Grasp, Fulcrum, Periodontal instruments & probing Flashcards
Grasp for holding periodontal instruments, that allows precise control of the working-end, permits a wide range of movement & facilitates good tactile conduction:
The modified pen grasp
This image shows:
Modified pen grasp
In the modified pen grasp, ____ & _____ hold the instrument
thumb & index finger
In the modified pen grasp, the ____ stabilizes
middle finger
In the modified pen grasp, the _____ is used to fulcrum (hinge/pivot)
Ring finger
In the modified pen grasp, the ____ is used to roll the instrument
thumb
In the modified pen grasp, fingers maintain contact & work together to:
adapt the instrument
Where does movement come from in the modified pen grasp?
The wrist
Placement on the instrument, functioning to hold the instrument:
index & thumb
Placement rests slightly on the shank, functions to help guide the working end & feels vibrations transmitted from the working-end to the shank:
middle finger
Placement is on oral structure (often a tooth surface), and functions to stabilize the hand for control and strength:
ring finger
Placement near ring finger, held in a natural, relaxed manner and has no function in the grasp:
pinky finger
stabilizing point for clinician’s hand during instrumentation:
fulcrum
The three types of fulcruming techniques include:
- intraoral
- extraoral
- advanced
_______ fulcrums provide the best stability for the clinician’s hand, decreases the likelihood of injury to the patient or clinician, and provides the best leverage and strength for instrumentation
standard intraoral fulcrum
a stabilizing point inside the patient’s mouth, against a tooth surface:
Intraoral fulcrum
a stabilizing point outside the patient’s mouth (e.g., against the patient’s chin or cheek)
Extraoral fulcrum
What fulcrum is shown in the image?
Intraoral fulcrum
Intraoral fulcrums can be ____ or ____
palm up or palm down
What fulcrum is shown in the image?
advanced fulcrum
Parts of the periodontal instrument include: (3)
- handle
- shank
- working-end
Part of the periodontal instrument used for holding the instrument:
handle
Part of the periodontal instrument that is the rod-shaped length of metal located between the handle and working-end of an instrument:
shank
Part of the periodontal instrument that does the work:
working-end
Label the following parts of the periodontal instrument:
a) handle
b) shank
c) working-end
Label the following parts of the periodontal instrument:
a) handle
b) shank
c) working-end
Label the following parts of the periodontal instrument:
a) handle
b) shank
c) working-end
The parts of the shank include:
- functional shank
- terminal shank
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:
functional shank
The portion of the functional shank nearest to the working-end:
terminal shank
Label the following parts of the shank:
a) terminal shank
b) working-end
c) functional shank
A shank that is bent in one plane (front-to-back):
simple shank
A simple shank can also be called:
straight shank
Simple shanks are used primarily on:
anterior teeth
What type of shank is seen in the following image?
simple shank
What type of shank is seen in the following image?
complex shank
A shank that has been bent in two plane (front-to-back & side-to-side):
complex shank
A complex shank may also be called:
angled/curved shank
A complex shank is used on:
posterior teeth
When determining if your shank is simple or complex, hold the instrument so that the:
working-end is facing you
If an instrument (shank) when viewed from the front appears to be straight, this is a:
simple shank
If an instrument (shank) when viewed from the front appears to be bent from side-to-side, this is a:
complex shank
Label which shank is simple, and which is complex:
A) Simple
B) Complex
The function of an instrument is determined, primarily, by the:
design of the working-end
The two main types of periodontal hand instruments include:
- sickle scalers
- curettes
Sickle scalers are ____ in cross-section of the blade
triangular
What type of scaling are sickle scalers used for?
Supragingival
How many cutting edges are present on a sickle scaler:
two
Curettes are ____ in cross-section of the blade
rounded
What type of scaling are curettes used for?
supra- and subgingival scaling
______ and ______ curette instruments are available
universal & area-specific
How many cutting edges are present on universal curettes?
2
How many cutting edges are present on area-specific curettes?
1
The end of a sickle scaler is a _____ while the end of a curette is a ____
tip; toe
What are the arrows pointing to in the following images?
Cutting edges
Describe the following aspects of a sickle scaler:
End:
Cutting-edge:
Angulation:
Cross-section:
Blade:
End: pointed toe
Cutting-edge: 2
Angulation: 90 degrees
Cross-section: triangular
Blade: straight
Describe the following aspects of a universal curette:
End:
Cutting-edge:
Angulation:
Cross-section:
Blade:
End: rounded
Cutting-edge: 2
Angulation: 90 degrees
Cross-section: half-eliptical
Blade: straight
Describe the following aspects of an area-specific curette (gracey’s curette)
End:
Cutting-edge:
Angulation:
Cross-section:
Blade:
End: rounded
Cutting-edge: 1 (lower end)
Angulation: 70 degrees
Cross-section: half-eliptical
Blade: curved away from cutting edge
Important for maintaining contact of working-end and tooth structure during instrumentation:
Adaptation
Incorrect adaptation resutls in:
ineffective calculus removal & tissue laceration
Important for efficient plaque and calculus removal:
activation
______, _____ & _____ work as a unit in activation of an instrument
wrist, hand & forearm
For activation, what is NOT effective, and what might this cause?
