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46 Cards in this Set
- Front
- Back
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How are ultrasonics similar to hand instruments?
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- calculus
- plaque/biofilm - pocket reductin - inflammation |
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How do ultrasonics differ from hand instruments?
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- effects on root surface
- access - effiency - ergonomics |
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What factors contribute to the increased effectiveness of ultrasonics?
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- multiple surfaces of tip are active for removal of calculus and plaque
- no cutting edge so can be used vert, horizontal and oblique - more time effective due to decreased debridement time, no sharpening needed, fast and easy stain removal - less tissue destruction --> faster wound healing and client comfort - simultaneous irrigation and lavage - bacterocidal effect (cavitation and acoustic turbulence) |
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What factors contrute to the conservation of root structure by ultrasonics?
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- conservation of cementum
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What factors contribute to the improved ergonomics by ultrasonics?
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- handpiece size
- reduced lateral pressure - reduced "pinch force" - alternate fulcrum facilitate neutral wrist and improved access allows for.. - less chance of repetitive stress injury |
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What factors contribute to the improved access by ultrasonics?
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- slimmer tip diameter
- shape of tip - no cutting edge so can be used vert, horizontal and oblique allows for.. - better access to furcations and concavities - better pocket penetration |
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What allows for the multifaceted assault on biofilm by ultrasonics?
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- mechanical removal
- acoustic turbulence - acousitic microstreaming - cavitation |
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Define: periodontal debridement
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- creation of biologically acceptable root surface by thorough removal of plaque, biofilm, calculus and endotoxins
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Where is the theoretical endpoint of debridement?
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microbial response
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Where is the clinical endpoint of debridement?
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- tissue response
- absence of inflammation (no persistant BOP) |
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What is the MOST accurate predictor of inflammation?
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persistent BOP
so.. converting of a bleeding site to non-bleeding results in histological health :) |
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Inflammation tells us _______ to treat, pocket depth tells us _______ to treat
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Inflammation tells us WHEN to treat, pocket depth tells us HOW to treat
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Components of magnetostrictive insert for US
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- stack
- seal - connecting body - nozzel - tip |
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What is meant by focused spray?
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- delivery of water directly to tip
- flushed away depostis - better water managment and less usage --> increased comfort for ptn and visibility for operator |
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What is temporary boost power?
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- increases power by 25% to remove spot areas of tenacious calculus
How? depress foot pedal all the way --> light on unit will indicate when boost mode is on |
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What is "the blue zone"?
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- provides ultra power range for subgingival debridementl short stroke length
- deplaquing - improves patient comfort - maximizes life of insert |
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List most to least powerful parts of the tip
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point of tip>concave face>convex back>lateral surface
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Low vs high power strokes?
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Low: shorter, lesss powerful stroke -
Higher: longer, more powerful stroke |
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Indications for using low vs high power strokes
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Low: removal of light deposit, biofilm and endotoxin
High: moderate - heavy calculus removal |
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Describe the relationship between frequency and active tip area and the clinical significance
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higher frequency = smaller active tip area
30KHz = 4.2mm 50KHx = 2.3mm Sig: frequency controls vibration - determines HOW MUCH of the tip is actively removing deposits |
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Infection control
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- autoclavable handpiece
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Client preparation - medical considerations
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- compromized immune system
- infectious disease transmitted by aerosol - pacemaker/defrillator - resp disease - swallowing difficulty - tinnitus/auditory dysfunction - children |
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Client preparatoin - dental considerations
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- areas of demin
- restorations - extreme sensitivity - implants - primary teeth - newly erupted teeth |
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Design/Uses for beaver tail insert
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- wider, flat tip
- best choice for moderate-heavy staining (esp nicotine, blackline and green teas) - removal of heavy supragingival deposites (ledges) |
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Design/uses for FSI 1000
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- 3 curve shank with tapered tip facilitates access to line angles and interproximal surfaces
- coined edges provide more energy at the contact points providing improved calculus removal - suprgingival use - gross removal of mod-heavy tenacious and radiographic calculus - |
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Describe benefits of coined edges
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- beveled edge increase efficacy of deposit removal
- US energy is targetted to each of the 4 corners rather than on the full circumference of a rounded working end |
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#10 vs #100 design
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#10: 1 curve shank with tapered tip
#100: 2 bend, straight shank with tapered tip |
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#10 vs #100 uses
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both provide:
- gross removal of mod-heavy calculus and stain - supraG or subG use |
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Uses for slim diameter tips
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removal of plaque, biofilm, endotoxins and light-moderate caculus, stains
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Uses for FSI-SLI 10S aka slim straight
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- light-mod deposits
- biofilm and endotoxin debridement - low-med power; blue zone - ≤4mm PD : anterior and posteriors OK - > 4mm PD : anterior ONLY |
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Uses/features of slim curved design (FSI SLI 10R, 10L)
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- right and left
- calculus removal and deplaqueing - furcation involvement - attachment levels ≥4mm - excellent acccess and adaptation to root anatomy - subgingival irrigation - SPS blue zone for light deposites - use low to medium power |
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Root substance loss depends on?
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- lateral force
- tip angulation - power setting - tip design* |
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Anatomical features that complicate instrumentation
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- palatal groove that extends into the cervical third of max lateral
- deep, linear, proximal root concavities and furcations of max 1st premolar - prox concavities extending from the furcation to the CEJ of max molars - deep linear root concavities on the prox surfaces of mand canines - wide shallow root concavities on mesial or mand molar - deep depression on root trunk and furcation of mand molar |
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Visual clues for right and left slimline inserts
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- post teeth: position insert stack over the ant teeth and place the point of the insert on the occlusal surface
- ant teeth: stack is placed parallal to incisal edge and tip is placed on incisal edge of the tooth -tip toward tisse |
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Face and tip of insert is toward ________
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Face and tip of insert is toward TISSUE not tooth/root (opposite of hand instruments)
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Features/uses for slimline 1000
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For: tight spaces, heavy tenatious calculus and furcations
- all in one, multi use instrument - improved access and familiar adaptation - combined bend profile and coined edges (working tip only) + slim tip and focus spray - 30% thinner diameter throughout the body of tip - more defined bend angle |
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Rule of thumb for tip choice
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the HEAVIER the deposit, the THICKER the tip, the HIGHER the power
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Grasp used for ultrasonics?
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pen grasp higher on instrument
- support hose and balance handpiece - 0-15º to tooth |
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Fulcrum for ultrasonics?
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- primarily extraoral
- insertion at ging marg - exploring pressure - keep tip in motion - multidirectional strokers |
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Altrente fulcrum tecniques
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- modified intraoral cross arch, opposite arch and finger on finger
- basic extraoral - knuckle rest, chin cup, finger assist |
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T/F: US should be used coronal to apically with no lateral pressure
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true
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When to use oblique (transverse) strokes
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- supra G and interproximal
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When to use vertical strokes
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- sub G
- supra G too - maximizes access to deep pockets |
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Subgingival adapation
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- position insert like a probe
- "vertical" insertion |
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Contact area adaption
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- position insert like a sickle scaler
- Oblique" stroke |
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T/F: Generally, there is no right or wrong stroke to use - all strokes are acceptable
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TRUE!
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