DT L6

USA

Design and Use of Explorers

  • Purpose: Used to detect and assess various dental conditions.

    • Supragingival calculus

    • Subgingival calculus

    • Cemental irregularities

    • Dental caries

    • Decalcification

    • Irregularities in restoration margins

    • Secondary caries around restorations

    • Crown and root anomalies

    • External root resorption

  • Features:

    • Fine, wire-like tip with sharp point.

    • Available in various lengths, diameters, and bends.

Explorer: Definition & Function

  • Assessment Instrument: Flexible, wire-like working-end.

  • Use: Detect subgingival calculus deposits.

  • Material: Made of flexible metal to conduct vibrations from working-end to clinician’s fingers.

Parts of the Explorer

  • Tip: 1 to 2 mm of the side is adapted to detect calculus deposits.

Lower Shank

  • Definition: The section of the shank nearest to the explorer tip.

Variety of Designs

  • Types of explorers:

    • A variety of designs exist; clinicians should understand each type's intended use:

      • Heavier/wider explorers for caries/restorations.

      • Fine diameter explorers for root structure exploration and calculus identification.

      • Tip bends for deep pockets; short explorers for shallow areas.

Supragingival vs. Subgingival

  • Supragingival: Instrument use above the gingival margin.

  • Subgingival: Instrument use beneath the gingival margin.

Basic Explorer Design Types

  • Types:

    • Shepherd hook

    • Straight

    • Curved

    • Pigtail and cowhorn

    • Orban-type

    • 11/12-type

Shepherd Hook Design

  • Description: Resembles a shepherd’s stick.

  • Use: Supragingival for dental caries examination and restoration margins.

Straight Explorer Design

  • Caution: Pointed tip may injure soft tissue.

  • Use: Supragingival for caries and restoration margins; not recommended subgingivally.

Curved Explorer Design

  • Warning: Pointed tip can injure soft tissue.

  • Purpose: Detect calculus in normal sulci or shallow pockets (1-3 mm).

Pigtail and Cowhorn Explorers

  • Description: Resemble a pig's tail or bull's horns.

  • Use: Detect calculus in normal sulci or shallow pockets, not deeper than cervical-third of the root.

Pigtail and Cowhorn Disadvantages

  • Issue: Curved lower shank can stretch tissue away from the root surface.

Orban-Type Explorer Design

  • Features: Tip bent at 90 degrees; straight lower shank.

Orban-Type Advantages

  • Benefit: Bent tip allows back of the tip to direct against soft tissue base of sulcus.

  • Use: Excellent for anterior teeth.

Orban-Type Disadvantages

  • Challenge: Straight shank complicates use on line angles, mesial and distal surfaces of posterior teeth.

Uses of Orban-Type

  • Calculation Detection: Subgingival on:

    • Anterior root surfaces.

    • Facial and lingual root surfaces of posterior teeth.

11/12-Type Explorer Design

  • Features: Tip bent at a 90-degree angle to lower shank; long, complex shank.

11/12-Type Advantages

  • Benefits: Smooth back of tip contacts soft tissue in sulcus/pocket.

  • Use: Ideal for anterior and posterior teeth.

11/12-Type Disadvantages

  • None: Effective throughout the mouth, suitable for healthy sulci and deep periodontal pockets.

11/12-Type Ideal Features

  • Design: Curved working-end, complex shank.

  • Capacity: Easily reaches root surfaces of all teeth types.

The Assessment Stroke

  • Definition: Used to detect calculus deposits or tooth surface irregularities; also called "exploratory stroke."

Finding Hidden Subgingival Calculus

  • Technique: Clinician relies on touch to locate calculus beneath gingival margin.

Tactile Sensitivity

  • Definition: Ability to detect calculus by feeling vibrations from the explorer tip transferred to the shank and handle.

