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174 Cards in this Set

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What is the major objective of nonsurgical periodontal treatment?
Create an environment in which the tissues can return to health and then be maintained in health.
What includes in nonsurgical periodontal therapy?
- patient instruction in preventive measure
- scaling
- root planning
- extrinsic stain removal (polishing)
- removal of sutures
- post-operative care
- treatment of hypersensetive teeth
- immediate, short term and maintanance evalutation
Oral Prophylaxis
a series of procedures whereby calculus, stain, and other accretions are removed from the clinical crowns of the teeth, and the clinical crowns of the teeth are polished.
Instrument selection
- versatile
- small in number
- durable
- sensitive
Insturment Identification
- blade shape or classification e.g curet
- design name and number e.g. Gracey 15/16
What is the major objective of nonsurgical periodontal treatment?
Create an environment in which the tissues can return to health and then be maintained in health.
Instrument parts
- blade
- face
- back
- Lateral borders / surfaces
- Cutting edge(s)
- shank
- handle
What includes in nonsurgical periodontal therapy?
- patient instruction in preventive measure
- scaling
- root planning
- extrinsic stain removal (polishing)
- removal of sutures
- post-operative care
- treatment of hypersensitive teeth
- immediate, short term and maintanance evalutation
what is blade?
list the varieties of a blade.
= working end

- shape
- curved or straight
- thick or thin
- balanced
- single ended or double ended
Oral Prophylaxis
a series of procedures whereby calculus, stain, and other accretions are removed from the clinical crowns of the teeth, and the clinical crowns of the teeth are polished.
A curet can have _______ and _______ cutting edges.
straight / rounded
Instrument selection
- versatile
- small in number
- durable
- sensitive
A sickle scaler can have __________ and __________ cutting edges.
straight / curved
Insturment Identificatio
- blade shape or classification e.g curet
- design name and number e.g. Gracey 15/16
List the varieties of instrument shank.
- thick or thin
- shorter or longer
- straight or angled (comlex)
- balanced
Instrument parts
- blade
- face
- back
- Lateral borders / surfaces
- Cutting edge(s)
- shank
- handle
what is blade?
list the varieties of a blade.
= working end

- shape
- curved or straight
- thick or thin
- balanced
- single ended or double ended
A curet can have _______ and _______ cutting edges.
straight / rounded
A sickle scaler can have __________ and __________ cutting edges.
straight / curved
List the varieties of instrument shank.
- thick or thin
- shorter or longer
- straight or angled (comlex)
- balanced
List the varieties of instrument handles.
- cone socket
- double ended or single ended
- large or small in diameter
- hollow or solid
- smooth or serrated (knurled)
A systematic and organized approach and proper technique will achieve what
Thouroughness
- complete removal of calculus
- comfort for patient
How are the patient tissues treated?
With maximum respect and gentleness
there is no exuse for roughness
a. true
b. false
a. true
list the metal used for the instruments.
- stainless steel
- carbide steel
- tungsten carbide
what are the advantages of stainless steel instruments?
- non-corrosive
- good cutting edge
What are the disadvantages of stainless steel instruments?
edge is destroyed easily when sharpening
what are the advantages of carbide instruments?
good cutting edge
What are the disadvantages of carbide instruments?
rusts easily
what are the advantages of tungsten carbide instruments?
- hardest metal
- holds best edge
What are the disadvantages of tungsten carbide instruments?
difficult to sharpen
functional shank
a shank that extends from the working end to the shank end closest to the instrument handle
terminal shank
a shank that extends from the working end to the first bend in the shank closest to the working end
a shank ideal for working in deep pockets
extended lower shank
The shank of extended lower shank is ____ mm longer than a standard shank.
3 mm
design features of the shank?
- simple
- comlpex
shank curvature
an instrument has a complex shank if it has bends that deviate from the long axis of the shank when tip or toe is facing you.
how does simple shank appear?
it appears straight when you holding the instrument so that the working end top or tip is facing you
How does complex shank appear?
it has side-to-side bends
- has bends that deviate from the long axis of the shank when the tip or toe is facing you
simple/short shank is used
1. for anterior or posterior teeth?
