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Perio > Instruments > Flashcards

Instruments Flashcards

1
Q

What are the probs in a perio kit

A

WHO BPE probe (screening)
-ball end 0.5mm
-3.5-5.5mm
-8.5-11.5mm

UNC 15 probe
-Used for 6 point pocket chart, check pockets
-grade at every mm
-starts black 4-5mm
-second 9-10mm
-third 14-15mm

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2
Q

What connects handle to end of blade

A

Shank

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3
Q

How should a lower shank be positioned in respect to the tooth

A

Positioned at long axis to the tooth

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4
Q

What are the 8 instruments in a PMPR kit

A

Mini sickle or point scaler​

Universal Columbia Curette​

Hoe scaler x 2 ​
a) red 156-157​

b) yellow 134-135​

Gracey Curettes x 4​
a) grey 1-2​

b) green 7-8 ​

c) orange 11-12​

d) blue 13-14
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5
Q

What does a finger rest do

A

The finger rest is the support/stability on which a lever (our finger) turns.​

Control​

Stability​

Safety to prevent injury​

Patient comfort

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6
Q

What is the positioning of an ideal finger rest

A

Ideal finger rest:

Tooth as close to tooth treating​

Prevents injury if patient moved suddenly or instrument slips​

Stable tooth rather than soft tissues(lips/cheeks) which can move/slide around​

May need to use a rest further away in difficult access e.g. treating upper left posteriors palatally , using upper right palate as a rest

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7
Q

What technique prevents injury to the hand

A

Neutral wrist
The wrist should be straight ​

Hand and forearm should be in the same horizontal plane​

Reduces risk of pressure of median nerve in wrist ​

Helps reduce risk of carpal tunnel syndrome​

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8
Q

What should be done prior to instrumentation of a tooth

A

Brobe the area prior to understand the depth and extant of pockets

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9
Q

What instrument is used only supragingivally

A

Mini sickle scaler

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10
Q

Where is the mini sickle scaler used

A

All buccal / lingual embrasures supragingival or just into into gingival margin​

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11
Q

Why is the mini sickle scaler not suitable for subgingival use

A

the sharp point can groove/damage the root surface ​

The pocket wall could be damaged

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12
Q

What are the properties of a mini sickle scaler

A

Curved blade triangular in cross section converging to a point​

Triangular in cross section​

Point of scaler must always be moved towards and into the embrasure

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13
Q

What are the red instruments

A

Mini sickle scaler
Universal columbia curette

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14
Q

How is the universal columbia curette used

A

Use light lateral force against the root surface to base of pocket , engage calculus with blade at 90°​

Use short overlapping strokes upwards

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15
Q

What are the properties of a Universal columbia curette
Red hoe

A

Curved spoon shaped blade with 2 cutting edges to form a rounded toe​

No sharp corners so can be used both supragingival and subgingival in all areas

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16
Q

What is the difference between the red and yellow hoes

A

Red 156-157 for mesial and distal surfaces​

Yellow134-135 for buccal lingual surfaces​

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17
Q

What can the red and yellow hoes be used for

A

supra/subgingival calculus removal​

All surfaces especially for gross calculus removal

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18
Q

How many cutting edges do hoes have

A

Single cutting edge

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19
Q

What does the single cutting edge of the hoes mean for use

A

Limited access if pocket is narrow​

Use a curette to fully smooth surface after using hoes

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20
Q

What are the colours ofthe Gracey curettes

A

Grey
Green
Orange
Blue

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21
Q

Where can each Gracey be used

A

Grey 1-2 anterior sextant​

Green 7-8 buccal/lingual posterior sextant​

Orange 11-12 mesial posteriors sextants​

Blue 13-14 distal posterior sextants

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22
Q

What are the properties of the Gracey curettes

A

The tip of the blade curves in 2 planes​

Area specific​

One cutting edge​

Offset blade

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23
Q

What angle are the gracey curettes preset at

A

70 degrees

24
Q

Which edge of the Gracey is the cutting edge

A

Larger outer curve

25
Q

How is the Gracey curette used

A

Confirm correct cutting edge by gently adapting it to the tooth with the lower shank parallel to the long axis to the tooth.​

Only the back of the instrument can be seen from above if correct.​

Use finger rest​

Use vertical and diagonal strokes

26
Q

What position is used to treat teeth 43-33 labial and ligual

A

7 oclock

27
Q

Where should the operator be to treat the right hand buccal posterior teeth aside

A

9 oclock

28
Q

At 11 oclock what teeth surfaces can the operator reach

A

44-48 lingual
34-38 buccal
13-23 labial and palatal
14-18 palatal
24-28 Buccal and palatal

29
Q

When are hand instruments preferable

A

Communicable diseases where aerosol may increase risk of infection e.g. Tuberculosis, Coronavirus​

