Dental Radiography, Periodontics, and Scaling Flashcards
(159 cards)
1
Q
Give the 3 primary parts of a dental x-ray machine
A
- Control panel
- Long arm
- Tube head
2
Q
How do you know when a radiography exposure has been attained?
A
Indicator light + sound
3
Q
What is the only thing you usually have to adjust on the control panel of an x-ray machine?
A
Dials or buttons for changing exposure time
4
Q
Long arm typically extends ____” to ____” from the control panel
A
72” to 86”
5
Q
Exposure time is based on _______, ________, and _______.
A
- Patient species
- Patient size
- Density of tissues needed to penetrate
6
Q
If not standing behind a barrier to take a radiograph, stand at a ____ to ____ angle _____ to the beam.
A
90-130º angle perpendicular to the beam
7
Q
ALARA
A
As low as resonably achievable
8
Q
radiography that uses an electronic intraoral sensor, a computer, and an x-ray machine to produce digital images
A
Direct Radiography (DR)
9
Q
DR
A
Direct Radiography
10
Q
an electronic intraoral sensor used in direct radiography
A
Charged Coupled Device
11
Q
What is an important step before utilizing a charged coupled device?
A
Cover with plastic infection barrier before placing in the patien’t mouth
12
Q
Why does direct radiography have limited use for large breed dogs?
A
You need many more views to obtain a full mouth series
13
Q
radiography that uses a phosphor plate and a scanner to produce digital images
A
Computed Radiography (CR or Indirect Digital System)
14
Q
CR
A
Computed Radiography
15
Q
What size images does direct radiography produce?
A
0, 1, and 2
16
Q
What size images does computed radiography produce?
A
4
17
Q
Which type of digital radiography is better for large breed dogs? Why?
A
Computed Radiography - because it can produce size 4 images which means less views needed to obtain a full mouth series
18
Q
occurs when the x-ray beam does not impact portions of the sensor, plate, or film, which results in areas with no image
A
Cone Cutting
19
Q
occurs when there are errors in peak kilovoltage (kVp) and mA settings or exposure times
A
Too Dark/Light Images
20
Q
occurs when there is inaccurate vertical angulation during alignment of the x-ray beam
A
Elongation/Foreshortening
21
Q
Do do you correct elongation or foreshortening of radiographs?
A
Elongation > angle was too low
Foreshortening > angle was too high
22
Q
Diagnostic images must include _____ and _____
A
2-3 mm of bone around the apex of the tooth and the level of the alveolar bone
23
Q
the dental radiography technique that requires placing the sensor parallel to the tooth’s long axis and is only used for mandibular teeth caudal to the 4th premolar
A
Paralleling Technique
24
Q
Describe the paralleling dental radiography technique
A
place the sensor parallel to the tooth’s long axis and is only used for mandibular teeth caudal to the 4th premolar
25
The paralleling technique is used for which teeth?
Mandibular teeth caudal to the mandibular 4th premolar
26
Where is the technology positioned using the paralleling technique?
1. Sensor placed parallel to long axis of tooth
2. Beam directed perpendicular (90º) to the sensor/teeth
3. Beam positioned to aim for center of sensor
27
Which dental radiography technique is this?
Paralleling Technique
28
the dental radiography technique that projects the x-ray beam at a right angle to an imaginary line that bisects the angle formed by the tooth's long axis and the plane of the sensory/film
Bisecting Angle Technique
29
Describe the bisecting angle radiography technique
projects the x-ray beam at a right angle to an imaginary line that bisects the angle formed by the tooth's long axis and the plane of the sensory/film
30
The bisecting angle technique is used for which teeth?
Maxillary teeth
Mandibular teeth rostral to the mandibular 4th premolar
31
How is the patient positioned for the bisecting angle technique?
Maxillary views > sternal recumbency
Mandibular views > dorsal recumbency
32
What is the technology positioning using the bisecting angle technique?
1. Sensor placed in the mouth between maxillary + mandibular teeth
□ Teeth always placed on very edge of sensor + rest of sensor inside mouth
□ Maxillary views > flat + cord coming out of the front of mouth
2. Determine angle between the long axis of tooth + the plane of the sensor
3. Determine bisecting line
4. Beam directed perpendicular (90º) to bisecting line
33
the imaginary line splitting the angle between the long axis of the tooth and the plane of the sensor
Bisecting Line
34
Which dental radiography technique is this?
Bisecting Angle Technique
35
the dental radiography technique that places the sensor on the occlusal plane and directs the beam perpendicular to the sensor
Occlusal Technique
36
Label the parts of these normal teeth
37
term used to describe structures appear light or white on processed x-ray images because they block or absorb radiation
Radiopaque (Radiodense)
38
Give 3 examples of radiopaque structures on a dental radiograph
1. cementum
2. dentin
3. bone
39
What is the most radiodense structure of the tooth?
