Powered Instrumentation

Question 1

What does a patient need to do for powered instrumentation?

Answer 1

Neutral seated position

Patient head to one side

Modified pen grasp and intraoral finger rests

Question 2

How should tip be adapted in powered instrument?

Answer 2

Follow manufacturer’s recommendations for tip adaptation.

Point or face of powered instrument should not be directly adapted to the tooth surface

Back and lateral surfaces can be adapted

Lateral surface is most effective for tenacious calculus.

Lateral surface should be adapted to the facial surface in a similar way to a periodontal probe.

Question 3

Which parts of the powered instrument tip should be used for calculus removal?

Answer 3

Back and lateral surface are recommended.

Point and face are not adapted to tooth surface.

Question 4

Which part of the tip should be adapted to the tooth?

Answer 4

The last 2 - 3mm of the back or lateral surface is the active portion of the tip and must be in contact with the tooth at all times. The tip-to-tooth surface angulation should be close to zero degrees.

Question 5

How should tip be oriented relative to the tooth in a powered instrument?

Answer 5

Transverse tip orientation - back or lateral surface positioned in a similar way to a curet.

Vertical tip orientation - back or lateral surface positioned in similar manner to probe.

Question 6

How is calculus removal different between curet and powered instrument?

Answer 6

With a curet calculus removal takes place from the base of the pocket towards the CEJ.

With a powered instrument calculus removal is removed from the top of the deposit to the bottom.

Question 7

How should powered instrument be moved?

Answer 7

Powered instrument breaks up heave calculus deposits by putting microfractures in the deposit.

A tapping motion is used against large calculus deposits.

A sweeping motion is used on light deposits and for deplaquing.

Tip is kept moving at all times and only a gentle pressure is needed. Vertical or oblique strokes are made with light pressure.

Question 8

Why is pressure not a good idea to use with powered instruments?

Answer 8

It decreases the effectiveness of the tip because it actually stops the tip from vibrating.

Question 9

What is correct technique with ultrasonic scalers?

Answer 9

Relax, let the machine do the work. Touch the lateral surface tip lightly against the tooth surface or deposit.

Keep your grasp very relaxed and use digital activation

Question 10

When are standard-diameter tips used?

Answer 10

Used for removal of medium to heave calculus deposits.

Used on coronal surfaces and for subgingival deposits easily accessed.

Question 11

How are stubborn calculus deposits removed?

Answer 11

Calculus deposits are not always removed in a single stroke

Select appropriate tip for task

Use a tip that withstandstands medium power

Maintain proper control and adaptation with strokes in all directions

May need to increase power

Question 12

Which part of the tip is most capable of removing stubborn heavy deposits?

Answer 12

Magnetostrictive = back surface

Piezoelectric = lateral surfaces

Question 13

What other functions can a powered scaler be used for?

Answer 13

A powered device tip can correct some defective margins of restorations to produce a smooth surface that will deter bacterial accumulation.

Question 14

What are slim diameter tips used for?

Answer 14

Has a similar design to a periodontal probe

Question 15

What are the 3 types of slim-diameter tips?

Answer 15

A straight tip

Right-curved tip

Left-curved tip

Question 16

What is the function of a slim-diameter tip?

Answer 16

Similar in design to a furcation probe. Works well on anterior roots that are not highly curved and shallow pockets of posterior teeth.

Question 17

Can straight tips be used for posterior teeth?

Answer 17

The straight tip does not adapt well to the curved surfaces found on the roots of posterior teeth. It is only used on root surfaces located 4 mm or less below the CEJ or on crown surface.

Question 18

What are curved slim tips used for?

Answer 18

Designed to facilitate adaptation to the curved root surfaces of posterior teeth. The back of the working end adapts best.

Used on posterior root surfaces located more than 4mm apical to CEJ

Used on root concavities and furcations on posterior teeth.

In transverse position can be used to remove deposits apical to contact area.

Question 19

When is the best time to use transverse technique vs vertical technique?

Answer 19

Transverse technique: Deposits above or slightly below the gingival margin

Vertical technique: Deposits below the gingival margin

Question 20

When is a cross-arch fulcrum used for powered instrumentation?

Answer 20

When adapting the tip back to posterior teeth.

Question 21

How can calculus be removed from the palatal root of the maxillary molars?

Answer 21

Palatal root curves in the lingual direction

Back surface of curved tip adapts best

Cross arch fulcrums are also useful

Question 22

How can calculus on the furcation area be located and removed?

Answer 22

Curved slim-diameter tip is used. Ideally a curved slim tip with a ball end.

1) Deactivate the tip (release foot from pedal)
2) Insert beneath the gingival margin
3) Move in an oblique direction until you detect the entrance to furcation

Question 23

What fits better in furcation area; a ball tip or a curet?

Answer 23

A ball tip fits better than a curet.

Question 24

How is the furcation area’s calculus removed?

Answer 24

1) Turn working end while rotating wrist.
2) Activate the instrument
3) Roll the ball of the working-end back and forth across the roof of the furcation.

Question 25

When is the right tip used and when is the left tip used?

Answer 25

To decide if a tip is right or left:

Rotate the insertion point so that it is facing away from you and the back is toward you. If the shank bends to the left it is the left tip if to the right it is the right tip.