Difficulty in swallowing lots of water from ultrasonic– Parkinson’s disease, Multiple sclerosis or severe gag reflex​

Cardiac pacemaker – check make and model ( patients have details given to them to check online or check with Cardiology) prior to using ultrasonic​

Access to certain areas of tooth can be difficult , hand scalers may offer better access

Demineralised areas – can be remineralising but removed by powerful ultrasonic​

Sensitivity – exposed dentinal tubules, recession, children with large pulp horns​

Children may be less able to tolerate ultrasonic scalers due to dental anxiety ​

Restorations-porcelain / composite can be marked by ultrasonic​

Titanium implants – ideally have implant inserts onto ultrasonic tips but may not be available

30
Q

Why are instruments sharpened

A

To improve calculus/biofilm removal​

Less force and time is required with sharp instruments

31
Q

How is instrument sharpness tested

A

An acrylic test stick

32
Q

How are instruments sharpened

A

Arkansas hand stone- natural stone from aluminium oxide with oil for steel instruments​

Hoes require a diamond abrasive without oil as they have tungsten carbide ​

Sharpening machines will be quicker​

A sharpening service will maintain your scalers and advise when to replace

33
Q

What are the benefits to ultrasonic scalers

A

Equally as effective as hand instruments​

More time efficient if patient able to tolerate water/suction​

Can be more efficient for stain removal​

Range of tips available for different areas requiring access​

Must monitor wear of scaling tips as wear can reduce effectiveness

34
Q

What are the properties of an ultrasonic scaler

A

Electric power generator​

Handpiece( black barrel)​

Insert with working tips​

Power is converted to about 25 000 microscopically small strokes per second​

Water is needed to cool vibrating tip

35
Q

What is used along side an ultrasonic scaler

A

High volume suction

36
Q

Where is a scaling tip placed when not in use

A

FLAT

37
Q

What can be used to remove gross calculus and stain

A

10 design

1 bend shank​

Tapered tip​

Supragingival or​

subgingival use

38
Q

What is the #100 design

A

Gross removal of mod-heavy calculus & stain​

2 bend shank ​

Tapered tip​

Supragingival or ​

subgingival use​

39
Q

What features does a #1000 design have

A

Gross removal of mod-heavy tenacious calculus​

3 bend shank ​

Tapered tip​

Access line angles & ​

interproximal surfaces​

Supragingival use

40
Q

How many bends does a 3 design have

A

1

41
Q

What are the properties of a #3 design

A

(best use for supragingival gross calculus which needs broken up)

Gross removal of mod-heavy calculus & stain​

1 bend shank ​

Tapered blunt tip​

Supragingival use

42
Q

What tips are used for subgingival narrow pockets

A

Used at low power
Focused Spray Slimline 1000

43
Q

When should a slim #10 and slim #1000 be used

A

Slim #10
-one bend better for >4mm PD anterior surfaces only

Slim#1000
-triple bend for up to 4mm depth in anterioror posterior

44
Q

What are the benefits of THINSert ultrasonic inserts

A

9° backward angle​
-Allows for easier adaptation

47% thinner diameter​
-Provides access in difficult areas without loss of tactile sensitivity​

Enhanced durability​
-Designed for light to moderate calculus and deplaquing​
-Allows use at a higher power setting

45
Q

What tyoes of water flow design in ultrasonic instruments are there

A

External flow ultrasonic insert​

​

​

Internal water flow insert through base of insert ​

​

Internal water flow insert through tip

46
Q

What flow of water is desirable

A

Constant flow with fine mist and some droplets showing

47
Q

What are the diameter tip options

A

Standard
Slim
Thin

48
Q

If a tip has lost 2mm of length how much less efficient is it

A

50%

49
Q

What is a wear guide

A

Comparison tool for tips to see how much loss of tip has occured

50
Q

How line should a tip be above on a wear guide

A

Atleast above the red line to be effective

51
Q

What directions are used to remove calculus

A

Olblique and vertical movements

52
Q

Where must the active portion of the tip be to remove deposits

A

In contact with the involved surface

53
Q

How does working from the molars forward make it easier for the patient

A

Relieved extent of mouth opening as you work forward

54
Q

When might an insert break off

A

Incorrect power setting​

Insert did not match application​

Improper sterilization & maintenance

55
Q

When would an insert overheat

A

Improperly adjusted water ​

NOT filling handpiece with water prior to insert insertion​

Use of an unserviceable insert ​

Adequate water pressure

56
Q

What steps should you follow when treating a perio patient

A

Choose the correct instrument (s)​

If using USS set it up, set the water spray/power setting​

Choose the patient position (both head position chair position​

Choose your seating position​

Choose the light position​

Identify your finger rest​

Remove the plaque/calculus​

Check you’ve done the job properly​

Continue treatment (eg next tooth)

Perio (6 decks)

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