Online Tutorial 3: Periodontal Instrumentation Principles

Question 1

What is periodontal debridement

Answer 1

• This is the removal of bacterial plaque biofilms and calculus deposits from the crown and/or root surfaces and from within the pocket space

Question 2

What are the aims of periodontal debridement

Answer 2

• Arrest the progression of periodontal disease
• Create an environment that assists in maintaining tissue health
• Increase the effectiveness of patient self care by removing plaque retentive biofilms

Question 3

What is root planing

Answer 3

This is designed to remove cementum or surface dentine that is rough and contains impregnated calculus

Question 4

Why is root planing not encouraged anymore

Answer 4

Can be too damaging to the root surfaces

Question 5

What are the 3 main parts of a periodontal instrument

Answer 5

• Handle
• Shank
• Working end

Question 6

What is the terminal shank

Answer 6

This is the part of the shank that is directly connected to the working end

Question 7

What is a simple and a complex shank

Answer 7

Simple shank = used for anterior teeth and is straight from the terminal shank to the working end
Complex shank = used for posterior teeth and there is a bend in the terminal shank connected to the working end

Question 8

What is the difference in the working ends between curettes and sickles

Answer 8

Curettes = Rounded end (toe)
Sickles = Pointed end (tip)

Question 9

What cross section does the working end of supra gingival scalers have

Answer 9

Triangular

Question 10

Are sickle scalers used sub or supra gingivally

Answer 10

supragingivally only

Question 11

What kinds of curet are there

Answer 11

Universal and site specific curettes

Question 12

What shape of cross section do curettes have

Answer 12

Semi-circular

Question 13

Are curettes used sub or supra gingivally

Answer 13

BOTH

Question 14

How many cutting edges do sickle scalers have

Answer 14

2

Question 15

What is the difference in the cutting edges of universal and site specific curettes

Answer 15

Universal: The face is perpendicular to the lower shank, so the 2 cutting edges are level with each other

Site Specific: Lower cutting edges is at a 70º angle to the tooth surface when the lower shank is parallel

Question 16

What teeth is the Universal 4L/4R curettes used for

Answer 16

Posterior teeth

Question 17

What teeth is the Universal 2L/2R curettes used for

Answer 17

Anterior teeth

Question 18

What is another name for the grace curettes

Answer 18

Site specific curettes

Question 19

When should you be in the 8-10 o’clock position for debridement

Answer 19

When debriding surfaces facing towards from you on anterior teeth

Question 20

When should you be in the 12 o’clock position for debridement

Answer 20

When debriding surfaces facing away from you on anterior teeth

Question 21

When should you be in about the 9:00 position for debridement

Answer 21

When debriding surfaces facing towards you on posterior teeth

Question 22

When should you be in about the 10-11 o’clock position for debridement

Answer 22

When debriding the surfaces facing away from you on posterior teeth

Question 23

What are the 3 main techniques needed when doing periodontal instrumentation

Answer 23

• Adaptation
• Angulation
• Application

Question 24

Describe the adaptation technique for perio instrumentation

Answer 24

This is the positioning of the first 1-2 mm of the working’s lateral surface in contact with the tooth

Question 25

Describe the angulation technique for perio instrumentation

Answer 25

This is the relation between the face of the working end of and the tooth surface

Question 26

What angle should there be between the face of the working end of tooth surface

Answer 26

70-80º

Question 27

What is the problem with over angulation in debridement

Answer 27

Can cause damage to soft tissues

Question 28

What is the problem with under-angulation debridement

Answer 28

Will leave burnished calculus, which is more difficult to remove

Question 29

Describe the application technique for perio instrumentation

Answer 29

applying pressure to the instrument after adapting and angulating it to the tooth surface

Question 30

Which direction are vertical and oblique strokes always in

Answer 30

Coronal direction, never downwards as this can cause damage

Question 31

The inner cutting edge of a sickle scaler should be used for which part of a tooth

Answer 31

The distal parts, one end of the scaler will be for the buccal-distal face and the other will be for the lingual-distal face

Question 32

Where are the common sites for calculus to build up

Answer 32

- Lingual aspect of the lower incisors | - Buccal aspect of the upper first molars

Question 33

Why is calculus build up more common on the lingual aspect of lower incisors and the buccal aspect of upper first molars

Answer 33

These areas are near the opening of the salivary glands

Question 34

What are the medical contraindications for ultrasonic instrumentation

Answer 34

- Pacemakers - Infectious disease - Immunocompromised - Respiratory problems - Dysphagia (prone to gagging

Question 35

What are the dental contraindications for ultrasonic instrumentation

Answer 35

- Implants (may damage titanium abutment) - Restorative materials - Demineralisation - Hypersensitive teeth

Question 36

What 3 connections are there for setting up a cavitron

Answer 36

- Blue water line to the yellow water ting to purge and the into the blue connection on the chair - Power cable - Foot peddle