Ch.38 Flashcards
Know the location and function of these instrument parts: Working end, Shank, Blade, Lower shank, and Handle
- Working end (the part used to carry out the purpose/ function)
- shank(For the shape of an instrument)
- Lower/ Terminal shank( For flexibility)
True/ False:
Handles with lighter weight enhance tactile sensitivity and increase fatigue.
FALSE
Handles with lighter weight enhance tactile sensitivity and LESSEN fatigue.
What is the purpose of having an instrument balance?
Provides ability for its adaptation, angulation, and activation(stroke).
what does it mean when the instrument has “instrument balance”?
The working end is centered in line with the long axis of the handle.
What is the process of scaling/ root debridement when it is broken down into its component parts:
1) Grasp (pen, modified pen, palm)
2) Fulcrum (intraoral, extraoral)
3) Insertion
4) Adaptation
5) Angulation
6) Lateral pressure
7) Stroke direction and length
What are instrument grasp functions?
- Stability
- Dominant hand
- Nondominant hand
How should the clinicians fulcrum and pressure be (unstable, heavy pressure, light pressure, stable, etc)?
- Stable, with moderate fulcrum pressure during the work stroke.
- Fulcrum should be placed near the tooth that is being scaled.
How is angulation formed on scalers and curets?
By the face of the cutting edge of the instrument with the surface to which the instrument is applied.
What is lateral pressure?
The pressure of the instrument against the tooth surface during activation. this would be described as light, moderate, or heavy pressure.
What is a stroke?
An unbroken movement made by an instrument; the action of an instrument in the performance of the task for which it was designed.
What are some types of stroke by action?
- PULL
- PlACEMENT
- COMBINED PUSH AND PULL
- WALKING STROKE
What is a PULL stroke characteristic?
-PULL: scaler removing calculus.
what is a PLACEMENT stroke characteristic?
-PlACEMENT: exploratory stroke when curet is being positioned.
What is a COMBINED PUSH AND PULL stroke characteristic?
-COMBINED PUSH AND PULL: explorer in a walking stroke(moving the instrument up and down with equal pressure on the surface.
What is a WALKING STROKE characteristic?
-WALKING STROKE: probe is moved up and down, gently touching coronal border of periodontal attachment with each down stroke.
What is an assessment stroke?
A stroke used to detect irregularities of the tooth surface( EX: calculus, carious lesions, or rough overhang margin.). An assessment stroke may also be called an exploratory stroke?
True/ False:
Stokes may be identified by the instrumentation being preformed(EX: probing stoke, scaling stoke, etc.)
TRUE
What are 4 different types of strokes by direction?
- Diagonal or Oblique
- Vertical
- Horizontal
- Curvilinear or Circular
What is a diagonal or oblique stroke?
A stoke that is diagonal across the surface being treated.
What is a vertical stoke?
Strokes that are parallel with the long axis of the tooth being treated.
What is a horizontal stroke?
Short strokes parallel with the occlusal surface of the tooth being treated.(May also be called Circumferential, strokes but SHOULD NOT go around the tooth or in large segments of a tooth due to the changing topography of the tooth surface.)
What is a curvilinear or circular stroke?
A stoke used with a handpiece. used with various pressure to apply polishing agent with rubber cup.
(polish amalgam restorations using stones, burs, rubber cups, or points)
How much pressure should be applied during an assessment stroke?
Light pressure
How much pressure should be applied during a scaling or a working stoke?
Definite, well-controlled, firm stoke of moderate to heavy pressure.
How much pressure should be applied during a root planing stroke?
Varying amount of pressure is applied.
How much pressure should be applied during a root debridement stroke?
Light pressure
What can occur if there is an insufficient or excessive amount of pressure during a stroke?
- Insufficient= burnished calculus and loss of control.
- Excessive= excess removal of tooth surface, loss of control, potential damage, patient discomfort, and clinician fatigue.
What are 5 factors that influence the selection of stroke?
- Size, contour, and position of gingiva.
- Surface and section of surface where the instrument is used.
- Probing depth
- Size and shape of instrument used
- Procedure objective(EX: nature of deposit to be removed)
True/ False:
The grasp of a scaler or curette is always held firmly.
FALSE
The grasp is light while the working end is being positioned for the stroke, then the instrument is held more firmly during the actual movement.
True/ False:
Hand stability during a stroke, the whole hand pivots or rotates on the fulcrum.
TRUE
True/ False:
The motion for a stroke is generated by a unified action of the shoulder, arm, wrist, and hand.
TRUE
True/ False:
The length of the scaling stroke is NOT limited by the extent of calculus deposit and or by the anatomic featured of the are where the deposit is located.
FALSE
What contributes to having adequate vision and accessibility?
- Pt and clinician positions
- Efficient use of direct or reflected illumination by mouth mirror for each tooth surface.
- Adequate, yet gentle, retraction of lips, cheeks, and tongue.
What are some effects of having adequate vision and accessibility?
- Thorough instrumentation
- Minimized trauma to oral tissue
- Reduced fatigue for pt. and clinician
- Increased pt. cooperation
Are curets supra or subgingival?
Subgingival
Are scalers supra or subgingival?
Supragingival
What is a type of curved scaler?
Sickle
What is a type of straight scaler?
- Jaquette
- File
- Hoe
- Chisel
What are the different types of curets?
- Universal
- Area specific
- Mini (and microminibladed)
What does the slender shank on a curet allow for?
Allows for entrance into the sulcus or pocket with minimal trauma to the gingival margin.