2. supra or subgingival calculus removal?
3. name the instrument with this shank?
1. anterior
2. supra
3. anterior sickle
simple/long shank is used
1. for anterior or posterior teeth?
2. supra or subgingival calculus removal?
3. name the instrument with this shank?
1. anterior
2. subgingival
3. anterior gracey
complex/short shank is used
1. for anterior or posterior teeth?
2. supra or subgingival calculus removal?
3. name the instrument with this shank?
1. anterior and posterior
2. supra
3. universal sickle
complex/intermediate shank is used
1. for anterior or posterior teeth?
2. supra or subgingival calculus removal?
3. name the instrument with this shank?
1. anterior and posterior
2. sub
3. universal curet
complex/long shank is used
1. for anterior or posterior teeth?
2. supra or subgingival calculus removal?
3. name the instrument with this shank?
1. posterior
2. sub
3. posterior gracey
list types of instrument used for scaling and root planning?
- curets
- sickles
- hoes
- files
- chisels
List characteristics of curets
- 2 cutting edges
- 1 cutting edge more curved on area specific curets
- face flat, base curved, back rounded
- shank - straighter for anterior, angled for posterior
- paired
how many cutting does a (single ended) curet have?
2 cutting edges
________ shank is used for anterior
a. straigther
b. angled
a. straigther
_______ shank is used for posteriors
a. straighter
b. angled
b. angled
purpose of curets
- scaling (supra and subgingival calculus)
- root planning
curets adapt well to cervical areas
a. true
b. false
a. true
Why are the curets the instruments of choice for subgingival scaling and root planing?
because the adapt well to cervical areas
list e.g. of universal curets
- columbia (SC) 13/14
- Barnhart 5/6
- SN 137 (curet end)
list e.g. of area specific curets
- Gracey (SAS) 1/2
- Gracey (SGR) 11/12
- Gracey (SGR) 13/14
- Gracey (SGR) 15/16
- Gracey (SGR) 17/16
how is the face angulated during insertion of a curet into sulcus?
flat to tooth
in the application of curet how do you adapt the cutting edge?
> 45 degrees but < 90 degrees
(ideally 60(?),70 - 80 degrees)
Larger curets are used for ___________ calculus
a. fine
b. heavy
b. heavy
small curets are used for ____________ calculus
a. fine
b. heavy
c. fine and heavy
d. root planning
e. both a and d
e. both a and d
for fine calculus and root planing
Columbia 13/14 is a:
a. universal curet
b. area specific curet
a. universal curet
Bannhart 5/6 is a:
a. universal curet
b. area specific curet
a. univeral curet
SN 137 (curet end) is a:
a. universal curet
b. area specific curet
a. universal curet
are Gracey's:
a. universal curets
b. area specific curets
b. area specific curets
Gracey 11/12, 15/16 are used:
a. mesial of posteriors
b. mesial of anteriors
c. distals of posteriors
d. distals of anteriors
e. mesial and distal of anteriors
a. mesial of posteriors
Gracey 13/14, 17/18 are used:
a. mesial of posteriors
b. mesial of anteriors
c. distals of posteriors
d. distals of anteriors
e. mesial and distal of anteriors
c. distals of posteriors
Gracey 1/2 are used:
a. mesial of posteriors
b. mesial of anteriors
c. distals of posteriors
d. distals of anteriors
e. mesial and distal of anteriors
e. mesial and distal of anteriors
characteristics of curved sickle
- 2 cutting edges on a curved blade
- face and 2 lateral sides merge to form a point
- triangular in section - internal anlge = 70-80 degrees
sickle - face and 2 lateral sides merge to form a ________:
a. half circle
b. point
c. rectangle
b. point
what shape is a sickle in cross section:
a. half circle
b. round
c. triangular
c. triangular
how many degrees is internal angle of a sickle?
70-80 degrees
List characteristics of a straight sickle.
