exam 2 Flashcards
what are the clinical endpoints of periodontal therapy?
bleeding on probing eliminated
probing depths reduced
attachment levels same or improved
inflammation is resolved
gingival appearance : reduced size normal color
subgingival microflora is lowered in numbers and there is a delay in repopulation
dental biofilm control record shows no improvement scores approaching 100% biofilm free
tooth surface is smooth no biofilm retentive irregularities
quality of life factors = oral comfort with freedom from pain
action created by the formation and collapse of bubbles in water by high frequency sound waves surrounding an ultra sonic tip
cavitation
face of a universal curet?
perpendicular (at a 90 degree angle to the lower shank)
these are used for subgingival scaling for removal of as much calculus as possible
universal curets
may have paired or complementary working ends. paired working ends are used for access to proximal surfaces from facial or lingual or palatial aspects
double ended instrument
What is an O ring for an ultra sonic scaler?
seals water to the hand piece
what are the characteristics of piezoelectric?
ceramic rod in the hand piece
activated by dimensional changed in quarts housed in hand piece
tip moves in linear pattern, forward and backward
omg lateral surfaces of the tip are active
adjustment at every line angle to maintain correct adaptation
25,000-50,000 cps
a curved, rounded dental instrument utilized for scaling, root planing, and gingival curettage
Curet
angulation and stroke of scaler?
the face of the blade is adapted to the tooth surface at approx 70 degree angle
pull stroke only
hollow handles are lighter and preferred to solid handles bc they have enhanced tactile sensitivity and lessen fatigue
weight
these are area specific curets which means that each curet is designed for adaptation to specific surfaces
graceys
what is the ideal instrument for comfort and best tactile sensitivity?
light weight, serrated, hollow handle with 3/8 or 5/16 inch diameter
a very fine line where two surfaces meet (example-the face and lateral surfaces meet to form the sharp cutting edge of a curet)
cutting edge
What is the treatment plan for a case type 3 or 4?
by quadrants with or without anesthesia at 1 week intervals
2 quads of the same side (right or left) may be completed in one appointment
examine quads previously treated for evidence of healing at each appt.
calculus left can be removed by remedial scaling procedures
at least 2 weeks after the scaling series, healing of the tissues is expected to be well under way. restoration of the clinical attachment permits probing.
these meet or are continuous (as in the rounded back of a curet) to form the back of the instrument
lateral surfaces
reduced length for special adaptation to root curvatures difffult to access
blade of area specific curets
how is the face on a curved / sickle scaler?
converged with the two lateral surfaces to form the tip of the scaler, which is a sharp point
internal angles of a curet?
70-80 degrees are formed where lateral surfaces meet the face
objective of area specific curet
to facilitate access to the base of deeper pockets
type of mechanical power driven scaler that functions from energy delivered by vibrating working tip in the frequency of 2,500-7,000 cps; driven by compressed air, the hand piece connects directly to a conventional rotary hand piece tubing
sonic scaler
the minimal pressure that is required of an instrument against the tooth to accomplish the objective of the assessment or treatment
lateral pressure
how is the back or under surface of a curet?
rounded
what are the 2 types of ultrasonic scalers?
magnetostrictive ultrasonic
piezo ultrasonic
purpose of scaler?
removal of supragingival calculus
using subgingival my can cause undue trauma to the gingival tissue and risk of scratching cemental surface
tactile sensitivity is decreased with larger heavier blades
what are the sharp parts of a blade?
cutting edge and lateral surfaces
ultrasonic scaling device activated by dimensional changes in crystals housed in the hand piece
piezoelectric
use of specific chemical or pharmaceutical agents for the control or destruction of microorganisms, either systemically or at specific sites
antimicrobial therapy
not responding to usually treatment
refractory
relationship between the working end of an instrument and the tooth surface being treated
adaptation
magnetostrictive inserts made of slat metal strips stacked, or sandwiched together. metal in stacks act like an antenna to pick up magnetic field and cause vibration
stack
instruments are made with shanks of varying degrees of thickness and rigidity that relate to the purpose for which they’re used. a heavier shank is stronger and able to withstand greater pressure without flexing. these are needed for heavy calculus removal.. less rigid more flexible shanks provide more tactile sensitivity and are used for more fine deposits
flexibility
Common posture for holding a dental instrument between thumb pads and index finger, with side of middle finger either supporting shank or placed lower on the handle. The fourth finger is used as a fulcrum (finger rest).
modified pen grasp
cross section of blade of a curet?
shaped like a half circle
how are the working ends on area specific curets?
paired mirror image, usually placed on a single handle. the original seven pairs are numbers 1-2, 3-4, 5-6, 7-8, 9-10, 11-12, 13-14
how is the shank for anterior teeth on curets?
shank, blade, and handle may be in a relatively flat plane for curets primarily adaptable to anterior teeth
curets with slender shank alllws entrance into the sulcus or pockets with minimal trauma to the gingival margin. the rounded back minimized possible trauma at the base of the pocket
design of curet
single ended instrument has how many working ends?
one
power driven scaling instrument that operates in a frequency range between 25,000 and 50,000 cps to convert a high frequency electrical current into mechanical vibrations
ultrasonic scaler
cutting edge of a universal curet?
continuous around the face; used on both sides and around the toe
what are the three brand names of local delivery antibiotic agents used for unresponsive areas during periodontal therapy?
