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Clinical Theory > Powered Instruments for Periodontal Debridement > Flashcards

Powered Instruments for Periodontal Debridement Flashcards

1
Q

how do powered instrumentation devices dislodge calculus

A

use a rapidly vibrating irrigated working end

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2
Q

what do powered instruments usually consist of

A

an ultrasonic generator, a handpiece, interchangeable tips or inserts

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3
Q

the three A’s of powered instrumentation

A

adaptation -2-3mm of insert tip
angulation - 0-15 degrees
activation - short, 2-3mm overlapping strokes

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4
Q

primary goal of periodontal debridement

A

removal of bacterial plaque and by-products

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5
Q

secondary goal of periodontal debridement

A

calculus removal

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6
Q

therapeutic endpoint of periodontal debridement

A

decrease in microbial load

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7
Q

clinical endpoint of periodontal debridement

A

tissue response

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8
Q

hand vs powered instrumentation

A

ultrasonic inserts produce smoother roots with: the least amount of damage, better calculus and biofilm removal, less operator fatigue

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9
Q

ultrasonic scalers

A

piezo and magneto

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10
Q

magnetorestrictive ultrasonic scaler

A

electrical energy is applied to coils in handpiece and magnetically changes dimension of metal stack to produce vibrations
elliptical movement
four active surfaces… can use any side of the instrument

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11
Q

piezoelectric ultrasonic scalers

A

electrical energy is applied to crystals in handpiece which emits vibrations
linear movement
two active surfaces… can only use lateral sides

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12
Q

what is ideal for furcation due to easy access

A

thin ultrasonic inserts

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13
Q

frequency

A

of strokes per second
does not change

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14
Q

amplitude

A

length of stroke
affected by power setting and is adjustable
increase in power increases amplitude
decrease in power decreases amplitude

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15
Q

tuning

A

water knob controls water flow
power knob controls length of the stroke

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16
Q

amplitude and deposit removal

A

lower: shorter strokes, less powerful, light calculus, biofilm, endotoxin removal
higher: longer strokes, more powerful, moderate-heavy calculus, moderate-heavy stain

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17
Q

4 mechanisms of action of powered instrumentation

A

mechanical: longitudinal sweeping action of oscillating tip
irrigation: lavage from the water
cavitation: bubbles collapse inward, releasing energy
acoustic microstreaming: forceful flow of cavitating fluid which enhances effectiveness

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18
Q

tip wear reduces

A

efficiency

19
Q

efficiency lost from worn tips

A

1mm wear: approx 25%
2mm wear: approx 50%

20
Q

powerline (standard) inserts

A

beavertail
FSI 10
FSI 100
FSI 1000

21
Q

beavertail - rounded toe

A

removes heavy cal
used on all power settings
vertical strokes

22
Q

FSI 10 - one bend

A

all surfaces
curved shank
tapered tip
moderate-heavy deposit
low-high power settings

23
Q

FSI 100 - two bend

A

straight shank
tapered tip
moderate-heavy deposit removal
low-high power settings

24
Q

FSI 1000 - triple bend

A

line angles and IP surfaces
square edges to provide more energy
moderate-heavy deposit removal
low-high power settings

25
Q

moderate to heavy calculus use

A

cavitron powerline ultrasonic inserts

26
Q

slimlines

A

straight - 30% slimmer
right and left - curved shank, allows adaptations
area specific
light to mod deposit and biofilm removal
low-med power

27
Q

light to moderate calculus use

A

cavitron slimline ultrasonic inserts

28
Q

cavitron thinsert

A

access to tight tissue, interproximal surfaces, misaligned teeth, increased tactile sensitivity because of thinness, light to mod deposit and biofilm removal, usable at all power levels

29
Q

to remove biofilm/light calculus use

A

cavitron thinsert ultrasonic insert

30
Q

staged instrumentation

A

initial debridement: gross removal of mod-heavy calculus or stain, standard insert indicated and higher level of power required
debridement: definitive removal of light deposits, biofilm, endotoxins, slim inserts indicated and low level of power required

31
Q

biofilm vs calculus removal

A

biofilm: small sweeping strokes, methodical, slim/thin inserts with round cross sections, low power level
calculus: tapping and sweeping strokes, power/standard inserts, power level as needed

32
Q

blue zone

A

a low power setting which maximizes patient comfort but may need to turn the power beyond depending on the nature of the deposit

33
Q

standard and beavertails operate on what power settings

A

all

34
Q

slimlines operate on what power settings

A

low to medium

35
Q

general contraindications to powered instrumentation

A

-patients with communicable diseases that can be transmitted by aerosols
-immunocompromised patients
-susceptibility to infection: diabetes, systemic lupus, chrohn’s disease, chemo
-hearing aids
-avoid with patients likely to overreact to stimuli

36
Q

cardiovascular contraindications

A

take caution when using on automatic implanted cardioverter defibrillators and pacemakers more than 10 years old

37
Q

respiratory contraindications

A

-COPD or other respiratory conditions
-acute pulmonary infections
-impaired swallowing
-severe gag reflex
-muscular dystrophy
-paralysis
-MS

38
Q

tooth conditions/anomalies contraindications

A

-demineralized teeth
-restorative materials
-dentin hypersensitivity

39
Q

cavitron SPS

A

offers the blue zone
offers power boost
offers sleeve with swivel
offers balance between efficiency and patient comfort
automatically maintains power and frequency settings as it meet the tooth/root

40
Q

piezo technology

A

has a fibreoptic light
works from the base of the pocket up

41
Q

magnetorestrictive technique review

A

fill handpiece with water
keep handpiece vertical
lubricate O ring
slide insert into handpiece vertically
adjust water flow

42
Q

patient preparation for powered instrumentation

A

explain procedure to patient
a preprocedure rinse is recommended to reduce the bacterial load in aerosols
personal protective equipment for the patient

43
Q

clinician preparation for powered instrumentation

A

wear a gown with a high neck and long sleeves, mask and protective eyewear and gloves
change mask every 20 minutes

Clinical Theory (18 decks)

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