- working end is straight
- face is flat
- shank angulation
-- straight (anterior)
-- modified or complex (posterior)
a sickle with straigth shank angulation is used for:
a. anteriors
b. posteriors
a. anteriors
a sickle with modified or complex shank angulation is used for:
a. anteriors
b. posteriors
b. posteriors
sickles are used
a. supragingival
b. subgingival
c. slightly sub, if tissue allows
d. both a and c
d. both a and c
supra calculus or slightly sub, if the tissue allows
list contraindications for subgingival use of sickle
- trauma to tissue due to shape of blade
- pointed, straight cutting edge, may gouge root
- decreased tactile sense with heavy blades
- small sickles for fine supra calculus under contacts
sickle application
- greater than 45 but less than 90 degrees (ideally 70-80 degrees)
- vertical pull stroke
- SN 137 (sickle end) for anterior teeth
- S204S for posterior teeth
sickle application is
greater than ___ degrees but less than ____ degrees
45 / 90
ideally 70-80 degrees
What type of storke do we use with sickle?
vertical
what type of stroke do we use with curet?
vertical to oblique pull stroke
SN 137 (sickle end) is used for:
a. posterior teeth
b. anterior teeth
b. anterior teeth
S202S is used for:
a. posterior teeth
b. anterior teeth
a. posterior teeth
Hoe characteristics
- single, straight cutting edge
- blade 99-100 degree angle to shank
- cutting edge at 45 degree angle (beveled)
- shank may be angled
hoe has _____, _______ cutting edge
a. double, rounded
b. single, curved
c. single, straight
d. double, straight
c. single, straight
hoe blade has a __ to __ degrees angle to shank
a. 45 - 90
b. 70 - 80
c. 99 - 100
d. 60 - 90
c. 99 - 100
Purpose of hoe
- heavy calculus
- supra calculus (may be 2 mm sub)
hoe is mainly used for:
a. sub calculus
b. supra calculus
b. supra
hoe is only used on the:
a. facial of anterior
b. lingual of anterior
c. distal of last molars
d. mesial of last molars
e. both b and c
e. both b and c
used only on the lingual of anterior and distal of last molars
Hoe - contraindications
- blade is to thick - distends tissue
- tooth is curved - cutting edge is straigth
- may gauge cementum
- decreased tactile sense
What are NOT contraindications of a hoe:
a.blade is to thick - distends tissue
b. tooth is curved - cutting edge is straigth
c. may gauge cementum
d. decreased tactile sense
e. increased tactile sense
e. increased tactile sense
hoe has to have 2 point contact when possible
a. true
b. false
a. true
when using hoe we only have to use the end of the cutting edge on the tooth
a. true
b. false
b. false
whole length of cutting edge on tooth
what type of stroke is used with hoe.
a. push
b. pull
b. pull
hoe's are usually used on proximals
a. true
b. false
b. false
not usually used on proximals
how many cutting edges does a file have?
a. one
b. two
c. four
d. multiple
d. multiple
(like a series of mini hoes)
Files - what shape is the working end:
a. round
b. oval
c. rectangular
d. can be all of the above
d. can be all of the above
working end is round, oval or rectangular
blades of a file are at ___ to ___ degrees angle to shank
a. 99 - 100
b. 90 - 105
c. 70-80
d. 45 - 90
b. 90 to 105 degrees
The shank of a file may be angled
a. true
b. false
a. true
file may be bulky to use
a. true
b. false
a. true
file - ______ tactile sense
a. increased
b. decreased
a. decreased
purpose of files
- calculus removal - crushes
- smooth CEJ
- removal of large deposits prior to root planning
- remove overhanging restorations
application of file - working surface is _____ tooth
a. flat against
b. angled to
a. flat against
application of files -
a. 1 point contact
b. 2 point contact
b. 2 point contact,when possible
list the characteristics of chisels
- straight cutting edge
- blade is continuous with shank
- blade end is flat with 45 degree angle
chisel has rounded cutting edge
a. true
b. false
b. false
straight cutting edge
the blade of chisel is:
a. angled 99-100 degree to shank
b. is continuous with shank
c. is at 90 - 105 degree to shank
b. is continuous with shank
The blade end of chisel is
a. rounded
b. pointy
c. flat
c. flat
The blade end of chisel is flat with ___ degree angle
a. 90
b. 70
c. 45
d. 60
c. 45
The purpose of chisel is to remove ____ calculus from interproximal / where papilla is ________.
