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174 Cards in this Set
- Front
- Back
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What is the major objective of nonsurgical periodontal treatment?
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Create an environment in which the tissues can return to health and then be maintained in health.
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What includes in nonsurgical periodontal therapy?
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- 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 |
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Oral Prophylaxis
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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.
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Instrument selection
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- versatile
- small in number - durable - sensitive |
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Insturment Identification
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- blade shape or classification e.g curet
- design name and number e.g. Gracey 15/16 |
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What is the major objective of nonsurgical periodontal treatment?
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Create an environment in which the tissues can return to health and then be maintained in health.
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Instrument parts
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- blade
- face - back - Lateral borders / surfaces - Cutting edge(s) - shank - handle |
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What includes in nonsurgical periodontal therapy?
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- 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 |
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what is blade?
list the varieties of a blade. |
= working end
- shape - curved or straight - thick or thin - balanced - single ended or double ended |
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Oral Prophylaxis
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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.
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A curet can have _______ and _______ cutting edges.
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straight / rounded
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Instrument selection
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- versatile
- small in number - durable - sensitive |
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A sickle scaler can have __________ and __________ cutting edges.
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straight / curved
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Insturment Identificatio
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- blade shape or classification e.g curet
- design name and number e.g. Gracey 15/16 |
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List the varieties of instrument shank.
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- thick or thin
- shorter or longer - straight or angled (comlex) - balanced |
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Instrument parts
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- blade
- face - back - Lateral borders / surfaces - Cutting edge(s) - shank - handle |
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what is blade?
list the varieties of a blade. |
= working end
- shape - curved or straight - thick or thin - balanced - single ended or double ended |
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A curet can have _______ and _______ cutting edges.
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straight / rounded
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A sickle scaler can have __________ and __________ cutting edges.
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straight / curved
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List the varieties of instrument shank.
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- thick or thin
- shorter or longer - straight or angled (comlex) - balanced |
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List the varieties of instrument handles.
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- cone socket
- double ended or single ended - large or small in diameter - hollow or solid - smooth or serrated (knurled) |
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A systematic and organized approach and proper technique will achieve what
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Thouroughness
- complete removal of calculus - comfort for patient |
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How are the patient tissues treated?
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With maximum respect and gentleness
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there is no exuse for roughness
a. true b. false |
a. true
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list the metal used for the instruments.
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- stainless steel
- carbide steel - tungsten carbide |
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what are the advantages of stainless steel instruments?
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- non-corrosive
- good cutting edge |
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What are the disadvantages of stainless steel instruments?
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edge is destroyed easily when sharpening
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what are the advantages of carbide instruments?
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good cutting edge
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What are the disadvantages of carbide instruments?
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rusts easily
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what are the advantages of tungsten carbide instruments?
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- hardest metal
- holds best edge |
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What are the disadvantages of tungsten carbide instruments?
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difficult to sharpen
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functional shank
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a shank that extends from the working end to the shank end closest to the instrument handle
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terminal shank
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a shank that extends from the working end to the first bend in the shank closest to the working end
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a shank ideal for working in deep pockets
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extended lower shank
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The shank of extended lower shank is ____ mm longer than a standard shank.
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3 mm
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design features of the shank?
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- simple
- comlpex |
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shank curvature
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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.
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how does simple shank appear?
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it appears straight when you holding the instrument so that the working end top or tip is facing you
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How does complex shank appear?
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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list types of instrument used for scaling and root planning?
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- curets
- sickles - hoes - files - chisels |
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List characteristics of curets
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- 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 |
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how many cutting does a (single ended) curet have?
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2 cutting edges
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________ shank is used for anterior
a. straigther b. angled |
a. straigther
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_______ shank is used for posteriors
a. straighter b. angled |
b. angled
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purpose of curets
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- scaling (supra and subgingival calculus)
- root planning |
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curets adapt well to cervical areas
a. true b. false |
a. true
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Why are the curets the instruments of choice for subgingival scaling and root planing?
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because the adapt well to cervical areas
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list e.g. of universal curets
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- columbia (SC) 13/14
- Barnhart 5/6 - SN 137 (curet end) |
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list e.g. of area specific curets
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- Gracey (SAS) 1/2
- Gracey (SGR) 11/12 - Gracey (SGR) 13/14 - Gracey (SGR) 15/16 - Gracey (SGR) 17/16 |
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how is the face angulated during insertion of a curet into sulcus?
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flat to tooth
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in the application of curet how do you adapt the cutting edge?
