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BDS2 CDS Periodontology > Instruments for periodontal treatment > Flashcards

Instruments for periodontal treatment Flashcards

ILO 2.2a: be competent at manipulation of scaling instruments

1
Q

what are the parts of a handheld periodontal instrument?

4

A
  • handle
  • shank
  • lower shank
  • blade
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2
Q

how should you hold instruments?

A

modified pen grasp
* instrument held between thumb and index finger
* middle finger held further up the shank for stability and strength
* middle finger can be used as a finger rest

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3
Q

what should the ideal finger rest be?

A
  • as close as possible to the tooth being treated
  • on a stable tooth rather than soft tissues
  • may need to use a finger rest further away in difficult to access areas
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4
Q

how should the wrist be positioned when using periodontal instruments?

A

neutral wrist
* wrist should be straight
* hand and forearm should be in same horizontal plane

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5
Q

how should you use the instruments when carrying out PMPR?

A
  • ensure the final third of the blade is always closely adapted to the tooth structure
  • use lateral upward strokes from base of pocket
  • rotate the instrument as you work around the tooth
  • lower shank should be parallel to the long axis of tooth
  • use overlapping multidirectional strokes upwards from the base of pocket
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6
Q

what position would left and right handed operators sit when working on the labial and lingual surface of 43-33?

A
  • right: 7 o’clock
  • left: 5 o’clock
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7
Q

what position would left and right handed operators sit when working on the buccal surface of 44-48?

A
  • right: 9 o’clock
  • left: 3 o’clock
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8
Q

what position would left and right handed operators sit when working on the lingual surface of 34-38?

A
  • right: 9 o’clock
  • left: 3 o’clock
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9
Q

what position would left and right handed operators sit when working on the buccal surface of 14-18?

A
  • right: 9 o’clock
  • left: 3 o’clock
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10
Q

what position would left and right handed operators sit when working on the lingual surface of 44-48?

A
  • right: 11 o’clock
  • left: 1 o’clock
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11
Q

what position would left and right handed operators sit when working on the buccal surface of 34-38?

A
  • right: 11 o’clock
  • left: 1 o’clock
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12
Q

what position would left and right handed operators sit when working on the labial and palatal surface of 13-23?

A
  • right: 11 o’clock
  • left: 1 o’clock
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13
Q

what position would left and right handed operators sit when working on the palatal surface of 14-18?

A
  • right: 11 o’clock
  • left: 1 o’clock
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14
Q

what position would left and right handed operators sit when working on the buccal and palatal surface of 24-28?

A
  • right: 11 o’clock
  • left: 1 o’clock
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15
Q

what surfaces of which teeth should the operator be scaling at 7 o’clock/5 o’clock?

A

43-33 lingual and labial

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16
Q

what surfaces of which teeth should the operator be scaling at 9 o’clock/3 o’clock?

A
  • 34-38 lingual
  • 44-48 buccal
  • 14-18 buccal
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17
Q

what surfaces of which teeth should the operator be scalling at 11 o’clock/1 o’clock?

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

what are the systemic health condition indications for hand instrumentation?

4

A
  • communicable diseases where aerosols may increase risk of infection e.g. TB or COVID
  • difficulty swallowing lots of water e.g. parkinsons, MS, severe gag reflex
  • cardiac pacemaker (check make and model)
  • access to certain areas of the mouth may be difficult with ultrasonic
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19
Q

what are the oral condition indicators for hand instruments?

5

A
  • demineralised areas can be removed with ultrasonic
  • sensitivity e.g. exposed tubules, recession
  • children may be less tolerable to ultrasonic scalers due to anxiety
  • porcelain or composite restorations can be marked by ultrasonic scalers
  • titanium implants need a rubber tip that may not be available
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20
Q

what are the 8 hand instruments used for PMPR?

A
  • mini sickle / point scaler
  • universal columbia curette
  • hoe scaler red 156-157
  • hoe scaler yellow 134-135
  • gracey curette grey 1-2
  • gracey curette green 7-8
  • gracey curette orange 11-12
  • gracey curette blue 13-14
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21
Q

describe the mini sickle / point scaler

A
  • double ended with two cutting edges
  • curved blade and triangular in cross section
  • cutting edges congerve to a sharp point
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22
Q

where can the mini sickle / point scaler be used?

A
  • used supragingivally
  • all buccal and lingual embrasure surfaces
  • sharp point can damage root surface and pocket walls
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23
Q

how do you use a mini sickle / point scaler?