a. supra / present
b. supra/ missing
c. sub / present
d. sub / missing
b. supra / missing
chisels are used on
a. posteriors
b. anteriors
c. molars
d. premolars
e. both b and d
e. both b and d
used on anterior teeth, sometimes premolars
full width of blade of chisel is used on the tooth
a. true
b. false
a. true
chisels are used from
a. distal to mesial
b. mesial to distal
c. lingual to facial
d. facial to lingual
d. lingual to facial
what type of stoke is used with chisel?
a. pull
b. push
c. horizontal
d. vertical
e. both b and c
f. both a and d
e. both b and c
horizontal and push stroke
Blade adaptation
relationship between the instrument and the surface of the tooth
result of improper adaptation
can damage tooth surface and cause tissue trauma
blade angulation
angle formed by the face of the blade when the cutting edge is placed against the tooth
the blade angulation is the same for all istruments
a. true
b. false
b. false
different for each type of insturment
Lateral pressure
the pressure of the instrument against the tooth
exploratory lateral pressure is:
a. light
b. moderate to heavy
c. lighter than scaling
a. light
lateral pressure used for root planing:
a. light
b. moderate to heavy
c. lighter than scaling
c. lighter than scaling
(scaling - moderate to heavy)
lateral pressure used for scaling:
a. light
b. moderate to heavy
c. lighter than scaling
b. moderate to heavy
list types of strokes
- pull
- push
- push and pull
- walking stroke
vertical stroke direction is _______ long axis
a. parallel with
b. perpendicular to
c. diagonal to
a. parallel with
horizontal stroke direction is _______ long axis
a. parallel with
b. perpendicular to
c. diagonal to
b. perpendicular to
oblique stroke direction is named:
a. parallel
b. perpendicular
c. diagonal
c. diagonal
the grasp of a scaler or curet is _______ while using an exploratory stroke
a. firm
b. light
b. light
After the instument is positioned, the instrument is is held _______ for the working stroke with which the calculus is removed.
a. more lightly
b. more firmly
c. less firmly
b. more firmly
The stroke involves the unified movement of the whole arm
a. true
b. false
a. true
The strokes should be long, overlapping and controlled while working in the instrumentation zone.
a. true
b. false
b. false
the strokes should be short, overlapping
when selecting an end of a instrument the "V" of the bend in the shank closest to the blade should be pointed towards the _______ surface for posterior teeth.
a. gingival surface
b. occlusal surface
c. distal surface
d. mesial surface
b. occlusal surface
The face of the blade ______ be against the tooth surface when you first place it
a. should be
b. should not be
b. should not be
in the end selection of the insrument the blade _____ wrap snuggly around the ____ surface.
a. should / distal
b. should / mesial
c. should not / distal
d. should not / mesial
c. should not / distal
tips for end selection
- the blade should point directly into the sulcus.
a. true
b. false
b. false
the blade should NOT point directly into the sulcus.
list different series of area specific curets
- Gracey
- Kramer-Nevins
- Turgeon
- After Five Gracey
- Mini Five Gracey
- Vision Curvette
- O'Hehir
on area specific curets 1 cutting edge is more curved
a. true
b. false
a. true
Relationship of face to lower shank
makes an area specific curet VERY special!
relation of face (of area specific curet) to the lower shank
a. face is in 90 degree
b. face is tilted
b. face is tilted
tilted face of area specific curet causes
one edge to be lower than the other on each working end
Tilted face on an area specific curet is _______ the design characteristics of sickle scalers and universal curets.
a. the same as
b. very different than
b. very different than
(area specific curet)
Which cutting edge is used for calculus removal?
a. higher
b. lower
c. right
d. left
b. lower
(area specific curet)
Why the lower cutting edge is also called working cutting edge?
