Prac quiz questions Flashcards
What are the types of motion activation?
Wrist activation (Doorknob like - more powerful, less fatigue, more often used for calculus removal with hand instruments)
Digital activation (Used more often for ultrasonic scaling and not recommended for calculus removal with hand instruments)
Digital activation
What is the purpose of a hand pivot?
Line angles maintain adaptation as working end moves around the tooth
What are the parts of the instrument?
Handle
Shank
Working end
What are the differences between a simple and complex shank?
Working end direction being faced:
Simple (used for anteriors) = straight
Complex (used for posteriors) =
Side to side for mesial and distal root surfaces.
Front-back bend reaches facial/lingual root surfaces
What is the role of the functional shank?
Allows working end to be adapted to the tooth surface
What is the role of the terminal shank?
Portion of the functional shank nearest to the working end
What does the use of the instrument for sub or supra gingival purposes depend on?
Shank length
What are the parts of the working end?
Face
Back
Lateral surfaces
Cutting edges
Toe/tip
What kind of stroke is used for perio probing?
Walking stroke without removing from tissue and without causing trauma
What is the ideal stroke pressure?
10 - 20 grams
How many measurements are recorded per tooth?
6
What factors limit the accuracy of perio measurements?
Position of the gingival margin
Interference from calculus deposits
Overhangs
Amount of pressure
Misread probe calibrations
What are the furcation gradations?*
Grade I:
Grade II:
Grade III:
What are the furcation gradations?*
Grade I:
Grade II:
Grade III:
What are the classes of mobility?*
Class I
Class II
Class III
Which teeth are assessed in CPITN?*
1s
6s
7s
What are the CPITN classifications?*
a
What is CPITN?*
a
What are the advantages of sharpening instruments?
Easier calc removal
Improved stroke control
Reduced number of strokes
Increased patient comfort
Reduced fatigue
What is the cutting edge a junction of?
Face and lateral edge
What is the internal angle on working end of the graceys?
70 - 80 degrees
What is the internal angle of the universal working end?
70 - 80 degrees
What are the differences between site-specific instruments relative to the unviersal?
Site-specific instruments have long, complex, lower shanks whereas universals have parallel edges.
Tilted edge
Only 1 cutting edge
Why is universal named that way?
Design features are made for anterior and posterior teeth:
Rounded back
Rounded toe
Semi-circular x-section
2 cutting edges
Face is perpendicular to the lower shank
How can small to medium calculus deposits be removed?
Using universal curettes
Why would we want to increase the working end length?
To reach the mesial/distal midline (longer is better for proximal surfaces of posterior teeth)
Which cutting edge is used for anterior teeth with universal instrument?
Outer edge (M with one end and D with the other) The lower shank reaches across the tooth.
What are the options for advanced fulcrums?
Finger-on-finger
Cross arch (L/R)
Opposite arch (max/mand)
Finger assist (non-dominant hand used to concentrate lateral pressure against the shank)
Extraoral - including chin cup
What are the advantages of extraoral fulcrums?
Easier access to maxillary 7s and 8s as well as to deeper pockets (especially narrow ones)
Improved parallelism of lower shank to molar teeth
Neutral wrist position for molar teeth
What technique is used for deep pockets?
Extraoral fulcrums
What are the disadvantages of using advanced extraoral fulcrums?
Greater degree of muscle coordination and instrumentation skill required
Greater risk of instrument stick injury
Reduced tactile information
TMJ problem makes patient unable to tolerate it.
What are the ways of performing extraoral fulcrums?
Knuckle rest with palm facing out OR
Chin cup
What are the benefits of a standard intraoral fulcrum?
Highest stability
Decreased likelihood of injury to patient or clinician (least strain on fingers)
Best leverage during instrumentation
What are the functions of a perio explorer?
Examination of:
Calculus deposits
Dental anomalies
Anatomical features
Dental restorations and sealants
What are the features of a 11/12 type explorer?
Tip is 90 degrees to lower shank
Long complex shank
What are the advantages to using an 11/12 type explorer?
Smooth back of tip contacts soft tissue
Complex shank
Universality is useful
What type of stroke is used to detect calculus?
Assessment / Exploratory stroke
What does a gritty bump tell us about calculus?
Could be small calculus
Ledge of calculus
Overhang
Underhang
Caries
What do you touch at the bottom of the gingival sulcus?
Junctional epithelium
What information can’t be gathered from probing depth?
Alveolar bone loss because it takes into account the gingival margin normally.
This means if there is movement of the gingival margin from its normal position slightly above the CEJ then the bone loss can’t be gathered from probing depth alone.
What is the clinical attachment level?
The location of the periodontal attachment system on the tooth.
Probing depth + gingival recession
What is furcation involvement?
Loss of alveolar bone and PDL in the space between the roots of a multirooted tooth
What are the parts of the working end of the curette?
Leading (toe)
Middle
Heel
4 ways to detect calculus, then explain the best version
Tactile
Visual inspection
Radiograph
Perioscope
What are the steps taken to sharpen a gracey?
Hold a stone 75 degrees to the ground
Hold instrument in your palm with the face of the instrument parallel with the countertop
Sharpen with upward stroke of the instrument
Sharpen the heel the middle and the toe separately
Make sure to sharpen around the edge of the toe to maintain the rounded curve at the toe
What are the 3 things charted on a perio chart?
Margin is -ve above CEJ and +ve below
Pocket depth is distance from margin to bottom of pocket
CAL is margin + pocket depth
What is the angulation of insertion/debridement?
Insertion = 0 - 40 degrees (Ideally 0)
Debridement = Angle of 60 - 80 ideally
Which end of Universal instrument to use for mesial/distal of molars and to label on an instrument which that is
Inner edge is used for the distal side
Outer edge is used on facial, lingual, and mesial surfaces
Give 5 important aspects of probing technique:
Walking the probe
Walking around the entire circumference
Adaptation
Parallelism
Stroke pressure (10 - 20g)
What are the identifying features of a hoe
working end is a 99 degree bend at the edge of the working end where the toe of the curet is
What are the identifying features of a 17/18?
It is purple with a label
What are the identifying features of a naber’s probe?
Graduated with a sickle shape
