length

What are the types of strokes?

vertical

horizontal

oblique

channeling

crosshatching (multidirectional)

What is the channeling stroke?

overlapping strokes on root surface that covers every mm of the tooth, going slower

short strokes, firm to light strokes

vertical or oblique direction

used for root planing to smooth things out

What does a channeling stroke utilize?

Utilizes the terminal 1/3 of the instrument blade

Utilizes a specific pattern based on length and width of deposit

What is the crosshatching stroke?

combination of vertical, horizontal, and oblique strokes

What are the 4 most common extra-oral fulcrums?

palm up

chin cupping

finger assisted

finger on finger: using non dominant

What are the things needed for fulcrum stability?

need a broad area of contact between the hand and patient's face

establish equal pressure of fulcrum to pressure exerted against tooth and blade

use extended grasp

What does a strong fulcrum look like?

palm up

fingers together and stationary

activation by shoulder

What are the benefits of an extra-oral fulcrum?

Allows your whole hand to activate a powerful stroke

Wrist kept in a neutral position

Gain improved ergonomics

What are the disadvantages of extra-oral fulcrums?

Misunderstandings or misinterpretations of the elements that comprise a properly established extraoral fulcrum

Some clinicians believe that they are too unstable and may result in slipping and injury to the patient

Where are your fingers going on the shank for distal and mesial?

distal behind

mesial on top

What are the benefits of standing dentistry?

Enhanced access

Increased operator visibility and direct vision

Easy movement around chair

Use larger muscle groups in upper torso and arms

Relieving stress on back

Allows stabilization and balance over both hips and feet

What should you do when standing?

Keep moving (to increase blood supply to legs)

Keep shoulders in line with body and forearms parallel to the floor

Keep working distance the same as in a seated position

Position patient's mandible as parallel to the floor as possible(when working on the mandibular arch)

Distribute weight evenly between both hips/legs/feet

What should you not do when standing?

Do not lean over the patient for a better view

Do not stand in one position for a long period of time (try sitting for maxilla and standing for mandible)

Do not stand with weight on one leg

What is the complementary approach of the ultrasonic?

1. Use ultrasonic at appropriate power to remove bulk of deposits

2. Follow with hand instruments for areas not accessible with ultrasonic

3. Finish with ultrasonic for debridement/flushing with thin tip -->

Irrigation

Reduce bacterial load