Advanced fulcrum techniques Flashcards
What is a fulcrum?
A finger rest used to stabilize the clinician’s hand during periodontal instrumentation.
What is an advanced fulcrum?
A variation of the conventional fulcrum used to gain access to root surfaces within periodontal pockets
What are the advantages of the standard intraoral fulcrum?
Standard intraoral fulcrum provides:
Best stability for the clinician’s hand
Decreases the likelihood of injury to the patient or clinician
Best leverage during instrumentation
Caution about fulcrums:
Advanced fulcrums are not intended to replace standard intraoral fulcrums
Standard intraoral fulcrums place the least amount of strain on the clinician’s fingers
If you use standard intraoral fulcrums poorly you will only create more problems for yourself by using an advanced fulcrum
It is not a cure all
What should be mastered before using advanced fulcrums?
MASTER standard fulcrums
Advanced fulcruming techniques require greater clinician skill
When should advanced fulcrums be used?
Use advanced fulcrums selectively in areas of limited access such as when working in a narrow deep periodontal pocket
What are the advantages of using advanced fulcrums?
Easier to access maxillary 2nd and 3rd molars.
Easier to access deep pockets
Improved parallelism of lower shank to molar teeth
Facilitates neutral wrist position for molar teeth
What are the disadvantages to using advanced fulcrums?
Requires a greater degree of muscle coordination and instrumentation skill
Greater risk of instrument stick
Reduce tactile information to the fingers
May cause muscle strain
What are the types of advanced fulcrums?
Basic extraoral: Dominant hand rests against patients cheek or chin, chin-cup technique
Cross arch: intraoral finger rest in which the finger rest
Finger-on-Finger: Intraoral fulcrum in which a finger of the non-dominant hand serves as a resting point for the dominant hand
Finger Assist: A finger of the nondominant hand is used to concentrate lateral pressure against the tooth surface
Opposite arch: Intraoral fulcrum established on the opposite arch from the treatment area