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> 45 degrees but < 90 degrees
(ideally 60(?),70 - 80 degrees) |
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Larger curets are used for ___________ calculus
a. fine b. heavy |
b. heavy
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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 |
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Columbia 13/14 is a:
a. universal curet b. area specific curet |
a. universal curet
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Bannhart 5/6 is a:
a. universal curet b. area specific curet |
a. univeral curet
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SN 137 (curet end) is a:
a. universal curet b. area specific curet |
a. universal curet
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are Gracey's:
a. universal curets b. area specific curets |
b. area specific curets
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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
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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
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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
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characteristics of curved sickle
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- 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 |
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sickle - face and 2 lateral sides merge to form a ________:
a. half circle b. point c. rectangle |
b. point
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what shape is a sickle in cross section:
a. half circle b. round c. triangular |
c. triangular
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how many degrees is internal angle of a sickle?
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70-80 degrees
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List characteristics of a straight sickle.
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- working end is straight
- face is flat - shank angulation -- straight (anterior) -- modified or complex (posterior) |
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a sickle with straigth shank angulation is used for:
a. anteriors b. posteriors |
a. anteriors
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a sickle with modified or complex shank angulation is used for:
a. anteriors b. posteriors |
b. posteriors
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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 |
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list contraindications for subgingival use of sickle
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- 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 |
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sickle application
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- 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 |
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sickle application is
greater than ___ degrees but less than ____ degrees |
45 / 90
ideally 70-80 degrees |
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What type of storke do we use with sickle?
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vertical
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what type of stroke do we use with curet?
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vertical to oblique pull stroke
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SN 137 (sickle end) is used for:
a. posterior teeth b. anterior teeth |
b. anterior teeth
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S202S is used for:
a. posterior teeth b. anterior teeth |
a. posterior teeth
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Hoe characteristics
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- single, straight cutting edge
- blade 99-100 degree angle to shank - cutting edge at 45 degree angle (beveled) - shank may be angled |
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hoe has _____, _______ cutting edge
a. double, rounded b. single, curved c. single, straight d. double, straight |
c. single, straight
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hoe blade has a __ to __ degrees angle to shank
a. 45 - 90 b. 70 - 80 c. 99 - 100 d. 60 - 90 |
c. 99 - 100
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Purpose of hoe
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- heavy calculus
- supra calculus (may be 2 mm sub) |
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hoe is mainly used for:
a. sub calculus b. supra calculus |
b. supra
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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 |
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Hoe - contraindications
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- blade is to thick - distends tissue
- tooth is curved - cutting edge is straigth - may gauge cementum - decreased tactile sense |
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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
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hoe has to have 2 point contact when possible
a. true b. false |
a. true
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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 |
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what type of stroke is used with hoe.
a. push b. pull |
b. pull
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hoe's are usually used on proximals
a. true b. false |
b. false
not usually used on proximals |
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how many cutting edges does a file have?
a. one b. two c. four d. multiple |
d. multiple
(like a series of mini hoes) |
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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 |
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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
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The shank of a file may be angled
a. true b. false |
a. true
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file may be bulky to use
a. true b. false |
a. true
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file - ______ tactile sense
a. increased b. decreased |
a. decreased
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purpose of files
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- calculus removal - crushes
- smooth CEJ - removal of large deposits prior to root planning - remove overhanging restorations |
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application of file - working surface is _____ tooth
a. flat against b. angled to |
a. flat against
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application of files -
a. 1 point contact b. 2 point contact |
b. 2 point contact,when possible
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list the characteristics of chisels
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- straight cutting edge
- blade is continuous with shank - blade end is flat with 45 degree angle |
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chisel has rounded cutting edge
a. true b. false |
b. false
straight cutting edge |
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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
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The blade end of chisel is
a. rounded b. pointy c. flat |
c. flat
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The blade end of chisel is flat with ___ degree angle
a. 90 b. 70 c. 45 d. 60 |
c. 45
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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
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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 |
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full width of blade of chisel is used on the tooth
a. true b. false |
a. true
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chisels are used from
a. distal to mesial b. mesial to distal c. lingual to facial d. facial to lingual |
d. lingual to facial
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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 |
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Blade adaptation
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relationship between the instrument and the surface of the tooth
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result of improper adaptation
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can damage tooth surface and cause tissue trauma
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blade angulation
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angle formed by the face of the blade when the cutting edge is placed against the tooth
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the blade angulation is the same for all istruments
a. true b. false |
b. false
different for each type of insturment |
