Ch. 37 Instruments And Principles For Instrumentation Flashcards
Assessment instruments
Removal instruments
Mirror, explorer, periodontal probe
Scaler (Supragingival, used before curet)
Curet (Subgingival)
Perio files
3 major parts of a periodontal instrument
Handle, shank, working end
Lower/terminal shank-section to blade, part of functional shank
Ergonomic handles are
? mm
10mm
Textured
Working end of a scaler or curet is called a
(Not toe or tip)
Blade
Parts of a blade
Face-inner surface of the blade opposite of back
Back-outer surface of blade opp of face
Lateral surface-sides of blade that converge to form the back of instrument
Cutting edge- where the face and the lateral surface meet
(sharp line or edge of a scaler or curet)
Working ends:
Single
Double ended paired and unpaired
Single ended-working end attached to only one side of instrument (mirror)
Double ended, unpaired-
2 working ends but differ in design and function
Double ended- paired-
Attached to both ends and mirror images of each other
(1 end facial buccal and 1 end lingual palatial of same tooth)
Universal
Fulcrum
Why is it essential
Support or point of rest on which a lever turns or pivots
-Stability
-Control of unit and stroke
-Prevention of injury-prevents irregular pressure and uncontrolled movement that may cause injury
-Patient comfort and confidence
Alternate finger rest
Substitute - missing or mobile teeth
Supplementary-finger on finger
Reinforced-additional strength and force for hard tenacious calc in pockets
Adaption
Blade divided into thirds
Heel, middle, toe
Side of Toe third always adapted to tooth
2-3mm of toe of curet on flat surface, 2mm at line angle
All line angles treasure instrument to be rolled to adapt toe third to tooth surface
Angulation
Angle formed between working end and tooth surface
Curet starts at 0 degrees angulation, faced closed when inserting into pocket
Scalers and curet face of blade opened to 70-80 degrees
Scalers do not go
Subgingival
Activation (stroke)
Stroke is unbroken movement made by instrument
Action of instrument in performance of task for which it is designed
Ex: probing or walking
Exploratory or assessment
Scaling or calculus removal
Root debridement
Lateral pressure
Pressure of instrument applied against tooth surface during activation
Keep pressure of force and pressure of fulcrum equal (light) helps stabilize control
Direction of strokes
Vertical-parallel to long axis of tooth
Horizontal-parallel to occlusal surface of tooth
*line angles of posterior, midline’s of anteriors
Oblique-diagonal to long axis of tooth
Scaling/calculus removal strokes
Short, well controlled and firm PULL-stroke, never push!
Movement away from sulcus or pocket
Firm grasp, mod to heavy pressure and movement of blade in v, h, and o directions while adapted
Pressure increases when transition from assessment (light) to removal to remain stable and controlled
Scalers
Used principally for removal of supragingival calculus
Slightly Subgingival only when tissue is spongy and flexible for easy insertion
Scalers- blade
2 cutting edges
Triangular cross section with a v shaped back
Internal 70-80* angles when lateral surfaces meet at face
Sickles
Scaler with curved blade
Face of blade is curved from lateral view
Jacquettes
Straight bladed scaler
Scaler specific instrumentation
Adaption- Tip third always adapted to tooth
For line angles, only 1-2 mm is used
Angulation- face of blade is adapted to surface at 70*
Activation-both light assessment strokes (light plaque) and heavy calculus removal strokes may be performed
Curets
Use
Design
Necessary when
Used for Supra and sub gingival removal and biofilm
Rounded back does not traumatize GM or base of sulcus/pocket when inserted
Necessary after power scaling to remove residual deposits or fine scale to complete debridement
Curet design
Blade=2 cutting edges on curved blade
Faces converge with 2 lateral surfaces to form rounded toe
Semicircular cross section with rounded back
Internal 70-80* angles
Universal curets
Adapted for Supra and sub use on any tooth surface
Removes large deposits quickly
Working ends are paired, mirrored on double ended instrument
Face is perpendicular (90 angle) to lower shank
Cutting edges, 2 per working end
Universal curet cutting edge
2 per working end
Parallel and level with each other
Both cutting edges are used
Area Specific Curet
Adaptation to specific surfaces
*larger shanks for deeper pockets
Ideal for fine scaling and root debridement
Working ends-paired mirror image on double ended instrument
1/2, 5/6, 11/12, 13/14 gracey
Area specific curet
How is face offset and cutting edge
Face is offset @ 70* in relation to lower shank
Creates offset blade
Cutting edge=one working lower cutting edge per working end
-working cutting edge is lower when handle held vertically
-only one used, only sharpened on one side (lower) and around toe
Curet specific instrumentation
Adaptation- toe third always on tooth surface
For line angles terminal 1-2 mm may be used
-universal=either cutting edge
-area specific=lower cutting edge
Angulation-face of blade adapted at various depending on action
-Supra 70*
-curet is inserted sub, blade closed 0* and then opened to remove deposits 70*
Activiation- light assessment strokes, mod root debridement and heavy calc may be preformed
Periodontal Files
Used to crush and fracture heavy calc prior to curet use
Document
Instruments avoided due to patient contraindications or discomfort (sensitive to ultrasonic scaler)
To remember not to use for the next appointment
