10. Periodontal Instrumentation Flashcards
• Do remove some levels of ____, in addition to supra- and subgingival plaque
cementum
UPPER ARCH
Chair Back ____ to the floor, patient’s chin ____
LOWER ARCH
Chair back ____ angle to floor, patient’s chin ____
parallel
up
45deg
down
Right-Handed Clinician vs. Left-Handed Clinician
Take a look
• When positioning for lower and upper anterior sextant > imaginary line down the teeth; the surfaces toward you (yellow), you position yourself at ____ o’clock; surfaces away, you position yourself from ____ o’clock
9
12
Modified Pen Grasp
* IMPORTANT * Thumb/forefinger, ring finger is \_\_\_\_, and \_\_\_\_ stays together * Working stroke > \_\_\_\_ finger flattens out > generates force to remove calculus, \_\_\_\_ is also pushing * Pad of third finger is on instrument shank > incorrect, want the \_\_\_\_ of the third finger, not the pad; if you work like this, you lose control and hinder maneuverability, and makes it difficult to execute a stroke
fulcrum
pinky
index
side
FULCRUMS
* Fulcrum as \_\_\_\_ to the tooth you're working on as possible * Max > \_\_\_\_ fulcrum, three fingers on chin * Fulcrum = \_\_\_\_ point
closed
extra-oral
pivot
Take a look at the hierarchy!
YAY
Instrument Parts
! Terminal shank
! Working end
! The terminal shank is most important when adapting the ____
• IMPORTANT: terminal shank location; in between \_\_\_\_ and the first \_\_\_\_ begins
working end
working end
curve
Periodontal Instrumentation
Gracey Curets
"Gracey 1/2, 7/8 (\_\_\_\_ teeth) " Gracey 7/8, (\_\_\_\_ teeth) "Gracey 11 /12 , 13/14, 15/16, (\_\_\_\_ teeth) ---" 11/12 and 15/16 used on direct \_\_\_\_ surfaces and \_\_\_\_ only ---" 13/14 used on \_\_\_\_ surfaces only
* \_\_\_\_ - more versatile gracey > use on anteronr and posterior * Know the instruments * They are all \_\_\_\_-specific, only for certain areas in mouth
anterior posterior posterior buccal/lingual mesials distal
7/8
site
Working-end Design
* The one end is \_\_\_\_ > important for Gracey's > the cutting edge > apply to root surface * Offset angle to the terminal shank
lower
GRACEY
Hold terminal shank ____ to the floor and find the ____ as cutting edge to adapt to tooth surface
perpendicular
lower edge
Activating the Gracey
! Close face of blade while inserting ____
! Open angle of face at ____ degrees to tooth surface
! Maintain terminal shank ____ to
the surface you are instrumenting
* IMPORTANT * Line terminal shank with the surface that you're instrumenting > not the \_\_\_\_ of the tooth
subgingivally
70
parallel
long axis
Angulation for Calculus Removal
* Enter sulcus > rounded back of gracey, and along the tissue and not traumatizing; establish terminal shank with the gracey * Inefficiently removing calculus (\_\_\_\_); but with 45 - less > it slips right over the calculus > \_\_\_\_ the calculus * Right > when burnish calculus when angle is too small > difficult to \_\_\_\_, and more difficult to \_\_\_\_
90
polishes
detect
remove
• Always instrumenting only a small ____mm band
1-2
ADAPTATION
• Always want to adapt; thumb and fore fingers, and roll, bc you constantly want to \_\_\_\_ the working end to the tooth surface
adapt
Horizontal Stroke
* Any instrument for a horizontal stroke * Horizontal > directing the toe \_\_\_\_, and coming across the direct \_\_\_\_ or direct \_\_\_\_ of molars, and direct \_\_\_\_ of second molars
apically
buccal
lingual
distals
• Point toe in direction you’re going to be ____; here going to scale distal surface of 9
scaling
GRACEY 11/12 and 15/16
* Both for \_\_\_\_ surfaces of molars * 15/16 - has a bigger curve in the shank than the 11/12, allows you to get to your \_\_\_\_ and access \_\_\_\_ to reach areas
mesials
molars
difficult
GRACEY 11/12 AND 15/16
Activation:
! Insert toe subgingivally at ____ line angle
! Strokes are activated across ____ and completion on ____ surface (proximal)
* Or \_\_\_\_ line angle * Same applies to the lingual
distal-buccal
buccal
mesial
distal-lingual
GRACEY 13/14
• Distals of \_\_\_\_ teeth
posterior
SCALERS
* Unlike gracey's, have two \_\_\_\_ edges > terminal shank > the face is \_\_\_\_ (at a right angle), one side is not lower than the other > two cutting edges * \_\_\_\_, \_\_\_\_-gingival only, \_\_\_\_ tip;
____ toe > indicated for ____ use)
cutting right anterior supra-gingival pointy
rounded
sub-gingival
• Universal curet can be used everywhere in the mouht, unlike the ____
gracey’s
WORKING STROKE
! Apply cutting edge (____ of working end) so that face of blade is angled at ____ degrees to tooth surface
! Begin at ____ of buccal/or lingual surface and move into the ____ surface
! Supragingival scaling stroke activated from gingival margin in a ____ direction
• If at \_\_\_\_ degree > the other side will traumatize
1/3 75-80 midline proximal coronal 90
UNIVERSAL CURETS Columbia \_\_\_\_ and \_\_\_\_ ! A universal curet may be used in any \_\_\_\_ of the mouth ! \_\_\_\_ cutting edges on each opposite working end ! Terminal shank is used to \_\_\_\_ the placement on proximal surface and direction of \_\_\_\_ ! \_\_\_\_ toe = curet (safe subgingivally) ! May be used to remove supra and subgingival deposits effectively
• Columbia have \_\_\_\_ shanks > a lot of calculus, go first with the Columbia, and then follow up with the Gracey's
13/14 4R/4L area 2 guide activation rounded heavier