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Lateral pressure
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the pressure of the instrument against the tooth
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exploratory lateral pressure is:
a. light b. moderate to heavy c. lighter than scaling |
a. light
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lateral pressure used for root planing:
a. light b. moderate to heavy c. lighter than scaling |
c. lighter than scaling
(scaling - moderate to heavy) |
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lateral pressure used for scaling:
a. light b. moderate to heavy c. lighter than scaling |
b. moderate to heavy
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list types of strokes
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- pull
- push - push and pull - walking stroke |
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vertical stroke direction is _______ long axis
a. parallel with b. perpendicular to c. diagonal to |
a. parallel with
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horizontal stroke direction is _______ long axis
a. parallel with b. perpendicular to c. diagonal to |
b. perpendicular to
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oblique stroke direction is named:
a. parallel b. perpendicular c. diagonal |
c. diagonal
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the grasp of a scaler or curet is _______ while using an exploratory stroke
a. firm b. light |
b. light
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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
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The stroke involves the unified movement of the whole arm
a. true b. false |
a. true
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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 |
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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
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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
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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
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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. |
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list different series of area specific curets
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- Gracey
- Kramer-Nevins - Turgeon - After Five Gracey - Mini Five Gracey - Vision Curvette - O'Hehir |
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on area specific curets 1 cutting edge is more curved
a. true b. false |
a. true
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Relationship of face to lower shank
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makes an area specific curet VERY special!
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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
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tilted face of area specific curet causes
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one edge to be lower than the other on each working end
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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
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(area specific curet)
Which cutting edge is used for calculus removal? a. higher b. lower c. right d. left |
b. lower
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(area specific curet)
Why the lower cutting edge is also called working cutting edge? |
because only the lower cutting edge is used
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(area specific curet)
The cutting edge that is not used is called |
nonworking cutting edge
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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
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advantage of the design feature (tilted face) of area specific curet
|
helps to protect the tissue
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Gracey curet
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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 |
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Universal curet
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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 |
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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 |
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Gracey curette 17/18
advantage of reduced blade length? |
enhances adaptation
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Gracey 15/16
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- blade finished for mesial posterior surfaces
- shank design of Gracey 13/14 - superior adaptability - Increased access for hard to reach areas - Immunity Steel |
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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
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Tips for end selection
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the angle (or bump) made by the shank bend closest to the blade should be pointed towards the occlusal surface for postrior teeth.
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Gracey 17/18 - use the cutting edge on the _____ of the angle
a. outside b. inside |
b. inside
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Gracey 15/16 - use the cutting edge on the _____ of the angle
a. outside b. inside |
a. outside
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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
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Gracay 17/ 18 is used on ______ surface
a. distal b. mesial c. occlusal |
a. distal
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design of Gracey 17/18
|
- sharp angles
- longer terminal shank - shorter blade |
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Gracey 17/18
Improved access and adaptation to molar regions and distal pockets a. true b. false |
a. true
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Gracey 15/16
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- mesial posterior use
- shank design of Gracey 11/12 - improved access and adaptation for molar regions |
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What is insertion?
|
action of moving the working-end beneath the gingival margin into the sulcus or periodontal pocket.
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what is the angulation for insertion?
|
- face-to-tooth surface angulation
- an angle between 0 and 40 degrees. |
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when inserting an instrument position the face as close to the tooth surface as possible
a. true b. false |
a. true
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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
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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
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correct end selection
|
- lower shank parallel to distal surface
- functional shank goes up and over the tooth. |
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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.
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During the insertion of the instrument the face is hugging the root surface.
a. true b. false |
a. true
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for calculus removal the angulation should be:
|
greater than 45 degrees and
less than 90 degrees |
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The face-to-tooth surface angulation for calculus removal is ideal
|
between 60-80 degrees
|
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What is the calculus removal stroke used for?
|
- lift calculus deposits off the tooth
|
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Calculus removal stroke is used with which instruments?
|
- curets
- sickle scalers - periodontal files |
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Name the characteristics of calculus removal stroke?
|
- brief
- tiny - biting strokes = used to snap a calculus deposit from tooth |
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What kind of lateral pressure is used for calculus removal stroke?
|
Moderate pressure
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face flat to tooth during insertion into sulcus
a. true b. false |
a. true
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to find apical edge of calculus you use which type of stroke?
|
exploring stroke
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area specific - cutting edge is already at the correct angulation when lower shank is parallel
a. true b. false |
a. true
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after detection of calculus, position blade and engage a push stroke
a. true b. false |
b. false
engage a pull stroke (vertical to oblique) |
