Powered Instrumentation Flashcards
What does a patient need to do for powered instrumentation?
Neutral seated position
Patient head to one side
Modified pen grasp and intraoral finger rests
How should tip be adapted in powered instrument?
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.
Which parts of the powered instrument tip should be used for calculus removal?
Back and lateral surface are recommended.
Point and face are not adapted to tooth surface.
Which part of the tip should be adapted to the tooth?
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.
How should tip be oriented relative to the tooth in a powered instrument?
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.
How is calculus removal different between curet and powered instrument?
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.
How should powered instrument be moved?
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.
Why is pressure not a good idea to use with powered instruments?
It decreases the effectiveness of the tip because it actually stops the tip from vibrating.
What is correct technique with ultrasonic scalers?
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
When are standard-diameter tips used?
Used for removal of medium to heave calculus deposits.
Used on coronal surfaces and for subgingival deposits easily accessed.
How are stubborn calculus deposits removed?
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
Which part of the tip is most capable of removing stubborn heavy deposits?
Magnetostrictive = back surface
Piezoelectric = lateral surfaces
What other functions can a powered scaler be used for?
A powered device tip can correct some defective margins of restorations to produce a smooth surface that will deter bacterial accumulation.
What are slim diameter tips used for?
Has a similar design to a periodontal probe
What are the 3 types of slim-diameter tips?
A straight tip
Right-curved tip
Left-curved tip
What is the function of a slim-diameter tip?
Similar in design to a furcation probe. Works well on anterior roots that are not highly curved and shallow pockets of posterior teeth.
Can straight tips be used for posterior teeth?
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.
What are curved slim tips used for?
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.
When is the best time to use transverse technique vs vertical technique?
Transverse technique: Deposits above or slightly below the gingival margin
Vertical technique: Deposits below the gingival margin
When is a cross-arch fulcrum used for powered instrumentation?
When adapting the tip back to posterior teeth.
How can calculus be removed from the palatal root of the maxillary molars?
Palatal root curves in the lingual direction
Back surface of curved tip adapts best
Cross arch fulcrums are also useful
How can calculus on the furcation area be located and removed?
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
What fits better in furcation area; a ball tip or a curet?
A ball tip fits better than a curet.
How is the furcation area’s calculus removed?
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.
When is the right tip used and when is the left tip used?
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.