What does the curved blade with a rounded end on a curet allow for?
Permits access to the base of the sulcus or pocket.
What does a rounded back on a curet minimize?
It minimizes possible trauma at the base of the sulcus or pocket.
When using a curet which stroke type should be used?
Pull stroke, either vertical horizontal, or oblique. Cutting edge is prepared when instrument is sharpened for use at 70 degrees.
What is the anatomy on a curet blade?( 5 things it has)
- Face (inner surface)
- Lateral surface
- Back
- Toe
- Cutting edge
What can a universal curet be used for?
Supra and subgingival scaling and root planing in all areas of the mouth.
True/ False:
A universal curet has two cutting edges that end in a rounded toe.
TRUE
True/ False:
The face of a universal curet is at 60 degrees to the lower shank.
FALSE
it is at 90 degrees (perpendicular) to lower shank.
True/ False:
Each instrument in the collection of the area-specific curet is designed to scale multiple areas of the mouth.
FALSE
They are designed to scale specific areas of t he mouth.
True/ False:
The basic reason that Gracey instruments are ideal for instrumenting periodontitis affected teeth lied wit the relationship of the face of the blade to the lower shank.
TRUE
With the angulation of area-specific curets the blade is applied to the tooth so that the face forms what degree angle with the tooth surface to be treated?
70 degree angle
True/ False:
With area-specific curets the toe third of the cutting edge is maintained on the tooth surface at all times.
TRUE
What are the objectives of the area-specific miniblade and microminiblade curets?
- To facilitate access to the base of deep pockets.
- To conform to the curvatures of roots on multi-rooted teeth and single-rooted with moderate to severe loss of attachment.
True/ False:
The area-specific miniblade and microminiblade curets have an elongated terminal shank of 6mm in order to adapt in the deep pockets.
FALSE
They are elongated by 3mm
True/ False:
The total length of the shank from the blade to the handle of the area-specific curet (miniblade and microminiblade) is not changed.
TRUE
True/ False:
The area-specific curet (miniblade and microminiblade) blade is 1/2 as long as a traditional Gracey curet.
TRUE
What does the reduced length of the miniblade blade do?
Facilitates adaptation to the curved featured of root morphology including concavities, longitudinal depressions on proximal surfaces, root surfaces within furcations, and interradicular convexities.
What is the purpose of scalers?
To remove supragingival calculus.
What does the use of a scaler subgingivally cause?
Trauma to the gingival tissue.
(This is due to the large size, thickness, and length of the blade. the pointed tip and straight cutting edges can’t be adapted to the curved tooth surfaces so the risk of grooving or scratching the cemental surface is a lot greater.)
Does the straight scaler (Jaquette) have a tip or a toe?
A tip (The blade converges to a point where the two cutting edges meet at the tip.)
True/ False: The straight (Jaquette) scaler cross sections of the face have a 70-80 degree internal angle.
TRUE
When using a scaler what is the degree angle of the balde to the tooth surface?
70 degrees
Scalers use what kind of stroke?
Pull stroke
What can small scalers be useful for?
The removal of fine supragingival deposits directly under contact areas and between overlapping teeth.
True/ False:
File scalers may be metal or diamond?
TRUE
True/ False:
The file scaler has multiple cutting edges lined up as a series of multiple blades that are at a 90 degree angle with the shank.
TRUE
True/ False:
Files have reduced tactile sensitivity because of the series of blades.
TRUE
What is the purpose and use of a file scaler?
Removal of calculus
Burnished calculus that is impervious to removal with other bladed instruments can be removed with the file scaler.
True/ False:
The entire working surface of a file should be placed flat against the area to be treated.
TRUE
Always follow up with a curet to leave a smooth surface on the roots
File Hirschfeld 9/10 should be used for what surfaces?
Facial and Lingual surfaces of the anterior teeth.
what are files_______________ used for?
- Hirschfeld 3/7
- Hirschfeld 5/11
- Hirschfeld 10/11
- Hirschfeld 12/13
- F and L surfaces of posterior teeth.
- M and D surfaces of posterior teeth
- F and L surfaces of posterior teeth
- M and D surfaces of posterior teeth
What are the characteristics of a Hoe scaler?
- Single straigh cutting edge
- Blade = 99 degree angle to shank
- Cutting edge= beveled at 45 degree angle to end of blade.
- Shank= variously angled
What is the purpose and use of a Hoe scaler?
Removes supragingival calculus, particularly large accessible, tenacious pieces.
True/ Flase:
A Hoe scaler can cause unnecessary distention of the pocket wall and it is difficult to use without gouging the cemental surface.
TRUE
A How scaler 2 point contact with the tooth. What does 2 point contact mean?
Contact of the cutting edge and the side of the shank with the tooth.
What kind of stroke is used with a Hoe scaler?
Pull stroke is used in a coronal direction.
What are some characteristics of the chisel scaler?
- Single straight cutting edge
- Blade = continuous with slightly curved shank
- End of blade = flat and beveled with 45 degrees.
What is the purpose and use of a chisel scaler?
- Removal of supragingival calculus from exposed proximal surface of anterior teeth where interdental gingiva is missing.
- Dislodgement of heavy calculus from proximal areas of mandibular anterior teeth.
True/ False:
Application of the full width of the cutting edge of the chisel scaler is NOT necessary.
FALSE
(full width of cutting edge is necessary because sharp corners can nick and degroove the tooth surface. Be sure to round the corners during sharpening.)
