instruments Flashcards
sickle scalers
Anterior Sickle Scaler
Used in the anterior region to remove supragingival
calculus deposits
Anterior Sickle Scaler instruments design
◦ Straight, rigid shank
◦ 2 cutting edges on each working-end
◦ Pointed tip (hence “sickle”)
adapting the ant sickle scaler
When adapting, the shank and handle should be parallel to the long axis of the tooth
sickle scaler angulation
Proper angulation (cutting edge against the tooth) for anterior sickle scaler = 45-90°
Over angulation (>90 °) will result in burnished calculus and/or tissue laceration
Under angulation (<45 °) will result in burnished calculus
NOTE: proper angulation will occur naturally if the shank/handle of the scaler is kept parallel to the long axis
of the tooth
Operator Positioning with ant sickle scaler
Surfaces toward you (max/mand arch):
Right-hand: 8:00
Surfaces away from you:
Right-hand: 11-12:00
Posterior Sickle Scaler
Same as the anterior scaler, but with a bend in the shank (complex design) for access in the posterior region
This instrument is meant to scale interproximal regions of posterior teeth, supra- and subgingival (slightly below the tissue) if spurs of interproximal calculus are present
Not designed for scaling deep periodontal pockets
adaptation and usage of post sickle scaler
Terminal shank is parallel to
the long axis of the tooth
Insert at line angle and scale
into the interproximal
perio explorer
Periodontal Explorer Use
- Used to detect subgingival calculus and tooth irregularities
- Allows clinician to assess the amount of calculus prior to removal (rough, clickable, burnished, spicules, etc.)
- Used to evaluate root surfaces following calculus removal
IF YOU CANNOT DETECT CALCULUS, YOU CANNOT REMOVE IT
Tactile Sensitivity
- Clinician’s ability to feel vibration transmitted from the instrument working-end with their fingers as they rest on the shank and handle
- This skill takes time to develop and practice
- Important skill needed to complete nonsurgical periodontal therapy
Instrument Activation of perio explorer
- Grasp explorer using modified pen grasp
- Light grasp to increase ability to feel vibrations
- Roll instrument between thumb and forefinger to keep tip adapted
can we offset with perio explorer? where?
yes, mesial can be offset to distal in posterior
terminal shank of perio explorer should be?
parallel to tooth
Exploring Anterior Sextants
Right-handed positions
Surfaces toward: 8:00
Surfaces away: 11:00
doing opposite surfaces in the anterior with perio explorer
instrument is flipped
Instrument Design universal currett
2 cutting edges
Rounded toe
Face that is parallel to the floor
when the terminal shank is held
at 12 o’clock position
currett
Where can the universal curettes be used?
- ALL surfaces of ALL teeth! (supra- and subgingivally)
- Shank length helps identify instruments that are better for shallow vs. deeper periodontal pockets
all universal currettes
Determining the Correct Working-End with universal curettes in posterior
- Toe of the instrument curves toward the mesial aspect of the tooth you are working on (left image)
- If the toe curves AWAY from the mesial aspect, the working-end is incorrect (right image)
terminal shank of universal currettes
When the terminal shank is parallel
to the long-axis of the tooth you can
be sure the correct working-end is
being utilized
Instrument Stroke of universal curette
The ideal stroke for using a universal
curette across a tooth surface (especially direct buccal/lingual) is oblique and overlapping
Universal Curettes in Anterior Teeth
- Begin at midline
- Scale into interproximal space
- Align HANDLE so it is parallel to
the long-axis of the tooth - FLIP the instrument when scaling
the other half of the tooth
positions for universal curettes
Surfaces Toward:
R.H clinician: 8:00
Surfaces Away:
R.H clinician: 12:00
Instrument Design of area specific curettes
ONE cutting edge; lower portion of the working-end
Rounded toe
Straight & complex shanks
Used in deep periodontal pockets due to their ability to adapt to root anatomy
gracey 1/2 use area
anteriors all surfaces
gracey 11/12 area use
mesial, buccal, lingual aspects of posterior teeth
gracey 13/14 area use
posterior distal
gracey 1/2 adaption
- Si m p le s h a nk ( h an dle s h o u l d b e p a ra l lel to l o n g a xi s o f th e to o th w h e n s ca l i n g)
- Fl i p i n s tr um en t i n o r d e r to cove r to wa r d a n d a way s u r f a ces
Gracey 13/14 identification of correct working end
Even though this instrument is used
for the DISTAL aspect of a posterior
tooth, use the “mesial curve” trick to
help identify the correct working -end
then offset instrument to distal line angle
