Ultrasonic Instrumentations Flashcards
How should you hold the handpick
vertically with the power on and press on the foot control to allow water to overflow out the handpiece
this allows water to flow over the stacks and maintain consistent performance of the insert
all of the air will be expelled from the handpick
What happens if air is not expelled from the handpiece
trapped air can cause the handpiece to exceed a comfortable operator temperature
What is magnetostrictive technology
a low voltage magnetic signal causes tip movement. the handpiece contains coils that activate the inserts, causing them to vibrate.
inserts are easily interchangeable with magneto technology
water flows over and through the stacks, preheating the water to a comfortable temperature, and then flows to the insert tip. the water at the tip is used to lavage away debris and endotoxins and to cool the tooth to tip interface that is present when using ultra sonic scaler
Where should you wrap the handpiece cable
wrap the handpiece cable around the forearm or hook it inside the pinkie finger of the handy instrument with to prevent wrist fatigue
What does the cavitron striate handpiece with swivel assist in
controlling drag and hand fatigue as it rotates 360 degrees
What is the cable made out of
a soft silicone-based material that easily drapes.
What is power
power is the length of the stroke
What happens when the power is set at medium to high
you will have a wider stroke
What kind of stroke do you want for heavy debris removal
a wider one
What inserts should you use for heavy calculus
a wider or larger diameter insert such as the
TFI(R) of FSI(R) 10, 100 or 1000 and a more powerful stroke
What kind of stroke will you require for fine root work
a smaller, shorter stroke to achieve periodontal debridement
you want to use the FSI slimline series on a low power setting
What is the basic rule of thumbs for inserts and power settings
the thinner the insert tip, the lower the power setting
What are the parts of an insert system
stack
connecting body
‘O’ ring
insert tip
What is a stack
they are the energy source for the insert
How should the stacks be oriented for peak performance
straight
any bending of the stacks may interfere with the performance of the insert
How should inserts be treated
as a fine grade surgical instrument
How will the insert fit if it is in proper working order
it will fit easily and freely into the handpiece
How do the stacks move
by elongation and contraction on a horizontal plane, like stretching an elastic band
the elongation and contraction creates a uniform movement
they do not move like an accordion
What do stacks have stamped on them
the date, tip style, frequency
What are the different tip styles
TFI, FSI and SLI
What are the different frequencies
30K/25K
What does the date code denote on the stack
the year first then the month of manufacturing
What us the connecting body
connects the energy source (stack) to the insert tip
What is the ‘O’ ring
stops the water from coming outside the handpiece and directs the water toward the tip
What happens as you ‘bleed’ the handpiece to expel air
water will overflow out of the handpiece which will wet the O-ring
What lubrication is required for the O-ring maintenance
water
NOT PETROLEUM OR CHEMICAL
What will petroleum do to the O ring
cause it to breakdown the rubber
What will chemicals do to the O rings
cause them to dry and crack
What is the insert tip
the tip is the working end of the insert
with magneto technology you can work with all surfaces of the insert
Why should you never use the point of any type of ultrasonic insert
it may cause gouging of the tooth surface
what are TFI inserts designed for
supragingival, moderate to heavy debris removal
they can be used for subgingival removal if the tissue is retractable
What are the FSI inserts for
for supragingival, moderate to heavy debris removal
Why do FSI inserts offer better visibility
less water because of the focused water delivery and enhanced power
the clinical will spend less time clearing the mouth and mouth mirror.
with the focused water spray, aerosols are decreased
What are SLi inserts
thinner than standard ones
available with an external water lube
What are the SLI designed for
light to moderate debris removal or fine root debridement
What is the straight insert of SLI 10S designed for
for pockets 4mm or less
can be used on every surface
Why is adaptation of the SLI 10S to the root surfaces for pockets that are 4mm or less not suitable
due to the straight design not fitting agains the curved tooth surfaces of concavities and furcations of periodontally involved root surfaces
What does the SLI10L and SLI 10R inserts allow
the contra-angle and curved tip inserts allow adaptation to deep pockets and furcation areas
What are the power scaling and air polishing system cavitron terms
ultrasonics magnetostrictive ultrasonics piezoelectric ultrasonics sonics air polishing
What is ultrasonics
devices operating at frequencies above the audible range
this includes systems in the 18 to 50 kHz range
What are magnetostrictive ultrasonics
A method of creating mechanical movement using a low voltage magnetic signal. The handpiece contains coils that activate the interchargeable inserts, causing them to vibrate.
