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Patient Care III > Grasp, Fulcrum, Periodontal Instruments, & Periodontal Probing > Flashcards

Grasp, Fulcrum, Periodontal Instruments, & Periodontal Probing Flashcards

1
Q

What is the modified pen grasp?

A
  • Grasp for holding periodontal instruments
  • Allows precise control of the working-end
  • Permits a wide range of movement
  • Facilitates good tactile conduction
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2
Q

How do you do the modified pen grasp?

A
  • 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
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3
Q

Where is the index and thumb for the modified pen grasp?

A

on the instrument handle

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4
Q

Where is the middle finger for the modified pen grasp?

A

rests lightly on the shank

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5
Q

Where is the ring finger for the modified pen grasp?

A

on oral structure; often a tooth surface

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6
Q

Where is the pinky for the modified pen grasp?

A

near ring finger, held in a relaxed manner

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7
Q

What is the function of the index and thumb for the modified pen grasp?

A

holds the instrument

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8
Q

What is the function of the middle finger for the modified pen grasp?

A
  • helps to guide the working-end
  • feels vibrations transmitted from the working-end to the shank
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9
Q

What is the function of the ring finger for the modified pen grasp?

A

stablilizes the hand for control and strength

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10
Q

What is the function of the pinky finger for the modified pen grasp?

A

no function

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11
Q

What is a fulcrum?

A

Stabilizing point for clinician’s hand during instrumentation

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12
Q

What are the 3 types of fulcrums?

A

Intraoral fulcrum
Extraoral fulcrum
Advanced fulcrum

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13
Q

What type of fulcrum provides best stability for the clinician’s hand?

A

Intraoral fulcrum

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14
Q

What does the intraoral fulcrum allow?

A
  • provide best stability for the clinician’s hand
  • decreases the likelihood of injury to the patient or clinician
  • provides the best leverage and strength during instrumentation
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15
Q

What is an intraoral fulcrum?

A
  • A stabilizing point inside the patient’s mouth against a tooth surface
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16
Q

What is an extraoral fulcrum?

A
  • A stabilizing point outside the patient’s mouth (e.g., against the patient’s chin or cheek)
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17
Q

What is the handle of the instrument?

A

used for holding the instrument

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18
Q

What is the shank of the instrument?

A

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

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19
Q

What is the working-end of the instrument?

A

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

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20
Q
A
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21
Q

What is the functional shank?

A

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

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22
Q

What is the terminal shank?

A

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

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23
Q

What is a simple shank?

A
  • A shank that is bent in one plane (front-to-back)
  • Simple shank=straight shank
  • Used primarily on anterior teeth
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24
Q

What type of shank is primarily used on anterior teeth?

A

simple

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25
Q

What is a complex shank?

A
  • 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
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26
Q

What type of shank is primarily used on posterior teeth?

A

complex shank

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27
Q

How do you determine if the shank is simple or complex?

A
  • 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

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28
Q

What type of shank is this?

A

simple

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29
Q

What type of shank is this?

A

complex

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30
Q

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

A

working-end

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31
Q

What are the 2 main types of periodontal hand instruments?

A

Sickle Scalers
Curettes

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32
Q

What does a sickle scaler look like?

A

Triangular cross-section of the blade

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33
Q

What type of scaling do you do with a sickle scaler?

A

Supragingival scaling

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34
Q

How many cutting-edges does a sickle scaler have?

A

2 cutting edges

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35
Q

What is the shape of a curette?

A

Rounded cross-section of the blade

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36
Q

What type of curette instruments are there?

A

Universal and area-specific instruments

36
Q

What type of scaling do you do with a curette?

A

supra- and subgingival scaling

37
Q

How many cutting edges does a universal curette have?

A

2 cutting edges

38
Q

How many cutting edges does a area-specific curette have?

A

1 cutting edge

39
Q

What are these areas of a instrument?

A
40
Q
A

sickle scaler

41
Q
A

universal curet

42
Q
A

area-specific curet

43
Q

What is the end of the sickle scaler?

A

pointed toe

44
Q

What is the end of universal and area-specific curettes?

A

rounded toe

45
Q

What is the angulation of a sickle scaler?

A

90 degrees

46
Q

What is the angulation of a universal curette?

A

90 degrees

47
Q

What is the angulation of an area-specific curette?

A

70 degrees

48
Q

Is the blade straight or curved on sickle scalers?

A

straight

49
Q

Is the blade straight or curved on universal curettes?