Example of Tactile Sensitivity

  1. Explorer tip quivers over calculus deposit.

  2. Vibrations are transmitted through the instrument.

  3. Clinician feels vibrations with fingers.

  4. Recognition of vibrations as calculus deposits.

The Best Design for the Job

  • Characteristics: Fine working-end and flexible shank enhance tactile feedback.

  • Purpose: Explorer is best for calculus detection.

Technique for Assessment Strokes

  • General Technique:

    • Short, overlapping strokes.

    • Tip, toe, point leads the way.

Technique Tips for Exploring

  • Grasp: Relaxed with the middle finger resting lightly on shank.

  • Adaptation: 1 to 2 mm of the side of the tip.

  • Pressure: Feather-light against tooth.

  • Strokes: Fluid, sweeping movements.

Technique Errors: Exploring

  • Issues to Avoid:

    • Firm, tense grasp reduces tactile feedback.

    • Excess pressure with the middle finger against shank.

    • Do not remove explorer tip during upward stroke.

Good Technique for Exploring

  • Maintain Contact: Keep tip in contact with root surface.

  • Stroke Length: Short, about 2-3 mm.

  • Coverage: Multiple strokes for complete root assessment.

Anterior Teeth Positioning

  • Note: Terminal shank across long axis of tooth.

Explorer Design Review

  • Task: Identify tip and lower shank for anterior teeth; lower shank positioned oblique to tooth's long axis.

Sequential Exploration for Anterior Teeth

  1. Explore surfaces toward you (for right-handed clinicians).

  2. Next, explore surfaces away from you.

Posterior Sextants Exploration

  • Technique Overview: Step-by-step guide to exploring posterior sextants, terminal shank parallel to the long axis.

Review Instrument Design for Posterior Teeth

  • Task: Identify tip and lower shank for posterior exploring.

Selecting Correct Working-End

  • Observation: Check relationship of lower shank to distal surface of a premolar.

Visual Clue: Correct Working-End

  • Clue: Lower shank parallel to distal surface; functional shank goes "up and over."

Visual Clue: Incorrect Working-End

  • Clue: Lower shank crosses facial surface; functional shank goes "down and around."

Rule for Working-End Selection

  • Guidance: For posterior teeth, remember "Functional shank up and over" and "Posterior = Parallel."

Tooth Surface Sequence for Exploration

  • Process: Start at the distofacial line and work towards the distal surface.

Steps for Effective Exploration

  1. Positioning: Explorer tip in the Get Ready Zone.

  2. Insertion: Lower handle, insert beneath gingival margin, make light strokes toward distal surface.

  3. Rolling: Roll handle slightly to maintain adaptation; explore halfway across the distal surface.

  4. Facial and Mesial Surfaces: Start at the distofacial line angle.

  5. Middle-third: Position the tip here while exploring the facial surface.

  6. Rolling for Adaptation: Maintain contact by rolling the handle.

  7. Mesial Surface Exploration: Continue exploring halfway across the mesial surface.

Sequence for Posterior Sextant

  • Follow established techniques for posterior sextant explorations.

Assessment Stroke Characteristics

  • Grasp: Relaxed, middle finger lightly on shank.

  • Adaptation: 1-2 mm of tip side adapted.

  • Pressure: Light pressure against tooth.

  • Activation: Wrist activation with fluid, sweeping strokes; many overlapping strokes to cover root surface.

Interpretation of Subgingival Conditions

  • Skill Development: Recognizing sensations beneath the gingival margin takes time and focus.

Normal Conditions

  • Feeling: No interruptions in the explorer's path.

Small Calculus Deposits

  • Sensation: Gritty feeling as the explorer moves over small deposits.

Large Ledge of Calculus

  • Experience: Explorer moves out and around the raised bump.

Overhanging Restoration

  • Movement: Explorer must pass over restoration.

Deficient Margin on Restoration

  • Trace: Explorer dips in to follow restoration contour.

Carious Lesion

  • Sensation: Explorer dips into rough areas.