D1 Spring Prev Exam 3

mouth mirror, explorers, probes

3 assessment instruments

manual/powered scalers, curettes (manual), periodontal files

Removal instruments (removal of calculus, stains, plaque)

1/2 gracey curette

For all surfaces of anterior teeth. Double-ended & area-specific.

11/12 gracey curette

Primarily for mesial of posteriors (also buccal/lingual). Double-ended, area specific

Instrument should not wrap around tooth - terminal shank should be parallel with long axis of tooth.

Insert with toe 1/3

13/14 gracey curette

Only for distal surfaces of posterior teeth.

Instrument should not wrap around tooth - terminal shank should be parallel with long axis of tooth.

handle

hold this part of the instrument

terminal shank

Last bend of the shank prior to working end

Should be parallel to long axis of tooth.

shank

connects working end with handle

working end

The tip or blade of the instrumnet

straight/simple shank

Shank with few or no bends (flat design) - for anterior teeth

angled/complex shank

Shank with multiple bends for better adaptation (proximals of posterior teeth).

Harder to reach --> more, deeper bends in the shank

Longer shanks can help reach deeper periodontal pockets.

blade

the working end of a scaler or curet

double-ended (unpaired)

Instruments with 2 ends that differ in design & function

double-ended (paired)

Instruments with 2 ends that are mirror images of each other. On side is for facial/buccal; the other for lingual

face

the part of the working end facing the tooth; opposite of the back of the working end

cutting edges

sharp edges of the working end

toe, face, curet

the 3 parts of the working end of a curette

tip, face, sickle

the 3 parts of the working end of a scaler

1) toe pointed in direction of movement

2) Terminal shank parallel w/long axis of tooth

3) Can only see part of the face of the blade.

3 rules for orientation of working end of instrument

Thumb, index, 3rd finger

3 fingers in contact with instrument in modified pen grasp

neutral wrist

proper wrist positioning to avoid carpal tunnel

fulcrum

Support/point of rest for instrument stability and precision.

Should be on the same arch & quadrant

insertion

placing instrument below gingival margin into the sulcus w/o traumatizing tissue.

0-40 degree angle

0-40 degrees

Angle range for instrument insertion (closed angle) - face is positioned against tooth surface

just past midline

insertion location for anteriors.

Make sure to overlap insertion sites

just past distal line angle

Insertion location for posterior teeth. Overlap insertion sites to avoid missing spots.

>90 degrees

scaling angle that may burnish calculus

45-90 degrees

ideal angle for carving calculus

adaptation

keeping the toe third of the working end instrument on the tooth in correct orientation (only terminal 1-2mm for line angles).

Need to keep the lower 1/3 of the instrument on working site (NOT middle or direct tip)

angulation

angle between working end of instrument & tooth surface.

Probe: Side of tip on tooth

Scalers/curets: Angle between blade face/tooth surface

70 degrees

Open angulation for effective calculus removal

activation (stroke)

Unbroken movement made by instrument - should be coordinated between arm, wrist, and fingers

walking strokes

Use with probe

exploratory strokes

Strokes with explorers/removal instruments for tactile sensitivity

scaling strokes (calculus removal)

Strokes with firm pressure for removal of calculus

lateral pressure

Pressure applied to tooth by instrument. Should be balanced with pressure on fulcrum.

If too high, may result in loss of control, soft tissue damage, & fatigue.

curettes

3 instruments used for supra-and sub-gingival calculus, biofilm, and stain removal.

Rounded tip (toe), face & lateral surface bordered by cutting edges.

2 cutting edges on curved blade.

universal curettes

Curettes adapted for supra-and subgingival instrumentation on any tooth surface.

Face is perpendicular to the lower shank; cutting edges are parallel & level with each other.

scalers

Instruments with curved blade for removal of supra-gingival calculus, biofilm, and stain.

Double-bladed, so it is not used below the gumline (otherwise use it like gracey 1/2)

Straight (unpaired w/flat shank) vs. modified/contra-angle (paired, mirrored instrument).

70 degree angulation.

Adaptation: Maintain tip-1/3 or terminal 3rd of cutting edge on tooth at all times.

tip wraps around tooth (wrap method)

How to find correct working end for 11/12 explorer

move diamond card (instrument is stationary)

How to sharpen an instrument. Finish on down stroke.

Always clean instrument before use.

110 degree (3 min. past 12)

Angle between handle and diamond card when sharpening.

Adapt the diamond card to the instrument to preserve rounded toe