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56 Cards in this Set
- Front
- Back
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In pockets >4mm, what % of roots had residual calc after traditional SRP according to a study?
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50%
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In a study where did the perioscope show most of the deposits were left? (4)
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1) CEJ
2) Root Concavities 3) Line Angles 4) All Furcations |
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What % of pockets & furcations that BOP have residual Calc?
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100%
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What are 3 "causes" of burnishing?
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1) Ultrasonic on low power can burnish
2) Hand Instruments that aren't sharp 3) Hand instruments/Ultrasonic used incorrectly. *Hand instruments & ultrasonics can be equally ineffective.* |
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How is an "After 5" the same or different from a Gracy 1/2?
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It’s the same instrument as a Gracey 1/2 but it has an extended shank.
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When is a "mini" used?
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In deeper pockets that are difficult to access.
They are not intended for heavy or tenacious calc. *Typically used in anterior pockets* |
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How much smaller is a Micro-mini than regular Mini's? Where are the best places to use micro-mini's and for what calc load?
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Micro Mini's are 20% smaller than mini's.
They are great for furcations, line angles & pockets > 5mm with light to mod calc only! |
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Nevi 2 & Nevi 4 are what type of instruments?
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Posterior Sickles
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Where is a great place to use a Nevi?
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Underneath a posterior contact.
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The Nevi 4 has a Rigid shank for the effective removal of…..
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Burnished or heavy, tenacious calc.
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What type of blade does a Nevi 4 have? Why?
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Nevi 4 has a Tapered, dual cutting blade.
Its very precise! |
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A Nevi 2 is super thin with a contra-angle cutting blade. What is it used for?
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Precise interproximal reach that easily gets under the contact point. It removes calc with minimal tissue trauma!
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What are 3 types of Periodontal Files?
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1) Hirschfeld
2) Orban 3) Bedbug Design |
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At CCD we have the Hirshfeld perio file.
How is the use of the 3/7 different from the 5/11? |
The 3/7 is for Buccal/Lingual use
The 5/11 is for Mesial/Distal Use |
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When is a periodontal file used?
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It’s a preliminary scaling tool. It crushes Heavy/tenacious calc.
**Once its broken up then I can go back with the ultrasonic or hand tools to finish the tooth.** |
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What is the sequence of instruments in Periodontal therapy?
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1) Perio Files
2) Ultrasonic 3) Curettes/Scalers |
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Why is it important to use a Perio File before trying to clean the tooth?
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A file crushes or fractures the calc so it can be removed by another instrument.
They can also crush or "roughen up" heavy or burnished calc that can't otherwise be easily removed. |
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When is a perio file contraindicated?
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For calc that is not tenacious or removeable with hand instruments or ultrasonics.
*Also contraindicated for flash overhangs that can be removed by curettes or hand piece.* |
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How many points of contact are needed to correctly use a Perio File?
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2
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For the sake of Board Exams, tell me again what are the names of 3 periodontal files.
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1) Hirschfeld
2) Orban 3) Bedbug Design |
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What are 3 advantages to the use of a Perio File?
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1) Has a rigid shank that enables the file to crush/fracture large calc deposits.
2) Has a thin, flat working end which promotes easy insertion to remove the large deposits that would be inaccessable by other instruments. 3) Useful when PT's health situation contraindicates the use of ultrasonics! |
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What are 4 disadvantages to using the Perio File?
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1)Limited Tactile sence
2) The flat head design limits use on curves, root surfaces or in furcations. 3) Use at the base of the pocket can traumatize the JE. 4) Over use can create rough root surfaces--> can only use directly on deposit. |
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How many cutting edges are on a perio file?
Cutting edges of the files are what degree angle to the base? |
3 Cutting Edges
Cutting Edges are at 90-105 degree angles to the base. |
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What shapes might the base of the file be? (3)
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Round, Rectangular or Oblong
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Why is the back of the file round?
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To allow Sub-G use.
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Where is the best place to insert the perio file and what happens if there isn't 2 point contact?
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Insert immediately below the deposit edge.
If no 2 point contact then you're not engaging the cutting edge correctly. *Adapt working end to the cal deposit while resitn the lower shank agains the tooth. Look at the picture in the notes.* |
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Should the entire face of the working end of the file be flat against the deposit?
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YES!!
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Where should the terminal shank of the file be in relation to the tooth?
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The terminal shank should be parallel to the tooth.
**Remember this tool is excellent for deep pockets in anterior teeth.** |
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Describe the pressure and technique to be used with a perio file.
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Firm lateral pressure with thumb and index finger and use a "Pull" stroke.
*You can use small oblique, horizontal & vertical strokes. Must be very small & controlled!* |
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How often is the Pull stroke repeated?