Finger pulling; operator fatigue
Components that contribute to activation of an instrument include: (5)
- blade adaptation
- instrument angulation
- blade insertion
- lateral pressure
- working stroke
Refers to the angle between the face of a bladed instrument and the tooth surface:
angulation
Angulation refers to the angle between:
face of a bladed instrument & tooth surface
Instrument used to search into and explore thoroughly:
Periodontal probe
The MOST important instrument used for assessing and diagnosing periodontitis:
periodontal probe
What is a periodontal probe used to measure? (9)
- probing depth
- gingival recession
- size of pathologic lesions
- clinical attachment level
- furcation involvement
- distance between teeth
- amount of attached gingiva
- bleeding on probing
- overbite/overjet
A slender, tapered, blunt instrument with millimeter markings on it:
periodontal probe
What is probing inaccuracy related to? (3)
- probe design
- pressure applied
- contour of tooth
Probing depth usually correlates to:
attachment loss
Probing depth is always an objective measure of the:
Distance between the base of the pocket and the crest of the gingiva (regardless of attachment loss)
Readings of probing depths may change over time due to:
changes in position of the gingival margin
Label the following types of probes:
a) implant probe
b) periodontal assessment probe
c) periodontal assessment probe
d) biotype probe
Used to evaluate the bone support in the furcation areas of bifurcated & trifurcated teeth:
Nabers (furcation) probe
When using a nabers probe, the correct working-end of the probe is when the lower (terminal) shank is positioned:
Parallel to the tooth surface being examined
Of the following images of a nabers probe, which is showing the correct use?
Top- correct
When using a nabers probe you do not need to read mm marking when:
identifying class of furcation
What type of probe is seen in this image?
Nabers (furcation) probe
act of walking the tip of the probe along the junctional epithelium (JE) within the sulcus or pocket for the purpose of assessing the health status of periodontal tissues:
probing
The movement of a calibrated probe around the perimeter of the base of a sulcus/pocket:
walking stroke
When probing, it is essential to evaluate the entire “length” of the pocket base, because:
The JE is not necessarily at a uniform level around the tooth
Probing is the act of walking the tip of a probe along the ______ within the sulcus or pocket, for the purpose of assessing the health status, of the periodontal tissues
Junctional epithelium (JE)
What grasp should be used for holding the probe?
Modified pen grasp
When probing, you should fulcrum:
Close to the tooth you are probing
When probing, ______ of the probe should always contact the tooth
working-end
When probing, the probe should be _____ to the long axis of the tooth, around all proximal surfaces, except when probing the ______ (due to the ____)
parallel; interproximal spaces; gingival col
When probing, where should the probe be placed?
below the gingival margin to the base of the sulcus
When probing, place the probe below the gingival margin to the base of the sulcus using _____ of pressure
10-15 grams
In health, the probe will stop at the:
junctional epitheliun
In disease, the probe will go into the:
connective tissue (not stop at the junctional epithelium)
Your probing depth will be calculated based on the line you see at the:
Gingival margin
After the probe is inserted you should keep the probe _____ as you move along the tooth
subgingival
Keep the probe subgingival as you move along the tooth and _____ along the circumference of the tootg
hop
When probing, begin at the ______ and back into the _____ aspect of the tooth; move forward toward the ____
distal line angle; distal; mesial
If you get multiple different measurements when probing your readings should be the:
deepest
Probing measures six sites per tooth, these include:
- Distofacial
- facial
- mesiofacial
- distolingual
- lingual
- mesiolingual
PD=
Probing depth/pocket depth
GM=
Gingival margin (measuring recession or overgrowth)
ATTACH=
Clinical attachment loss (CAL)
BOP=
Bleeding on probing
Base of pocket to gingival margin is the measure of the:
PD
CEJ to base of pocket is the measure of the:
Attachment level
CEJ to gingival margin (GM) is the measure of:
Recession
If the PD=2mm and the GM=3mm, then the attachment loss=
5mm
If the measurment for the gingival margin is (+), then:
recession is present
If the measurement for the gingival margin is (-), the gingival margin is:
Coronal to the CEJ (no recession)
PD=5mm
GM= -3mm
CAL= ____
2mm
PD= 5mm
GM=0mm
CAL= ____
5mm
PD=2mm
GM=3mm
CAL= _____
5mm
A CAL of 0=
no peridontitis
A CAL of 2=
early periodontitis
A CAL of
progression of periodontitis
A CAL of 7=
Continued progress of periodontitis