A

straight

50
Q

Is the blade straight or curved on area-specific curettes?

A

blade curved away from cutting-edge

51
Q

Why is adaptation important?

A
  • Important for maintaining contact of working-end and tooth structure during instrumentation
  • Incorrect adaptation results in ineffective calculus removal and tissue laceration
52
Q

Why is activation important?

A
  • Important for efficient plaque and calculus removal
  • Wrist, hand, and forearm work as a unit; finger pulling is not effective and causes operator fatigue
53
Q

What are the components of activation?

A
  • Blade adaptation
  • Instrument angulation
  • Blade insertion
  • Lateral pressure
  • Working stroke
54
Q

What is angulation?

A

Refers to the angle between the face of a bladed instrument and the tooth surface

55
Q

What is the meaning of probe?

A

to search into and explore very thoroughly

56
Q

What is a probe used to measure?

A
  • Probing depth
  • Clinical attachment level
  • Amount of attached gingiva
  • Gingival recession
  • Furcation involvement
  • Bleeding on probing
  • Size of pathologic lesions
  • Distance between teeth
  • Overbite/overjet
57
Q

What is the shape of a perio probe?

A

The periodontal probe is a slender, tapered, blunt instrument with millimeter markings on it

58
Q

How does probing inaccuracy occur?

A

Probing inaccuracy is related to probe design, pressure applied,
contour of the tooth, etc.

59
Q

Probing depth usually correlates to…

A

attachment loss

60
Q

What is a probing depth?

A

an objective measure of the distance between the base of the pocket and the crest of the gingiva regardless of the degree of attachment loss

60
Q

What is a nabers (furcation) probe used for?

A

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

61
Q

How do you use a nabers probe?

A

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

62
Q

What is probing of a tooth?

A

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

63
Q

What is a walking stroke?

A

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

64
Q

Why is it essential to evaluate the entire “length” of the pocket base?

A

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

65
Q

What direction should the probe face?

A

Probe should be parallel to the long axis of the tooth around all proximal surfaces, except when probing the interproximal spaces

66
Q

How much pressure should you use when probing?

A

10-15 grams of pressure

67
Q

Where will the probe stop in health?

A

junctional epithelium

68
Q

Where will the probe stop in health?

A

probe will go into the connective tissue

69
Q

Keep the probe _________ as you move along the tooth

A

subgingival

70
Q

How should you probe a tooth?

A

Begin at the distal line angle and back into the distal aspect of the tooth; move forward toward the mesial

71
Q

Probing measures six sites per tooth. These are…

A
  1. distofacial
  2. facial
  3. mesiofacial
  4. distolingual
  5. lingual
  6. mesiolingual
72
Q

only one reading per site is recorded; if probing depths vary within a sire, the _______ reading obtained in that site is recorded

A

deepest

73
Q

What is the pocket/probing depth?

A

Base of pocket to gingival margin

74
Q

What is the attachment level?

A

CEJ to base of pocket

75
Q

What is recession?

A

CEJ to Gingival Margin (GM)

76
Q

What is the PD, GM (recession), and attachment loss for this tooth?

A

PD - 2 mm
GM - 3 mm
Attachment loss - 5 mm

77
Q

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

A

recession is present

78
Q

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

A

the gingival margin is coronal to the CEJ- no recession

79
Q

What is the PD, GM (recession), and attachment loss for this tooth?

A

PD - 5 mm
GM - -3 mm
Attachment Loss - 2 mm

80
Q

What is the equation for clinical attachment loss (CAL)?

A

PD + GM = CAL

probing depth + gingival margin

81
Q

What is the PD, GM (recession), and attachment loss for this tooth?

A

PD - 5 mm
GM - 0
Attachment loss - 5 mm

82
Q

What is the PD, GM (recession), and attachment loss for this tooth?

A

PD - 2 mm
GM - 3 mm
Attachment loss - 5mm

83
Q

PD = 3
GM = (-3)
CAL = 0

Does this tooth have periodontitis?

A

No

84
Q

PD = 5
GM = (-3)
CAL = 2

Does this tooth have periodontitis?

A

Early periodontitis

85
Q

PD = 4
GM = (-1)
CAL = 3

Does this tooth have periodontitis?

A

Yes
Progression of periodontitis

86
Q

PD = 5
GM = +2
CAL = 7

A

Does this tooth have periodontitis?
Yes

Patient Care III (8 decks)

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