grasp, fulcrum, periodontal instruments, and periodontal probing Flashcards
thumb and index finger:
middle finger:
ring finger:
thumb and index finger: hold the instrument
middle finger: stabilizes
ring finger: used to fulcrum (hinge/pivot)
movement is in the
wrist
index and thumb
placement:
function:
placement: on the instrument handle
function: hold the instrument
middle finger
placement:
function:
placement: rests lightly on the shank
function: helps to guide the working-end
feelings vibrations transmitted from the working-end to the shank
ring finger
placement:
function:
placement: on oral structure; often tooth
function: stabilizes the hand for control and strength
pinky finger
placement:
function:
placement: near ring finger, held in a natural, relaxed manner
function: has no function in grasp
stabilizing point for clinician’s hand during instrumentation
fulcrum
3 types of fulcruming techniques
intraoral fulcrum (best)
extraoral fulcrum
advanced fulcrum (non-dominant hand)
a stabilizing point inside the patient’s mouth against a tooth surface
intraoral fulcrum
(palm up or down fulcrums)
a stabilizing point outside the patient’s mouth (against patient’s chin or cheek)
extraoral fulcrum
used for holding the instrument
handle
rod-shaped length of metal located between the handle and working-end of an instrument
shank
the part of the instrument that does the work of the instrument
working-end
part of the shank that allows the working-end to be adapted to the tooth surface; begins below below working-end and extends to the last bend in the shank nearest the handle
functional shank
the portion of the functional shank nearest to the working-end
terminal shank
a shank that is bent in one plane (front-to-back)
simple shank design
a simple shank=____ shank
straight shank
simple shanks are used primarily used on what teeth
anterior teeth
a shank that has been bent in two planes
complex shank
complex shank =____shank
angled/curved shank
complex shanks are used primarily on what teeth
posterior teeth
when viewed from the front and the shank appears straight, what shank is this
simple
when viewed from the front appears to be bent from side-to-side, what shank is this
complex
the function of an instrument is determined by
the design of the working end
to determine an instrument’s use, you must be able to recognize
the design characteristics of the face, back, lateral surfaces, and cutting edges of the working-end
2 main types of periodontal hand instruments
sickle scalers
curettes
this scaler has triangular cross-section of the blade
sickle scalers
sickle scalers do what gingival scaling
supragingival scaling
how many cutting edges does the sickle scalers have
2
this scaler has rounded cross-section of the blade
curettes
what gingival scaling does curettes do
supragingival and subgingival
for this type of scaler, it has universal and area-specific instruments available
curettes
how many cutting edges do curettes have
2 cutting edges for universal
i cutting edge for area-specific
what are the angulations of
1. sickle scalers:
2. universal curettes:
area-specific curettes:
- sickle scalers: 90 degrees
- universal curettes: 90 degrees
area-specific curettes: 70 degrees
important for maintaining contact of working-end and tooth structure during instrumentation.
incorrect use of this results in ineffective calculus removal and tissue laceration
adaptation
important for efficient plaque and calculus removal
wrist, hand, and forearm work as a unit; fingers pulling is not effective and cause operator fatigue
activation
components of activation
- blade adaptation
- instrument angulation
3.blade insertion - lateral pressure
- working stroke
refers to the angle between the face of a bladed instrument and the tooth surface
(always tilt towards the tooth)
angulation
to search into and explore very thoroughly
:
also the most important instrument used for assessing and diagnosing periodontitis
probe
9 examples what a probe is used to measure
- probing depth
- clinical attachment level
- amount of attached gingiva
- gingival recession
- furcation involvement
- bleeding on probing
- size of pathologic lesion
- distance between teeth
- overbite/overjet
used to evaluate the bone support in the furcation areas of bifurcated and trifurcated teeth
nabers (furcation probe)
how to use nabers probe
when lower (terminal) shank is positioned parallel to the tooth surface being examined
and
DO NOT read mm when identifying class of furcation
act of walking the tip of probe along junctional epithelium (JE) within sulcus or pocket for the purpose of assessing health status of periodontal tissue
probing
use what technique for holding probe
modified pen grasp
-fulcrum close to the tooth you are probing
-working end of probe should always contact the tooth
probe should always be parallel to the long axis of the tooth around all proximal surfaces, except when probing
interproximal spaces (due to gingival col)
in health, probe will stop at:
in disease:
health: junctional epithelium
disease: go into connective tissue
as you move along the tooth, keep the probe _____ as you move along the tooth
subgingival (below the gingiva)
how to “hop” along circumference of tooth:
- begin at distal line angle and back into distal aspect
- move forward toward the mesial
- probing depth readings should be at deepest
probing measures six sites per tooth
- distofacial
- facial
- mesiofacial
- distolingual
- lingual
- mesiolingual
PD
GM
ATTACH(CAL)
BOP
PD= probing depth/pocket depth
GM= gingival margin (measuring recession or overgrowth)
ATTACH(CAL)= clinical attachment loss
BOP= bleeding on probing
base of pocket to gingival margin
pocket/probing depth PD
CEJ to base of pocket
attachment level
CEJ to gingival margin (GM)
recession
(CAL) if the measurement for the gingival margin is (+) then
recession is present
(CAL)if the measurement for the gingival margin (-) the gingival margin is
coronal to the CEJ, no recession
[go on the slide and practice math problems]