What are piezoelectric ultrasonics
A method of creating mechanical movement using a high voltage electric signal. The handpiece contains non-removable crystals.
What are sonics
Devices operating in the audible range. Current sonic units operate at 3 to 8 KHz (3,000 to 8,000 cycles per second).
What is air polishing
A controlled stream of sodium bicarbonate or aluminum trihydroxide is used for therapeutic and cosmetic purposes in the removal of stain, biofilm, and soft debris. Also used for prophylaxis of orthodontic patients, and preparation for sealants second bonding.
What are the frequency terms
frequency cycle kilohertz optimum frequency active tip area
What does frequency mean
The number of times per second the insert tip moves back and forth during one cycle.
What does cycle mean
One complete linear or elliptical stroke path.
What does kilohertz mean
Equal to 1000 hertz, or 1000 cycles per second (cps).
What does optimum frequency mean
Range between 18 kHz and 32 kHz is above the audible frequency. It is within a range to allow greater patient comfort and maximum life of the insert.
What does active tip area mean
Affected by frequency. In the 25 to 30 kHz range, the active tip area is approximately 4.3mm. In the 40 to 50 kHz range, the active tip area is generally less than 2.4mm.
What are the different types of tuning
auto
manual
What is auto tuning
The tip frequency is controlled automatically by the internal system of the Cavitron
unit.
What is manual tuning
The tip frequency is adjusted using the tuning knob. This term is often mistaken for power.
What are the power terms
power stroke amplitude load clinical power
What is power
The electrical energy in the handpiece used to generate the movement of the insert. Increasing the power increases the distance the insert moves (stroke) without changing the frequency.
What is stroke
The maximum distance the insert tip moves during one cycle. The power knob adjusts the stroke.
What is amplitude
Equal to one half the stroke.
What is load
The resistance on the insert when placed against deposit on the tooth surface.
What is clinical power
The ability to remove deposits under load. The stroke frequency and type of motion, elliptical or linear, and the angulation of the motion against the tooth surface are factors that determine clinical power.
What are the ultrasonic effects
accoustics
acoustic streaming
acoustic turbulence
cavitation
What are the acoustics
Energy associated with sound waves.
What is acoustic streaming
Unidirectional fluid caused by ultrasonic waves. Acoustic streaming occurs at lower acoustic pressures than cavitation.
What is acoustic turbulence
Tip stroke causes coolant to accelerate, producing an intensified swirling effect which disrupts the bacteria matrix, biofilm. This effect is increased as the power knob is adjusted to higher power settings.
What is cavitation
The formation of bubbles in liquids by rapid changes such as those induced by ultrasound. When bubbles implode, they produce shock waves in the liquid.
What is the ultra sonic unit composed of
an electric power generator, a handpiece and an insert with a working tip
How many small mechanical strokes does the ultrasonic produce
25,000 per second
they are transmitted to the working tip
What is the amplitude of the vibratory movement in the long axis fo the tip
about 0.006 - 0.1 mm
What happens when the tip is brought into contact with a calculus deposit
the vibrational energy dislodges it from the tooth surface.
Why is water circulated within the handpiece
Because of the heat liberated by ultrasonic vibrations, water is circulated within the handpiece and expelled to cool the vibrating tip, where a spray is produced.