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Until the deposit has been crushed enough to be removed.
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What is the Diamond Coated File Scaler used for?
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Residual Calc.
*Its kept in the dispendsary, has bits of diamonds on it…files little bits of calc that you can't otherwise get.* |
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What type of motion can you use with a Diamond Coated File?
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Both "Push" & "Pull" motion
*It provides accss to scale in small, narrow pockets & furcations.* *Think of it as an emery board to remove minute calc remnants from the root.* *Use these with a very light touch, even pressure to avoid gouging.* |
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What is a tangled file?
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A sharpening file
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What instrument is excellent for removing stain on the linguals of anterior teeth?
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Furcation Curettes! Its due to the spoon shaped end.
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Furcation Curettes are less likely to ________ than Gracey Curettes
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gouge
*This is due to the shallow, half moon shape that fits into roof or floor of furcation.* (This is especialy true of the Quentin style of furcation curette.) |
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How are Curvettes different from Curettes? (3 items)
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1) The blade is slightly curved upward
2) The blade length is 50% shorter 3) There is a greater risk of gouging or grooving due to the upward curvature. **Some curvettes have an added feature of 5 & 10 mm markings on the shank so you can visually determine the depth of the pocket.** |
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Where are Gracey 1/2, 3/4 used? How about 5/6, 7/8? 11/12 &13/4?
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Gracey 1/2, 3/4 are used on the anterior teeth.
Gracey 5/6 & 7/8 are used on Pre Molars Gracey 11/12 & 13/14 are used on Molars. *Remember some are used Distal vs Facial/Mesial.* |
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On the Gracey instruments, what happens to the shanks as the number on the instrument gets bigger?
1/2--> 13/14 |
The shank gets "bendier" as the number goes higher.
You have a more complex shank design which is great for PT's who can't open up very wide. |
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How is a Gracey 11/12 similar or different to a Gracey 15/16?
What about the relationship between a Gracey 13/14 & 17/18? |
It’s the same instrument but the 15/16 has more bend in the shank.
The same can be said for the 13/14 & 17/18. |
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Does an intra oral or extra oral fulcrum have more power?
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Intra Oral…because you are fulcroming off of the teeth vs being outside of the mouth.
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Do the Gracey 11/12, 15/16 have more or less bend in the terminal shank than the 13/14, 17/18?
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Less.
You can think of the bigger number having greater bend. See Pics in Notes. |
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When is an "Implacare" used?
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For routing scaling of Implants…it won't damage them.
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Why are "Plasteel" tips better for using on implants?
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Most plastic scalers are too flexible for use on implants. Traditional stainless steel or plastic instruments containing glass or graphite can scratch titanium abutments.
*Plasteel tips are more rigid & less flexible than other plastic maintenance instruments* |
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What is the purpose of a chisel?
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To break away thick calc.
They are designed for proximal surfaces too closly spaced for the use of other scalers or when ultra sonic won't work OR may not be an option (AIDS/COPD Pt) |
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Where is a chisel usually used?
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In the Anterior portion of the mouth.
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How do you "activate" a chisel?
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By using a push motion while the side of the blade is held firmly against the tooth to avoid gouging.
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What are 3 occasions that the use of a McCalls 17/18 UNIVERSAL Curette would be an excellent choice to use?
(The McCalls was in the clear plastic packaging in our instrument collection.) |
1) Furcations
2) Distal surface of the last teeth in the arch 3) Heavy Calculus |
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What is the function of a Hoe Scaler?
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To remove ledges or rings of calculus
*It can be used Super G or Sub G* |
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Why is a 2 point contact necessary when using the Hoe Scaler?
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To stabalize the instrument.
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What 2 instruments require a 2 point contact?
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1) Perio Files
2) Hoe Scalers |
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Is the Hoe Scaler used in a pull or push stroke?
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Pull Only!
Don't want to damage anything |
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How much is the blade bent on a Hoe Scaler? (What degree of angle?)
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99 degree angle but the cutting edge has a 45 degree bevel!
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What is so great about Langer Curettes?
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They combine the Gracey shank & the effeciency of the Universal curette blade. (They are completely universal.)
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On a furcation insert, what is so great about using a ball tip? (3 items)
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1)The ball end allows greater tip surface area for a thorough debridement
2) Less gouging 3) Better tacktile sense. |
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What is so great about the 11/14 or the 12/13 Gracey Curettes?
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These combinations of working ends allow you to complete and entire facial or ligual sextant without changing instrument or operator positioning.
You can go faster. Increases your efficiency! |
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Name 3 fulcrums discussed in class?
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1) Finger on Finger
2) Open or closed palm 3) Finger assisted for > pressure **Review the pics from the notes.** |
