periodontal debridement, sickle scalers, and universal curettes

_________ plays a significant role in causing periodontal disease, it is difficult to prevent or control periodontal disease is this is present

calculus

what is calculus

calculus is mineralized plaque covered w a living layer of plaque biofilm

what color does calculus change into as it is found more subgingivally and why

goes from a more yellow color to a black color; gets more black bc it has more hemoglobin in it

calculus is ________

tenacious

debridement

instrumentation of crown and root surfaces to remove deposits

scaling

descriptive term for calculus removal stroke using scalers or curettes

root planning

descriptive term for smoothing the root to remove infected and necrotic tooth substance (liek necrotic cementum)

3 types of instrument strokes

• exploratory

• scaling

• root planning

exploratory stroke and what grasp you have

• using a scaling instrument to explore for calculus

• light grasp

scaling stroke and what grasp you have

• firm grasp is achieved by squeezing the instrument between the thumb, index finger, and middle finger while pushing down on the fulcrum finger

• stroke activation occurs w lateral movement of the wrist and forearm

• working stroke is a pull stroke

root planing stroke and what grasp you have

strokes are more numerous and lighter than the scaling stroke

rank the 3 types of stroke from least to most heavy handed

exploratory (lightest grasp) → root planing → scaling (most firm)

is this a good example of the modified pen grasp

no

is this a good example of the modified pen grasp

no

is this a good example of the modified pen grasp

yes

is this a good example of the modified pen grasp

yes

in the modified pen grasp, do you want your middle finger on the upper or lower shank

upper

positives for having a folcrum

• provides a stable base for leverage

• enhances control- avoids slipping and laceration of tissue

a fulcrum must be located to allow ________ motion

wrist-forearm (want to use big muscles)

what are the 5 types of fulcrums

• conventional intraoral

• extraoral

• cross arch

• finger-on-finger

• assisted

describe the intraoral fulcrum

• ideally establish as close as possible to the working area

• middle finger rests against ring finger to create a ‘built-up’ fulcrum

describe the 2 different techniques you can use for the extraoral fulcrum

• palm down

• palm up

what fulcrum is this

cross arch fulcrum

what fulcrum is this

finger-on-finger fulcrum

what fulcrum is this

assisted fulcrum

funx of sickle scalers

designed for the removal of medium to large supragingival calculus and calculus just below the contact

describe the anterior sickle

double ends are 2 different types

describe the posterior sickle

double ends are mirror images

the design of sickle scalers are _________ in cross section

triangular

the design of sickle scalers, the face of the blade is at ____ degrees to ______ shank

90 degrees to lower shank

is this the correct orientation of a posterior sickle scaler

NO → should NOT be perpendicular tot he tooth; should be parallel

is this the correct orientation of a posterior sickle scaler

yess

how to orient anterior sickle scaler

lower shank must be tilted towards the tooth surface to achiever angulation between 70-80 degrees → lower shank should not be perpendicular but not 100% parallel

the angulation of a posterior sickle/curette/explorer should be _________ to the long axis of the tooth

parallel

the angulation of a anterior sickle/curette/explorer should be _________ in reference to the tooth

across the tooth

when thinking of stroke activation, you want to maintain adaptation of 1 mm of tip of cutting edge to tooth surface → _________

tangent

when thinking of stroke activation, you want to roll the handle to move ___________

interproximally

when thinking of stroke activation, you want to press down w…

press down w fulcrum finger and rotate wrist /forearm to apply lateral pressure against tooth

when thinking of stroke activation, the tip shoudl be adapted to tooth and should NOT cause….

tissue to blanch

for anterior teeth, how do we refer to surfaces of teeth

• surfaces toward you when sititng at 8:00 (for R handed)

• surfaces away from you when you sit at 12:00

_________ is key for the activation stroke

leverage

what is the sequence of efficiency

• do all surfaces B/L that are towards you

• then do away surfaces

sickles are NOT recommended for…

use on root surfaces

universal curettes are designed to use throughout…

the mouth

funx of universal curettes

can be used supra and subgingivally to remove small to medium sized calculus

universal curettes have ___ cutting edges per working end, like sickle

2

universal curette blade is ___ degree to lower shank

90 degrees

what are the 3 types of curettes in an SRP kit, and “*” the ones we have in our kit

• columbia 13/14

• 4R/4L**

• McCall 17/18**

uses for columbia 13/14

• smaller

• designed for use on anterior teeth and premolar

uses for 4R/4L (in our kit)

• larger

• designed for use on molars

uses for McCall 17/18

• designed for use on 2nd and 3rd molars

• good for line angles and buccal, and lingual surfaces

good or bad and why

good: lower shank is parallel to long axis of tooth

good or bad and why

bad:lower shank NOT parallel

good or bad and why

bad: is parallel but blade should be toward tooth, not tissue

orientation os stroke

• face of working end is at 90 degrees to lower shank

• blade slightly rotated toward tooth and is slightly closed

• B/L stroke: horizontal/oblique stroke

• M/D surfaces: vertical stroke

7 steps of mandibular molar stroke

1. select correct working end

2. position tip near distofacial lien angle and move blade below deposit

3. tilt lower shank toward distal surface to 70-80 degrees

4. pull up to remove deposit

5. reporsition working end at distofacial line angle

6. work across facial surface pulling toward you to remove deposit

7. roll handle to adapt to mesial, get under deposit and pull up

_______ (wet/dry) calculus is more visible than ____ (wet/dry)

dry is more visible than wet

air can deflect free gingiva to see…

subgingival calculus

the use of compressed air can remove saliva that ultimately leads to…

greater visibility

the use of compressed air can make it easier to see what type of caries

root caries

pre-debridement, what are the 7 things you need to do first

• health history update

• evaluate radiographs

• operator position

• pt positioin

• oral exam

• probe

• explore

ergo principle #1

neutral posture promotes a balance of muscle forces in the body → workers should minimize time spent in awkward positions

neutral head position

• ears above shoulders

• head tilt 0-15 degrees

in the neutral operator position, upper arms are parallel to…

long axis of the body

in the neutral operator position, forearms are parallel to…

the floor

in the neutral operator position, weight is…

evenly distributed

in the neutral operator position, knees are slightly…

below the hips

in the neutral operator position, your seat height should be positioned low enough so that…

your heels are on the floor

in the neutral operator position, you want to pivot from your…

hips (not your back)