What does the spray used for the ultrasonic consist of
The spray consists of vacuum bubbles, which supposedly implode creating microcosms of energy, which together with the ultrasonic vibrations disrupt plaque, calculus and the organisms therein (cavitation effect).
What is the advantage of sonic scalers
Sonic scalers have the advantage that they can be connected directly to the air turbine outlet on the dental unit
What is the difference with sonic scalers
Their mechanism of action is similar to that of ultrasonic devices. However, the vibration frequency of these instruments is lower, usually less than 16,000 cycles per second.
What is the area of application for ultra sonic scalers
A variety of different tips are available so that an ultrasonic scaler may be used to carry out supragingival AND SUBGINGIVAL scaling at least as quickly as with hand instruments.
What is an issue seen with the ultra sonic
The poorer tactile sensitivity of the ultrasonic scaler by comparison with hand instruments should, in theory, make it unsuitable for subgingival use where the operator cannot see the field.
What is the usage of the ultra sonic scaler
Fill the barrel with water BEFORE placing insert in the barrel. This keeps the tip cooler and increases the longevity of the inserts. Adjust the water spray
Why should the ultrasonic tip be kept in motion at all times
The ultrasonic instrument tip should be kept in motion at all times, with a light brushing stroke to avoid overheating any part of the root surface.
What doe she power control adjust
The power control adjusts the amplitude of the tip movements.
How should trauma be kept to a minimum
To keep trauma to a minimum, the lowest possible setting, consistent with satisfactory resonance should be used
In general what should the power not exceed
50%
What does polishing do
Polishing aims to produce smooth surfaces, which are less likely to accumulate plaque. Polishing is also necessary to remove any stains left after scaling.
What is used fo polishing
Polishing can be completed by using a slowly rotating, webbed, rubber cup held in a special contra-angle hand piece. (A bristle brush will traumatize the gingiva.)
What helps in the removal of heavy staining
Commercial polishing pastes are usually effective but pumice and water slurry is helpful in the removal of heavy staining.
What is the seating positions fo rate 43-33 labial and lingual
7 o’clock
What is the seating positions for the 44-48 buccal
9 o’clock
What is the seating position for the 34-38 lingual
9 o’clock
What is the seating position for the 14-18 buccal
9 o’clock
What is the seating position for the 44-48 lingual
11 o’clock
What is the seating position for the 34-38 buccal
11 o’clock
What is the seating position for the 13-23 labial and palatl
11 o’clock
What is the seating position for the 14-18 palatal
11 o’clock
What is the seating position for the 23-28 buccal and palatal
11 o clock
What happens following RSD
bacterial remnants will tend to be washed out of the pocket by blood and gingival fluid. Within a few hours an acute inflammatory reaction occurs in the soft tissue pocket wall.
What happens to the remnants of the pocket epithelium after RSD
Remnants of pocket epithelium proliferate and the pocket wall is fully epithelialised within 2 days. Involution of the pocket epithelium occurs, giving rise to new junctional epithelium.
After 5 days what happens after RSD
epithelial reattachment commences at the apical extremity of the pocket, and progresses coronally until, under conditions of ideal plaque control
When is epithelial reattachment complete
14 days and a new gingival sulcus is formed near to the crest of the gingivae. Some shrinkage of the gingiva will occur due to loss of oedema.
what heals after the dentopeithelial junction
The formation of functionally orientated collagen to replace granulation tissue tends to lag behind the healing of the dentoepithelial junction, immature collagen not appearing until after 3 weeks.
What does pocket charting at the reassessment stage often reveal
decreased pocket depth
Why is there decreased pocket depth at re assessment
- Decreased oedema leading to gingival recession
* An increase in clinical attachment resulting from:
Why is there an increase in clinical attachment
- the formation of a long junctional epithelium
- an increase in “tissue tone” which produces resistance to probing
within how many weeks has most of the healing response occurred with
8 weeks
However, there will be continued gradual improvement seen even 9-12 months after the completion of active treatment, provided that good plaque control is maintained.
