Periodontal Instrumentation Flashcards
how do periodontal instruments facilitate placement of the working end against the tooth surface
the shanks of most are bent in one or more places
simple shank
will appear to be straight
use on anterior teeth because they are wedge shaped
complex shank
has side to side bends
use on posterior teeth because of the large bulky crowns
complex shank facial and lingual
front to back shank bends allow you to reach the facial and lingual surfaces of the root
complex shank proximal surfaces
side to side bends allow you to reach the mesial and distal surfaces of the root
rigid and flexible shank compared by size of deposit removed
rigid shank = heavy deposit
flexible shank = small to medium deposits
flexible shank characteristics
enhances amount of tactile information
desirable for explorers used to detect subgingival margins
vibrations are transmitted
functional shank
portion of the shank that allows the working end to be adapted to the tooth surface
begins below working end and extends to the last bend in the shank nearest the handle
lower shank
portion of the functional shank that is nearest to the working end
also called terminal shank
simple shank use
simple shank with short functional shank length: supragingival use on anterior teeth
simple shank with long functional shank length: subgingival use on anterior teeth
complex shank use
complex shank with short shank length: supragingival use one posterior teeth
complex shank with long shank length: subgingival use on posterior teeth
extended lower shank
can reach the middle and apical third of the root surface
important shank characteristics
determine if shank is simple or complex
recognize shank flexibility
recognize the functional shank
recognize the lower shank
recognize an extended lower shank
double ended instruments
curets and explorers
may have: unpaired working ends or paired working ends
parts of working end
face, back, lateral surfaces, cutting edges, toe or tip
cutting edge
a sharp edge formed where the face and lateral surfaces meet
some working ends have two cutting edges
significance of cross section
determines whether the instrument can be used subgingival or supragingival
cross section uses
working ends that are triangular in cross section are limited to supragingival use
working ends that are semi-circular in cross section may be used supragingivally and subgingivally
what instruments are used for assessment vs calculus removal
assessment: periodontal probes and explorers
calculus removal: sickle scalers, curets, periodontal files
sickle scaler
used to remove supragingival calculus deposits
triangular in cross section
pointed tip
pointed back
curet
used to remove calculus deposits
semi-circular in cross section
rounded toe
rounded back
periodontal file
used to crush large calculus deposits
each working end has several cutting edges
what is instrumentation
a fine motor skill
involves small movements
wrist rocking motion
hand, wrist, arm work as a unit to produce a rotating motion used to move the working end of an instrument
less fatigue
uses of wrist-rocking motion
used for calculus removal with hand-activated instruments
allows the clinician to maintain a neutral upper body posture
keeps the workload on forearm and wrist instead of hand and fingers
the fulcrum finger supports the weight of the hand
digital motion activation
moving the instrument by flexing the thumb, index and middle fingers
used whenever physical strength is not required
moves the instrument by making push-pull movements with fingers
uses of digital motion activation
used primarily with ultrasonic instruments and periodontal probes and explorers
not recommended for calculus removal with hand instruments
may be used to instrument restricted areas, such as furcations of multirooted teeth
orientation of roots
maxillary roots incline inward
mandibular anteriors tilt inward
mandibular premolars more vertical
mandibular molars tilt outward
why is true angulation and correct orientation important
assists in correct placement of the working end on root surfaces
initial placement of the working end begins by correct orientation to the tooth surface plane
