Dental Calculus and Ultrasonics

Question 1

What initiates periodontal disease?

Answer 1

Plaque initiates the immune response

Question 2

What is the aim of periodontal treatment?

Answer 2

To reduce pathogens in the subgingival biofilm to a level which is conducting to healing

Question 3

What is calculus?

Answer 3

inert deposit found on root surfaces when plaque gets calcified

Question 4

Where do you normally find calculus?

Answer 4

lingual aspects of teeth and around upper 6s

Question 5

Why do you commonly find calculus on lingual aspects of teeth and around upper 6s?

Answer 5

sublingual and parotid glands constantly secreting saliva

Question 6

What is another form of calculus in the oral cavity?

Answer 6

tonsils tones

Question 7

In what instance is calculus not a problem?

Answer 7

If the patient isnt susceptible to periodontal disease OR has no LOA

Question 8

What makes calculus a plaque retentive factor?

Answer 8

It creates a rough surface for more plaque to stick to

Question 9

Where do you find supragingival calculus?

Answer 9

above the gum

Question 10

What colour is supra gingival calculus?

Answer 10

yellow - brown

Question 11

Where do you commonly find supra gingival calculus?

Answer 11

opposite openings of salivary ducts (lingual lower incisors, buccal upper molars)

Question 12

What are the characteristics of supra gingival plaque?

Answer 12

Fairly hard and brittle
Matt
Looks like demineralised enamel

Question 13

What type of calculus is found above the gum?

Answer 13

supra gingival

Question 14

What type of calculus is yellow/ brown in colour?

Answer 14

Supra gingival

Question 15

How do you detect supragingival calculus?

Answer 15

drying teeth with 3in1

Question 16

Where is subgingival calculus?

Answer 16

below gum

Question 17

What type of calculus is found below gum?

Answer 17

subgingival

Question 18

what colour is subgingival calculus?

Answer 18

dark green - black

Question 19

what type of calculus is dark green - black in colour?

Answer 19

subgingival

Question 20

where do you commonly find subgingival calculus?

Answer 20

attached to root surfaces, within periodontal pockets throughout the mouth

Question 21

what are the characteristics of subgingival calculus?

Answer 21

very hard

Question 22

why is subgingival calculus dark green- black in colour?

Answer 22

chromogenic bacteria and metabolism of blood-based products

Question 23

How may you detect subgingival calculus?

Answer 23

gently blowing with 3in1
cross calculus probe on root surfaces
CP12

Question 24

When may you see subgingival calculus on a radiograph?

Answer 24

if its calcified enough

Question 25

What is grey-tinges gingival between incisors a sign of?

Answer 25

subgingival calculus

Question 26

What is a cross calculus probe used for?

Answer 26

detecting calculus

Question 27

What does a cross calculus probe look like?

Answer 27

double ended

Question 28

When using a cross calculus probe where should the lower shank be?

Answer 28

parallel to the long axis of the tooth

Question 29

When placing a cross calculus probe in the pocket where should hook side be facing?

Answer 29

facing the tooth

Question 30

What are the 5 things you must consider when choosing when to hand or power scale?

Answer 30

1. the patient 2. the deposit 3. the site 4. the skill 5. time

Question 31

Why must surfaces be checked by hand after using a power scaler?

Answer 31

its hard to detect residual deposits on toots while using power scaler

Question 32

Where can a power scaler be used?

Answer 32

supra and sub gingivally

Question 33

What does the water spray in a power scaler provide?

Answer 33

constant lavage and irrigation

Question 34

What are the 2 types of power scalers?

Answer 34

ultrasonic and sonic

Question 35

What generates an ultrasonic power scaler?

Answer 35

piezo-electricity OR magnetostricition

Question 36

what generates a sonic scaler?

Answer 36

passage of compressed air

Question 37

What frequency does the working tip of sonic scaler work at?

Answer 37

6-8kHz

Question 38

What movement is the tip of a sonic scaler?

Answer 38

elliptical to almost circular

Question 39

what are micro-mega, titan, kavo examples of?

Answer 39

sonic scalers

Question 40

what frequency does the working tip of an ultrasonic scaler oscillate at?

Answer 40

25-42kHz

Question 41

What are the 2 types of ultrasonic scalers?

Answer 41

piezo-electric and magnetostrictive

Question 42

What odes the piezo-electric scaler incorporate?

Answer 42

a crystal of piezo-electric material

Question 43

When do vibrations of the magnetostrictive scaler not work?

Answer 43

if held too hard

Question 44

What is the general mechanism of power scalers?

Answer 44

mechanically remove deposits via oscillation/ vibration of tip

Question 45

What are the 2 effects of power scaling?

Answer 45

cavitation and acoustic microstreaming

Question 46

what is cavitation?

Answer 46

knocks calculus off and kills anaerobic bacteria with bubbles of energy growing and imploding

Question 47

if cavitation doesnt occur what does it inhibit?

Answer 47

acoustic microstreaming

Question 48

what is acoustic microstreaming?

Answer 48

movement of fluid adjacent to the vibrating tip and generates stresses within intermediate area which damages bacterial cell wall

Question 49

What is the overall effect of cavitation and acoustic microstreaming on bacteria?

Answer 49

affect the permeability of bacterial cell membrane

Question 50

What type of patients cant you use power scalers on?

Answer 50

- patients with hearing aid - patients with indwelling cardiac device/ implant/ cochlear implant - patients with TB, throat, and respiratory infections - patients who cant tolerate high volume aspiration

Question 51

what do power scalers emit?

Answer 51

electromagnetic radiation

Question 52

what device can electromagnetic radiation interfere with?

Answer 52

cardiac pacemakers

Question 53

at what distance can electromagnetic radiation effect cardiac pacemakers?

Answer 53

1 metre

Question 54

what rate of coolant is needed with power scalers?

Answer 54

20ml/ minute

Question 55

what type of scalers do implants require?

Answer 55

carbon and plastic cover tips

Question 56

Where does the most damage come from on a power scaler?

Answer 56

the tip