DH III- Powered Instrumentation

What do powered instruments do?

dislodge calculus from the tooth surface

disrupt biofilm

flush out bacteria

converts air pressure into high frequency sound waves that produce vibrations of the working end ,driven by compressed air from the dental unit

sonic

operate a low frequency; 3000-8000

sonic cps

converts electrical energy into high frequency sound waves that produce rapid vibrations

ultrasonic

more efficient and example is the cavitron

ultrasonic

ultrasonic cps

18000-50000

use of electrical energy to activate crystals within the handpiece to produce vibrations

piezoelectric

transfer energy to metal stacks or a ferrous rod (ferromagnetic) to produce vibrations of a powered working-end

magnetostrictive

magnetostrictive frequency

20-40 kHz

piezoelectric frequency

29-50 kHz

magnetostrictive stroke pattern

elliptical

piezoelectric stroke pattern

linear

magnetostrictive

metal rod or stack of metal sheets

crystals activated by ceramic handpiece

piezoelectric

all surfaces active on instrument

magnetostrictive

only active on lateral sides of instrument

piezoelectric

area of no vibration- located at tip of instrument

nodal point

another word for irrigation

lavage

tip of instrument must be adapted to remove debris

True

limitations of powered instrumentation

clinical skill level

production of aerosols

most common mode of action of powered instrumentation

mechanical

small size working end

ultrasonic

large size working end

hand instrumentation

minimal distention of pocket wall, easily inserted

ultrasonic

must be positioned apical to deposit

hand instrumentation

coronal- apical

ultrasonic

hand instrumentation

apical-coronal

very rapid vibrations of powered working end create microfractures in calculus deposit that result in gradual removal of deposit

mechanical removal

constant stream of water exits near point of working end; constant flushing action within pocket

fluid lavage

why is irrigation of the working end used in powered instrumentation?

dissipate heat

water stream penetrates the base of the pocket and washes toxic products and free floating bacteria from pocket

water irrigation

a greater area is cleaned when water is used for power instrumentation compared to instrumentation without water

true

forceful flow of cavitating fluid; enhances effectiveness beyond the surface actually touched by the tooth- swirls

acoustic microstreaming

formation of tiny bubbles when water stream contacts the vibrating working end

cavitation

what does caavitation do to bacteria?

tear bacterial cell walls

is cavitation for biofilm or calculus or both?

biofilm only

heat damage to dental pulp

too little water

__________ water flow for calculus removal and _________ less water flow needed for deplaquing

more, less

also known as vibration

frequency

measures how many times the working end vibrates per second. cannot be changed by the clinician

frequency

what is the frequency we use in clinic?

30 k

also known as stroke length

amplitude

measure of how far the working end moves back and forth during one cycle; this can be adjusted using the power setting on device

amplitude

longer more powerful stroke, fine mist, used to remove calc

high amplitude

shorter less powerful stroke, used for deplaquing

low amplitude

most slim diameter working ends cannot be used at higher power levels because of risk of breakage

true

difficulty in swallwoing

dysphagia

can you use a regular tip on an implant

no

temporary numbness

sensorineural dysfunction

1. electrical energy to handpiece

2. magnetic energy to inserts

order of transfer on energy

more of a chipping action of removal of calc

25 k

more of a slurry action of removal of calc

30 k

sustained performance system, the ability of the system to sense the need for additional power and automatically adjust for it- keeps power steady

SPS Technology- cruise control

generates the energy to go through the stack - moves back and forth

drive coil

measures motion in back of insert and if + pressure goes on tooth then the energy drops , lighter pressure, brins it back up to correct energy

feedback coil

10, 100, 1000

standard tip

straight, straight 1000, curved

slim diameter

thin

thinsert

1 bend

10

2 bends

100

3 bends

1000

heavy thicker diameter

moderate to heavy calc

moderate power

more metal= more power

standard insert

similar design to probe

thinner diameter than standard

slight calc and biofilm

keep in "blue" zone

slimline insert

January 2006

0601

September 2017

1709

the energy source for the insert

should be straight

include date, tip style, and frequency stamped

stack

connects the energy source (stack) to the insert tip

connecting body

rubber, stops the flow of water from coming outside the handpiece and directs the water toward the tip

o-ring

use the point of tip on the tooth

False- can remove enamel

disperses the greatest amount of energy

should not be adapted toward the tooth surface

it could damage the tooth

point of tip

may be placed against a large calculus deposit

tip

disperses the second greatest amount of energy

should not be adapted directly against the tooth surface

face of tip

disperses less energy than the face

back of tip

least amount o energy dispersion

can be adapted directly against the tooth surface

most frequently used

lateral surfaces

larger diameter tips

shorter shank lengths

heavy deposit removal

mostly supragingival use

standard diameter tip

40% smaller in diameter

longer shank lengths

light deposits and deplaquing

subgingival use

slim diameter tip

broad bulky tip

resembles a beaver tail

supragingival use

large sized calculus ledges

stain removal

beavertail tip

shank bends to facilitate access to proximal surfaces and line angles

supraingival use

small-large deposits

standard diameter triple bend

curved shank and tapered tip

supra- small to large

sub- deposits near gingival margin

standard diameter universal tip

extended shank

similar in design to a probe

subgingival - 4mm or less in depth

slim diameter straight tip

right and left tips

extended shanks

subgingival - greater than 4mm

slim diameter curved tips

has ball shaped end

subgingival use

deplaquing of furcation areas and root concavitites

slim diameter furcation tips

active tip area

2-4mm

worn tip -1 mm

25% less effective

worn tip- 2 mm

50% less effective

put tips into cold sterilization and apray with disinfection

false- causes wear

best method for tip sterilization

cassette and miele