Online Tutorial 3: Periodontal Instrumentation Principles Flashcards
What is periodontal debridement
- This is the removal of bacterial plaque biofilms and calculus deposits from the crown and/or root surfaces and from within the pocket space
What are the aims of periodontal debridement
- Arrest the progression of periodontal disease
- Create an environment that assists in maintaining tissue health
- Increase the effectiveness of patient self care by removing plaque retentive biofilms
What is root planing
This is designed to remove cementum or surface dentine that is rough and contains impregnated calculus
Why is root planing not encouraged anymore
Can be too damaging to the root surfaces
What are the 3 main parts of a periodontal instrument
- Handle
- Shank
- Working end
What is the terminal shank
This is the part of the shank that is directly connected to the working end
What is a simple and a complex shank
Simple shank = used for anterior teeth and is straight from the terminal shank to the working end
Complex shank = used for posterior teeth and there is a bend in the terminal shank connected to the working end
What is the difference in the working ends between curettes and sickles
Curettes = Rounded end (toe) Sickles = Pointed end (tip)
What cross section does the working end of supra gingival scalers have
Triangular
Are sickle scalers used sub or supra gingivally
supragingivally only
What kinds of curet are there
Universal and site specific curettes
What shape of cross section do curettes have
Semi-circular
Are curettes used sub or supra gingivally
BOTH
How many cutting edges do sickle scalers have
2
What is the difference in the cutting edges of universal and site specific curettes
Universal: The face is perpendicular to the lower shank, so the 2 cutting edges are level with each other
Site Specific: Lower cutting edges is at a 70º angle to the tooth surface when the lower shank is parallel
What teeth is the Universal 4L/4R curettes used for
Posterior teeth
What teeth is the Universal 2L/2R curettes used for
Anterior teeth
What is another name for the grace curettes
Site specific curettes
When should you be in the 8-10 o’clock position for debridement
When debriding surfaces facing towards from you on anterior teeth
When should you be in the 12 o’clock position for debridement
When debriding surfaces facing away from you on anterior teeth
When should you be in about the 9:00 position for debridement
When debriding surfaces facing towards you on posterior teeth
When should you be in about the 10-11 o’clock position for debridement
When debriding the surfaces facing away from you on posterior teeth
What are the 3 main techniques needed when doing periodontal instrumentation
- Adaptation
- Angulation
- Application
Describe the adaptation technique for perio instrumentation
This is the positioning of the first 1-2 mm of the working’s lateral surface in contact with the tooth
Describe the angulation technique for perio instrumentation
This is the relation between the face of the working end of and the tooth surface
What angle should there be between the face of the working end of tooth surface
70-80º
What is the problem with over angulation in debridement
Can cause damage to soft tissues
What is the problem with under-angulation debridement
Will leave burnished calculus, which is more difficult to remove
Describe the application technique for perio instrumentation
applying pressure to the instrument after adapting and angulating it to the tooth surface
Which direction are vertical and oblique strokes always in
Coronal direction, never downwards as this can cause damage
The inner cutting edge of a sickle scaler should be used for which part of a tooth
The distal parts, one end of the scaler will be for the buccal-distal face and the other will be for the lingual-distal face
Where are the common sites for calculus to build up
- Lingual aspect of the lower incisors
- Buccal aspect of the upper first molars
Why is calculus build up more common on the lingual aspect of lower incisors and the buccal aspect of upper first molars
These areas are near the opening of the salivary glands
What are the medical contraindications for ultrasonic instrumentation
- Pacemakers
- Infectious disease
- Immunocompromised
- Respiratory problems
- Dysphagia (prone to gagging
What are the dental contraindications for ultrasonic instrumentation
- Implants (may damage titanium abutment)
- Restorative materials
- Demineralisation
- Hypersensitive teeth
What 3 connections are there for setting up a cavitron
- Blue water line to the yellow water ting to purge and the into the blue connection on the chair
- Power cable
- Foot peddle