A

manipulate so the point always moves towards and into the embrasure

24
Q

descibe the universal columbia curette

A
  • double ended with two cutting edges
  • curved, spoon-shaped blade
  • cutting edges form a rounded toe
25
where can the universal columbia curette be used?
* used **throughout the mouth** * **supra** and **subgingivally** * no sharp corner to damage ginigvae
26
how do you use a universal columbia curette?
* use light lateral force to engage calculus at a 90 degree angle * short overlapping strokes upwards
27
describe the yellow and red hoes
* **double ended** with **single cutting edge** * blade is set at a 100 degree angle to the shank and the cutting edge is beveled at 45 degrees
28
where can the yellow and red hoes be used?
* **all surfaces of all teeth** * **supra** and **subgingival** for gross calculus * yellow 134-135 - **buccal/labial** and **lingual/palatal** surfaces * red 156-157 - **mesial and distal** surfaces
29
how do you use the yellow and red hoes?
* use in overlapping strokes * cutting edge should be angulated at 90 degrees to the tooth surface * use a curette to fully smooth the surface after
30
describe the gracey curettes
* **double ended** with **one cutting edge** * **offset blade** at an angle to the lower shank * angle of **110 degrees** between the lower shank and face of blade * toe of the **blade curves upwards and to the side** * **longer, outer convex edge** is the cutting edge
31
where can the gracey curettes be used?
* **supra** and **subgingival** for fine or deep calculus * grey 1-2 - **anterior sextant** * green 7-8 - **buccal / lingual in posterior sextants** * orange 11-12 - **mesial in posterior sextants** * blue 13-14 - **distal in posterior sextants**
32
how do you use the gracey curettes?
* use vertical and diagonal strokes * lower third is in contact with the tooth
33
with what systemic health conditions should you use hand instruments oover ultrasonic?
* **communuicable diseases** where aerosol may increase risk of infection * **difficulty swallowing lots of water** * **cardiac pacemaker** - check make and model
34
with what oral conditions should you use hand instruments over ultrasonic?
* **demineralised areas** * **sensitivity** * **children** may be less tolerable to ultrasonic scalers due to **dental anxiety** * **porcelain / composite restorations** may be marked by scalers * **titanium implants** - use an implant insert if available on ultrasonic tip
35
why do you need to sharpen hand instruments?
* to **improve calculus / biofilm removal** * **less force** and **time** required
36
what methods are there to sharpen hand instruments?
* Arkansas hand stone * sharpening machines * hoes require a diamond abrasive without oil
37
what components make up an ultrasonic?
* electric power generator * handpiece * insert with working tips * water
38
how would you use an ultrasonic?
* **turn the instrument on** and **fill water reservoir** * **connect the barrel** and **turn the water supply up** * use the **pedal** to **fill the barrel with water** until it almost overflows * place the **insert into the barrel** * press the foot pedal to get a **fine mist spray** out the end of the tip - adjust the power if needed
39
descibe the #10 design tip
* **1 bend shank** * tapered tip
40
where and what is the #10 design tip used for?
* **supra or subgingival** * gross removal of moderate-heavy calculus and stain
41
describe the #100 design tip
* **2 bend shank** * tapered tip
42
where and what is the #100 design tip used for?
* **supra and subgingival** * gross removal of moderate-heavy calculus and stain
43
describe the #1000 design tip
* **3 bend shank** * tapered tip
44
where and what is the #1000 design tip used for?
* **supragingival** * gross removal of moderate-heavy tenacious calculus * can access line angles and interproximal surfaces
45
describe the #3 design tip (beaver tail)
* **1 bend shank** * tapered **blunt** tip (wide)
46
where and what is the #3 design tip used for?
* **supragingival** * gross removal of moderate-heavy calculus and stain
47
describe the slim #10 and #1000 design tip and where are they used?
* #10 - **1 bend shank** * #1000 - **3 bend shank** * more **defined bend angle** * indicated for use on **surfaces with minimal contour** after heavy calculus is removed * supragingival - **>4mm anterior surfaces only** * subgingival - **<=4mm posterior or anterior**
48
describe the slim curved design tips and where are they used?
* left and right **curved shank** * **area specific** * enahnces adaption - **posterior root surfaces**, **concavities** and **furcations**
49
describe the THINsert ultrasonic inserts
* **9 degrees backward angle** for easier adaption * **47% thinner diameter** for access in difficult areas * **enhanced durability** for light-moderate calculus
50
how much active area do ultasonic tips have and how does bluntness affect work?
* new tips have **4.2mm** of active area * tips become **less effective** with use
51
what can be used to test the wear of an ultrasonic tip? what would it tell you?
wear guides * if the tip measures to the **blue line**, **1mm** of active area is worn and results in a **25% efficiency loss** * if the tip measures to the **red line**, **2mm** of active area is worn and results in a **50% efficiency loss**
52
how would you adapt ultrasonic instruments?
* oblique adaption * vertical adaption * the **active portion** must contact the **surface** * adapt the lateral surface in a **vertical position** at the midline of the tooth and stroke **horizontally** between **mesial and distal line angles** * at the **line angle**, transition to **oblique adaption** and stroke **vertically**
53
what surfaces in the mouth would the left curved insert adapt to?
* UR buccal * UL palatal * LR lingual * LL buccal
54
what surfaces in the mouth would the right curved insert adapt to?
* UR palatal * UL buccal * LR buccal * LL lingual
55
why would an insert break or not work?
* incorrect **power setting** (too high) * insert **not matching application** * **improper sterilisation and maintenance**
56
why would an insert overheat?
* **improperly adjusted water** * not **filling handpiece** with water prior to insert insertion * use of **unserviceable insert** * **adequate water pressure**

BDS2 CDS Periodontology (6 decks)

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