Ch. 37 Instruments And Principles For Instrumentation

Question 1

Assessment instruments

Removal instruments

Answer 1

Mirror, explorer, periodontal probe

Scaler (Supragingival, used before curet)
Curet (Subgingival)
Perio files

Question 2

3 major parts of a periodontal instrument

Answer 2

Handle, shank, working end

Lower/terminal shank-section to blade, part of functional shank

Question 3

Ergonomic handles are
? mm

Answer 3

10mm

Textured

Question 4

Working end of a scaler or curet is called a
(Not toe or tip)

Answer 4

Blade

Question 5

Parts of a blade

Answer 5

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)

Question 6

Working ends:

Single
Double ended paired and unpaired

Answer 6

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

Question 7

Fulcrum

Why is it essential

Answer 7

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

Question 8

Alternate finger rest

Answer 8

Substitute - missing or mobile teeth

Supplementary-finger on finger

Reinforced-additional strength and force for hard tenacious calc in pockets

Question 9

Adaption

Answer 9

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

Question 10

Angulation

Answer 10

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

Question 11

Scalers do not go

Answer 11

Subgingival

Question 12

Activation (stroke)

Answer 12

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

Question 13

Lateral pressure

Answer 13

Pressure of instrument applied against tooth surface during activation

Keep pressure of force and pressure of fulcrum equal (light) helps stabilize control

Question 14

Direction of strokes

Answer 14

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

Question 15

Scaling/calculus removal strokes

Answer 15

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

Question 16

Scalers

Answer 16

Used principally for removal of supragingival calculus

Slightly Subgingival only when tissue is spongy and flexible for easy insertion

Question 17

Scalers- blade

Answer 17

2 cutting edges

Triangular cross section with a v shaped back

Internal 70-80* angles when lateral surfaces meet at face

Question 18

Sickles

Answer 18

Scaler with curved blade

Face of blade is curved from lateral view

Question 19

Jacquettes

Answer 19

Straight bladed scaler

Question 20

Scaler specific instrumentation

Answer 20

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

Question 21

Curets
Use
Design
Necessary when

Answer 21

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

Question 22

Curet design

Answer 22

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

Question 23

Universal curets

Answer 23

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

Question 24

Universal curet cutting edge

Answer 24

2 per working end

Parallel and level with each other

Both cutting edges are used

Question 25

Area Specific Curet

Answer 25

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

Question 26

Area specific curet
How is face offset and cutting edge

Answer 26

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

Question 27

Curet specific instrumentation

Answer 27

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

Question 28

Periodontal Files

Answer 28

Used to crush and fracture heavy calc prior to curet use

Question 29

Document

Answer 29

Instruments avoided due to patient contraindications or discomfort (sensitive to ultrasonic scaler)
To remember not to use for the next appointment