Grasp & Fulcrum

Question 1

Handle:

Answer 1

used for holding the instrument

Question 2

Shank:

Answer 2

rod-shaped length of metal
located between the handle and
working-end of an instrument

Question 3

Working-End:

Answer 3

the part of the instrument
that does the work of the instrument

Question 4

Functional shank:

Answer 4

the part of the shank that allows the
working-end to be adapted to the tooth surface;
begins below the working-end and extends to the last
bend in the shank nearest the handle

Question 5

Terminal shank:

Answer 5

the portion of the functional shank
nearest to the working-end

Question 6

Shank Design
• Simple
(3)

Answer 6

• A shank that is bent in one plane (front-to-back)
• Simple shank=straight shank
• Used primarily on anterior teeth

Question 7

Shank Design
• Complex
(3)

Answer 7

• A shank that has been bent in two planes
(front-to-back and side-to-side)
• Complex shank=angled/curved shank
• Used on posterior teeth

Question 8

How to determine if
your shank is
simple or complex

Answer 8

• Hold the instrument so that the working-end
toe is facing you
• Instrument A, when viewed from the front
appears to be straight, therefore, simple shank
design
• Instrument B, when viewed from the front
appears to be bent from side-to-side, therefore
this instrument has a complex design

Question 9

The function of an instrument is
determined, primarily, by the
design of the

Answer 9

working-end.

Question 10

To determine an instrument’s use,
you must be able to recognize the
design characteristics of the (4)

Answer 10

face,
back, lateral surfaces, and cutting
edges of the working-end.

Question 11

The Modified
Pen Grasp
• Grasp for
• Allows
• Permits
• Facilitates

Answer 11

holding periodontal instruments
precise control of the working-end
a wide range of movement
good tactile conduction

Question 12

The Modified Pen
Grasp- continued

Answer 12

• Thumb and index finger hold the
instrument
• Middle finger stabilizes
• Ring finer used to fulcrum (hinge/pivot)
• Thumb is used to roll the instrument
• Fingers maintain contact and work
together to adapt the instrument
• Movement is in the wrist

Question 13

Finger Placement and Function
Digit (s): Index and Thumb
Placement:
Function:

Answer 13

On the instrument handle
Hold the instrument

Question 14

Finger Placement and Function
Digit (s): Middle Finger
Placement:
Function:

Answer 14

Rests lightly on the shank

Helps to guide the workingend
Feels vibrations transmitted
from the working-end to the
shank

Question 15

Finger Placement and Function
Digit (s): Ring Finger
Placement:
Function:

Answer 15

On oral structure; often a tooth surface
Stabilizes the hand for control and strength

Question 16

Finger Placement and Function
Digit (s): Pinky Finger
Placement:
Function:

Answer 16

Near ring finger, held in a natural, relaxed manner
Has no function in the grasp

Question 17

What is a
Fulcrum?

Answer 17

Stabilizing point for clinician’s
hand during instrumentation

Question 18

3 types of
fulcruming
techniques

Answer 18

Intraoral fulcrum*
Extraoral fulcrum
Advanced fulcrum

Question 19

INTRAORAL FULCRUM

Answer 19

• A stabilizing point inside the
patient’s mouth against a
tooth surface

Question 20

EXTRAORAL FULCRUM

Answer 20

• A stabilizing point outside
the patient’s mouth (e.g.,
against the patient’s chin or
cheek)

Question 21

What is the full meaning of probe?

Answer 21

• to search into and explore very
thoroughly

Question 22

Therefore, the — is the
MOST important instrument used for
assessing and diagnosing periodontitis

Answer 22

periodontal probe

Question 23

probe design

Answer 23

The periodontal probe is a slender, tapered, blunt instrument with
millimeter markings on it
Many different variations and design differences are noted among
different manufacturers

Question 24

Probing inaccuracy is related to (3)

Answer 24

probe design, pressure applied,
contour of the tooth, etc.

Question 25

Probing depth usually correlates to attachment loss, but it is
always an objective measure of the distance between the

Answer 25

base of
the pocket and the crest of the gingiva regardless of the degree
of attachment loss. Readings may change over time due to
changes in the position of the gingival margin

Question 26

Nabers
(furcation)
Probe

Answer 26

Used to evaluate the bone support in
the furcation areas of bifurcated and
trifurcated teeth

Question 27

How to use a Nabers Probe

Answer 27

• The correct working-end of the
probe is when the lower
(terminal) shank is positioned
parallel to the tooth surface
being examined.

Question 28

Nabers Probe- continued
• Do not need to read mm
markings when identifying

Answer 28

class
of furcation

Question 29

Probing=

Answer 29

act of walking the tip of a probe
along the junctional epithelium(JE) within
the sulcus or pocket for the purpose of
assessing the health status of the
periodontal tissues

Question 30

Walking stroke is the movement of a

Answer 30

calibrated probe around the perimeter of
the base of a sulcus/pocket.

Question 31

Essential to evaluate the entire “length” of
the pocket base because the

Answer 31

JE is not
necessarily at a uniform level around the
tooth.

Question 32

skipped
The Basics of
Probing

Answer 32

• Use modified pen grasp technique for holding
the probe
• Fulcrum close to the tooth you are probing
• Working-end of the probe should always
contact the tooth
• Probe should be parallel to the long axis of the
tooth around all proximal surfaces, except when
probing the interproximal spaces (due to the
gingival col)
• Place the probe below the gingival margin to the base
of the sulcus (10-15 grams of pressure)
• In health, the probe will stop at the junctional
epithelium
• In disease, the probe will go into the connective tissue
• Your probing depth will be calculated based on the
line you see at the gingival margin
• Keep the probe subgingival (below the gingiva), as
you move along the tooth
• “hop” along the circumference of the tooth
• Begin at the distal line angle and back into the distal
aspect of the tooth; move forward toward the mesial
• Your probing depth readings should be the deepest

Question 33

Probing measures
six sites per tooth

Answer 33

1. distofacial
2. facial
3. mesiofacial
4. distolingual
5. lingual
6. mesiolingual
   Note: only one reading per site is recorded; if probing depths vary within a sire, the deepest
   reading obtained in that site is recorded

Question 34

PD =

Answer 34

probing depth/ pocket
depth

Question 35

GM =

Answer 35

gingival margin (measuring
recession or overgrowth)

Question 36

ATTACH =

Answer 36

clinical attachment loss
(CAL)

Question 37

BOP =

Answer 37

bleeding on probing

Question 38

Pocket/Probing Depth (PD):

Answer 38

Base of pocket to gingival margin

Question 39

Attachment Level:

Answer 39

CEJ to base of pocket

Question 40

Recession:

Answer 40

CEJ to Gingival Margin (GM)

Question 41

If the measurement for the
gingival margin is (+),

Answer 41

recession is present

Question 42

If the measurement for the
gingival margin is (-),

Answer 42

the
gingival margin is coronal to
the CEJ- no recession