because only the lower cutting edge is used
(area specific curet)
The cutting edge that is not used is called
nonworking cutting edge
The nonworking cutting edge of an area specific curet is angled _______ soft tissue wall of the pocket
a. towards the
b. away from
b. away from
advantage of the design feature (tilted face) of area specific curet
helps to protect the tissue
Gracey curet
area of use - area specific
blade angle - offset = face 60-70 degrees to shank
use of cutting edge - only 1 cutting edge
cuvature of cutting edges - curved in 2 planes = blade curves up and to the side
Universal curet
area of use - universal
blade angle - Not offset = face 90 degree to shank
use of cutting edge - both cutting edges
cuvature of cutting edges - curved in 1 plane only
gracey curette 17/18
What are the advantages of accentuated anlges and long terminal shank
- Imporves access to deep pockets on distal
- increases crown clearance
- reduces interference from opposing arch
Gracey curette 17/18
advantage of reduced blade length?
enhances adaptation
Gracey 15/16
- blade finished for mesial posterior surfaces
- shank design of Gracey 13/14
- superior adaptability
- Increased access for hard to reach areas
- Immunity Steel
the blade of Gracey 15/16 is finished for _______ surfaces.
a. distal posterior
b. distal anterior
c. mesial posterior
d. mesial anterior
d. mesial posterior
Tips for end selection
the angle (or bump) made by the shank bend closest to the blade should be pointed towards the occlusal surface for postrior teeth.
Gracey 17/18 - use the cutting edge on the _____ of the angle
a. outside
b. inside
b. inside
Gracey 15/16 - use the cutting edge on the _____ of the angle
a. outside
b. inside
a. outside
for the end selection for anterior area specific curets, use cutting edge
a. angled up or towards the sky
b. angled down or towards the floor.
b. angled down or towards the floor
Gracay 17/ 18 is used on ______ surface
a. distal
b. mesial
c. occlusal
a. distal
design of Gracey 17/18
- sharp angles
- longer terminal shank
- shorter blade
Gracey 17/18
Improved access and adaptation to molar regions and distal pockets
a. true
b. false
a. true
Gracey 15/16
- mesial posterior use
- shank design of Gracey 11/12
- improved access and adaptation for molar regions
What is insertion?
action of moving the working-end beneath the gingival margin into the sulcus or periodontal pocket.
what is the angulation for insertion?
- face-to-tooth surface angulation
- an angle between 0 and 40 degrees.
when inserting an instrument position the face as close to the tooth surface as possible
a. true
b. false
a. true
What do we have to do first before using a double ended insrument?
we must decide which working end to use on the treatment area
to select the correct working end, observe the relation of the ___ shank to the _____ surface of the tooth.
a. upper / distal
b. upper / mesial
c. lower / distal
d. lower / mesial
c. lower shank / distal surface
correct end selection
- lower shank parallel to distal surface
- functional shank goes up and over the tooth.
proper technique for insertion
lower your hand and the handle until the face is hugging the tooth surface at a 0 degree angle to the tooth.
During the insertion of the instrument the face is hugging the root surface.
a. true
b. false
a. true
for calculus removal the angulation should be:
greater than 45 degrees and
less than 90 degrees
The face-to-tooth surface angulation for calculus removal is ideal
between 60-80 degrees
What is the calculus removal stroke used for?
- lift calculus deposits off the tooth
Calculus removal stroke is used with which instruments?
- curets
- sickle scalers
- periodontal files
Name the characteristics of calculus removal stroke?
- brief
- tiny
- biting
strokes = used to snap a calculus deposit from tooth
What kind of lateral pressure is used for calculus removal stroke?
Moderate pressure
face flat to tooth during insertion into sulcus
a. true
b. false
a. true
to find apical edge of calculus you use which type of stroke?
exploring stroke
area specific - cutting edge is already at the correct angulation when lower shank is parallel
a. true
b. false
a. true
after detection of calculus, position blade and engage a push stroke
a. true
b. false
b. false
engage a pull stroke (vertical to oblique)