Mini cyclone HCL (Arestin)
Doxycycline Polymer (Atridox)
Chlorhexadine Chip (Periochip)
paired instruments are mirror images of each other to provide access to the proximal surfaces of posterior teeth. one adapts from the facial and other from lingual and palatial aspects
modified or contra angle of scaler
this connects the working end with the handle.. shape and rigidity of the this determines access of the working end to accomplish the intended purpose for which the instrument is designed
shank
LPS complex found in the cell wall of many gram negative microorganisms. contained superficially within periodontal involved cementum
endotoxin
cutting edge of an area specific curet?
continuous around the face
follow for fine scaling and root planing
area specific curet
the support or point of test on which a lever turns in a moving body. this is always used when instruments are applied to the teeth and gingiva
fulcrum / finger rest
shank of area specific curets
terminal (lower shank) elongated by 3 mm to adapt in deeper pockets
when is a single appointment adequate?
case type 1 or 2
only a few teeth present
overall design
handle
objectives of a finger rest:
stability unit control prevention of injury comfort for patient control of length stroke
what are the characteristics of magnetostrictive ultrasonic scaler?
utilities stack of metal strips in the hand piece
vibrations in the tip creating a magnetic field
tips are moved in an elliptical pattern = all surfaces of tip are active
frequency 18,000-45,000 cycles per second
how are the cutting edges in curets?
curve around to meet at the toe
how are the working ends of a universal curet?
paired mirror image, usually placed on a single handle
the blade of an area specific gracey curet in which the lower shank is at a 60 degree angle to the face of the blade. contrars with a universal curet blade which is at a 90 degree angle with the lower shank
offset blade
face of an area specific curet?
offset (at an angle of approximately 70 degrees) in relation to the lower shank
the therapeutic washing of pocket and root surface to remove endotoxins and loose debris
lavage
how many cutting edges does a curved/sickle scaler have?
two cutting edges on a curved blade
use of dental mouth mirror to view the area of instrumentation. indirect lighting is provided by the mirror
indirect vision
ultrasonic scaling device that generates a magnetic field and produces tip vibrations by the expansion and contraction of a metal stack or rod
magnetostrictive
the blade forms a 70 degree angle within the tooth
angulation of curet
curet designed for use on any tooth surface where the adaptation, angulation and other principles of instrumentation can be correctly and effectively accomplished
universal curet
refers to that part used to carry out the purpose and function of the instrument. each is unique to the particular instrument. the blade is this
working end
this is essential for effective, controlled action of instrument
stability
what are the three major parts of an instrument?
working end
shank
handle
serrations- handles. at be smooth, rubbed or knurled. for control and comfort without muscle fatigue, a smooth handle is avoided
surface texture
what combination may non surgical therapy include?
removal of plaque, calculus, endotoxins, and other bacterial products.
root planing to remove residual calculus and create smoother surface
irrigation using an antimicrobial agent
sustained release antibiotic or antimicrobial agent particularly for refractory infections (ex: arrestin and chlorhexidine)
removal of iatrogenic biofilm retainers
concurrent dental therapeutic interventions
analysis and correction of occlusal caries
section of the shank is adjacent to the blade. it is sometimes elongated to give better access to deeper pockets (example- gracey after 5’s)
lower or terminal shank
what is the standard instrument for subgingival scaling and root planing?
curets
sequence of treatment instruments:
EXD 11/12 explorer ultra sonic scalers universal curet area specific curet
in cross section, how is a curved/sickle scaler?
triangular
angulation of shank for scaler
adaptable to primarily for anterior teeth, although may be used for scaling pre molars when the lols and cheeks permit retraction for correct angulation
what type of stroke is used for curets?
pull strike only. applied in vertical, horizontal, or oblique directions
four diameters of handles are available (3/8, 5/16, 1/4, and 3/16 inch).
diameter
adaptation and angulation of universal curet?
determine the side that is correct for the surface being treated
Deposit that has had the outermost layer removed so the surface is smooth; difficult to remove because the cutting
burnished calculus
straight shanks are for unrestricted areas, while angles are for more restricted areas
shape of shank
instrument designed for initial removal of calculus prior to finishing with a curet
scaler
after ultrasonic cleaning to complete the procedure as needed. removal of supragingival calculus close to the gingival margin
curet
how many blades does a curet have?
one or two cutting edges on a curved blade
how is the shank on posterior teeth?
the shank is contra angled for access to proximal surfaces (curvey)
describe the face of a curet.
flat in cross section
toe third or lower third of the cutting edge is maintained on the tooth surface at all times
adaptation of curet
characteristics of a straight / jacquette scaler
two cutting edges on a straight blade, face is flat
specialized instrument designed with specific angles in the shank for adaptation to a certain group of tooth surfaces
area specific curets
separable from the shank and working end. they permit instrument enhances and replacements
cone socket
