advanced fulcrum techniques Flashcards
Extraoral fulcrum technique: resting the _____ or ___ of hand against the patient’s ____ or _____ and underlying mandible
Use _______ in areas of ______ access
Not a ________ for the intraoral fulcrum
Extraoral fulcrum technique: resting the fingers or palm of hand against the patient’s chin or cheeks and underlying mandible
Use selectively in areas of limited access
Not a replacement for the intraoral fulcrum
intraoral fulcrum grasp:
intraoral fulcrum stabilization:
grasp: modified pen grasp held near the junction of the handle and shank, close to working end
stabilization: pad of ring finger on a stable tooth, ring finger is a support beam, middle/ring/pinky touch and work as a unit
extraoral fulcrum grasp:
extraoral fulcrum stabilization:
- grasp is lower on the handle, further from the working end
- length of middle/ring/little finger rest on the pts skin underlying the mandible; all THREE fingers press against mandible; middle/ring/pinky touch and work as a unit
extraoral fulcrum:
advantages (4)
disadvantages (4)
easier to access max molars; easier access to deep pockets on molars; improved parallelism of lower shank to molars; facilitates neutral wrist position for molars
requires greater degree of muscle coordination and instrumentation skill; greater risk for instrument stick; reduces tactile information; not well tolerated by TMD patients
Modified-pen grasp further ___ on the ______
Middle finger rests on ____, not on _____ = decrease in tactile sensitivity
Two Basic Types: what are they called and where are they used
Modified-pen grasp further up on the handle
Middle finger rests on handle, not on shank = decrease in tactile sensitivity
Two Basic Types:
- Palm facing out (knuckles): For maxillary posterior in the quadrant closest to the clinician
- Chin-cup: For maxillary posterior in the quadrant away from the clinician
finger assist: lateral pressure on the shank
If adequate ______ pressure cannot be applied while using an _______ fulcrum, additional pressure can be applied to the ______ using the ____ finger of the ________ hand
If adequate lateral pressure cannot be applied while using an extraoral fulcrum, additional pressure can be applied to the shank using the index finger of the non-dominant hand
OPPOSITE ARCH FULCRUM
indication:
works similarly to ________ and can be used _________
improved access to _________
facilitates _________
Indication: difficult to reach areas in molar regions
Works similarly to the extraoral fulcrum in maxillary posterior and can be used interchangeably
Improved access to deep pockets
Facilitates parallelism on proximal root surfaces
CROSS ARCH FULCRUM:
crosses the ______; no longer ___ teeth away
indication:
crosses the midline; no longer 1-4 teeth away
need for increased power on the posterior distals (tenacious calc)
FINGER ON FINGER:
indications: 3
rest the ___ finger of your _______ hand on the ____ finger of your _______ hand
partially edentulous areas; mobile teeth; tight mentalis + needing retraction (tight lip)
rest the ring finger of your dominant hand on the index finger of your non-dominant hand
what are each US tip used for:
standard:
straight slim line:
L and R slim lines:
standard: removal of supragingival mod-heavy deposits. shallow pockets that do not require tissue distention. removes extrinsic stains. med-high power setting
straight slim: removes light-mod deposits on anterior and posterior root surfaces. removes plaque and biofilm. low power setting
curved slim: removes light-mod deposits on root concavities, convexities, and furcations. removes plaque around root surfaces. low power setting.
stroke direction of a curet vs US
curet: apical to coronal (below the deposit)
US: coronal to apical (channeling)
SLIM DIAMTER STRAIGHT:
Removal of ___-___ supragingival and subgingival calculus
______ removal
Root debridement
“_________” on all root surfaces multiple times are needed
Removal of light-mod supragingival and subgingival calculus
Biofilm removal
Root debridement
“Crosshatching” on all root surfaces multiple times needed
SLIM AND ULTRA SLIM STRAIGHT:
- all ______ pockets
- posterior pockets must be _mm or ____
- power setting?
- ALL anterior pockets (deep or shallow)
- 4mm or LESS in posterior pockets
- low-medium power setting
SLIM DIAMETER CURVED (L/R)
- posterior pockets:
- f________
- improved adaptation in _______
- power setting?
- t/f: it’s used like a nabers probe
- posterior pockets: 5mm or more
- furcations
- improved adaptation in root concavities
- power setting: low-medium
- false, just similar curved shape
how to determine L vs R
what does L vs R indicate
hold inserts together with the tips pointing away from each other. The one point pointing left is L, the one pointing right is R
indicates which way the working end is curved, not the area of interest (L doesn’t mean left side of mouth; R doesn’t mean right side of mouth)
where can the Right slim line be used
- vertical orientation like a probe:
LINGUAL UR posterior
BUCCAL UL posterior
LINGAL LL posterior
BUCCAL LR posterior
where can the LEFT slim line be used
- vertical orientation like a probe:
BUCCAL UR posterior
LINGUAL UL posterior
BUCCAL LL posterior
LINGUAL LR posterior
L and R technique:
Designed to adapt the ____ of the insert to the tooth surface
_______ orientation (tip down like probe)
Avoid “__________”
Angulation of __-__ degrees
Combination of _____, _______, ______ Strokes (________)
Video and text mention “Transverse” or “Curet-like” technique for shallow pocketing: these areas can be treated with a _____ insert that is already being used in the ______ of a quadrant
Designed to adapt back of insert to tooth surface
Vertical orientation (tip down like probe)
Avoid “tip to tooth”
Angulation of 0-15 degrees
Combination of Horizontal, Oblique and Vertical Strokes (Crosshatching)
Video and text mention “Transverse” or “Curet-like” technique for shallow pocketing- these areas can be treated with straight insert that is already being used in anterior of quadrant
