Exam 3 Power Scaling Flashcards
What are powered instruments:
Instrument with a rapidly vibrating tip used to __ ___ and ___ ___ ____ from tooth and root surfaces, and to __ out bacteria from beneath the gingival margin
dislodge calculus
disrupt plaque biofilm
flush
What are the benefits of power scaling?
- Effective calculus and biofilm removal
- Pocket penetration/accessing furcations
- Irrigation (lavage)- healing
- Shorter instrumentation time- fatigue
- Restoration recontour/cement removal
- No sharpening- no cutting edge
2 types of powered instrumentation: ____ & _____
Classified based on ____
Sonic and Ultrasonic
operating frequencies
- Operates at a low frequency of 3,000-8,000 cycles/second.
- Driven by compressed air from the dental unit.
Sonic
- Operate inaudibly at a frequency of 18,000-50,000 cycles/second
- Driven by electrical current
Ultrasonic
2 SUBTYPES OF ULTRASONIC
Piezoelectric
Magnetostrictive
Electrical energy activates ceramic crystals or rings within the handpiece to make the tip vibrate
Piezoelectric
Electronic energy is transferred to metal stacks or rods or to make the tip vibrate.
Magnetostrictive
Is the power box of a powered unit
- Non-critical
- Semi critical
- Critical
Non critical
Is the handpiece of a powered unit
- Non-Critical
- Semi critical
- Critical
Semi Critical
Is the handpiece TIP
- Non critical
- Semi critical
- Critical
Critical
Do you need to sterilize the handpeice for cavitron and peizo after evey use
every use
Scaler Tip Motion:
Magnetostrictive
Orbital tip motion
Scaler Tip Motion:
Piezoelectric
Linear tip motion
3 Modes of Action (How it Works)
- Mechanical Removal
- Water Irrigation
- Cavitation
Water Irrigation:
Rapid vibrations of tip against tooth causes ___ ____- water stream cools tip
frictional heat
Water stream within the pocket washes
away toxins, blood and bacteria within the pocket
Lavage
Tiny bubbles formed by water
stream. Bubbles collapse, which produces
shock waves that may alter or destroy bacterial
cell walls.
Cavitation
How many times the tip vibrates per second (kHz)
Frequency
Which unit ??
- 25,000-50,000
- 25,000- 42,000 kHz.
- 1500-8000 kHz
- Piezoelectric units frequency
- Magnetostrictive units frequency
- Sonic units frequency
How far the instrument tip moves back and forth during one cycle. (length of stroke)
Amplitude
shorter distance = lower power
Lower Amplitude
higher distance = higher power
Higher amplitude
Controlled through power knob on unit. Always use lowest effective power setting. Low for soft deposit removal and medium for hard deposit removal.
Amplitude
more forceful stroke =
patient discomfort. (pain)
Higher power
less forceful stroke = patient discomfort. (more comfortable for patient)
Lower power
less water going through tip
warmer water
Use __ water for calculus removal and ___ water for deplaquing
more
less
Calculus removal halo
de-plaquing drip
Light to moderate calculus
Improved for subgingival access due to 30% thinner than powerlines
Slimeline 10 and 1000 (triple bend)
Cavitron ultrasonic insert
use pictures
Moderate to heavy calculus
Thicker inserts with larger tips, specifically designed for efficient removal of heavier deposits
Powerline 10
Cavitron ultrasonic insert
All surfaces of the working end of the insert disperses energy ______
vibrations
______- Less vibrations than face or point; OK to adapt to tooth/root.
Lateral surfaces/sides
For removing supragingival medium to heavy deposits in all quadrants
G1
For removing supra- and subgingival medium to heavy deposits in all quadrants (burnished calclulus)
P10
For removing light calculus and plaque biofilm in deep periodontal pockets and supra in all quadrants
P20
Working end of piezoelectric tips:
only the ____ surfaces/sides of the working end are active
lateral
higher frequency active tip will have a shorter or longer active tip area. You should adapt __mm to the tip to the tooth surface
shorter
2-3mm
1mm of tip wear = ___ decrease in efficiency
25%
2mm of wear= ___ % decrease in efficiency
50%
Contaminated Aerosols. Protect yourself and your ___
environment
We need to wear a level ___ mask when working with aerosols
level 3
use the ___ evacuation whenever possible and __ ____ rinse
HVE
Pre-procedural rinse
Contraindications and Precautions for Use
- Communicable diseases- Aerosol production allows for dissemination of bacterial and viral infections; Hepatitis, TB, respiratory infections.
- High susceptibility to infection- Immunosuppressed patient due to disease or chemotherapy, uncontrolled diabetics, patients with organ transplants or chronic, debilitating medical conditions.
- Respiratory risk- Emphysema, cystic fibrosis, asthma, cardiac disease with secondary pulmonary disease, pneumonia, breathing problems.
- Unshielded cardiac pacemaker- Piezoelectric ok- only concern with magnetostrictive; may need physician consult to verify type of pacemaker present.
- Dysphagia (difficulty swallowing) or prone to gagging- MS; ALS; Muscular dystrophy, paralysis
- Age- Primary teeth and newly erupted teeth have large pulp chambers- more susceptible to damage from vibrations and heat.
Oral conditions- hypersensitive teeth; demineralized enamel surfaces, exposed dentin
-Restorations- Veneers, cast crowns, composite restorations- avoid these localized areas; place ultrasonic tip adjacent or apical to restoration- use dental chart and radiographs for guidance.
Lateral pressure is __ like a exploere
light
Adaptation is
Angulation is
last 2-3 mm of lateral side
0 degree angel formed when the face of the instrument is against the tooth surface-pivot on fulcrum
For removal of light calculus and biofilm disruption, insert like the ___
probe
for removal of moderate/heavy calculus is the same as _____
explorer/curet style.
What term describes the use of vertical, oblique, and vertical strokes during instrumentation?
Multi direcetional
Disadvantages
Less tactile sensitivity Water control evacuation needed Production of aerosols Medical contraindications Potential occupation hazard (noise/vibration)