Thin layer of enamel covering the crown
40
a cribriform plate of bone lining the tooth socket
Lamina dura
41
appears as a white line adjacent to the periodontal space surrounding a healthy tooth
Lamina dura
42
term used to describe structures that appear dark or black on processed x-ray images because the photos easily pass through the sensor
Radiolucent
43
Give 3 examples of radiolucent structures on a dental radiograph
1. soft tissue
2. periodontal ligament space
3. mandibular canal
44
How are the periodontal ligaments identified on a radiograph?
Not visible themselves BUT you can identify the space they're in by the black line surrounding the roots
45
What 4 supporting structures make up the periodontium?
1. Periodontal Ligament
2. Gingival Connective Tissue
3. Alveolar Bone Forming the Tooth Socket
4. Cementum Covering the Surface of the Root
46
the moat around the tooth formed by the free gingiva
Gingival Sulcus
47
inflammation of the gingiva
Gingivitis
48
______ is the earliest stage of periodontitis
Gingivitis
49
inflammation of the gingiva and other structures of the periodontium
Periodontitis
50
What causes periodontitis?
Accumulation of subgingival plaque
51
a white-tan film that collects around and within the gingival sulcus of a tooth
Plaque
52
Plaque will mineralize into dental calculus within ___-___ hours if not removed
24-48 hours
53
a light-brown or yellow, raise, irregular deposit adherent to the tooth and root surfaces
Dental Calculus
54
What occurs concurrently with periodontitis that can spread to other organs?
Bacteremia
55
the nonsurgical instrumentation that focuses on removal of hard and soft deposits from supragingival and subgingival surfaces of teeth, as well as the disruption of nonadherent bacteria within the sulcus
Periodontal Debridement
56
the number of times that the scaler tip moves back and forth in 1 second
Frequency
57
cps
cycles per second
58
What are the two types of scalers?
1. Sonic scalers
2. Ultrasonic scalers
59
Sonic scalers use ____ and ____ as power
air compressor and high speed air line
60
Sonic scalers have an _____ shaped vibration pattern
elliptical
61
Ultrasonic scalers use ______ converted to ______ to produce ______
electrical energy converted to mechanical energy to produce rapid vibrations
62
the disruption of bacteria in plaque caused by streaming of fluid over the tooth surface or churning of fluid within the confined pocket space
Acoustic Turbulence/Microstreaming
63
the energy created from the implosion of thousands of water bubbles striking the vibrating working end of a scaler in order to disrupt bacterial cell walls
Cavitation
64
What is the most important safety precaution to take before a scaling procedure? Why?
Intubate patient and check that the ET cuff is fully inflated > prevents pneumonia
65
Rinsing the patient's mouth with chlorhexidine before scaling reduces ______ and ______
aerosolized bacteria and bacteremia
66
PPE for the VT performing the scaling and all coworkers in the vicinity includes
1.
2.
3.
4.
1. Gloves
2. Masks capable of high bacterial filtration
3. Eye protection > plastic goggles or disposable face shields
4. Gown or scrub top that can be changed after the procedure
67
Why are the patient's eyes lubricated and covered before a scaling procedure?
Protects against debris + contaminated fluid
68
Scaling tips are replaced ______ or ______.
annually or when the metal stacks of insert become bent or worn down to 2 mm
69
1mm scaler tip wear = ____% decreased efficiency
25%
70
scaler tip designed for removing medium and heavy deposits
Broad Tip
71
scaler tip designed for accessing the subgingival pockets and furcation areas, while also improving tactility
Slim Tip
72
Slim tip scalers have a ____ diameter at the blunt end which mimics _____
0.5 mm diameter
mimics periodontal probes
73
scaler tip which is slower and less effective on supragingival calculus and too large to be effective subgingivally, but is still used by many practices
Universal Tip
74
______ tip scalers are reserved for cats and smaller dogs with minimal calculus
Universal tip
75
scaler tip designed for cleaning the crowns of teeth
Board/Beaver Tail/Gross Remover Tip
76
scaler tip designed for subgingival cleaning
Periodontal Tip
77
scaler tip with a 0.2 mm diameter and requires a light touch due to its extreme fragility
Precision Tip
78
scaler tip used for open-flap procedures only
Diamond-Coated Tip
79
Diamond-Coated Tips should only be used with _______ and by ______
slow speed handpiece
highly skilled clinicians
80
Where does vibration occur on ultrasonic scalers?
Back, face, lateral surfaces, point
81
the concave surface of an ultrasonic scaler
Face
82
The strongest vibrations of an ultrasonic scaler are ___ to ___ from the tip
2 to 4 mm
83
The two types of ultrasonic scalers are ________ and _________
Magnetostrictive Ultrasonic Scalers
Piezoelectric Ultrasonic Scalers
84
Magnetostrictive ultrasonic scalers use ______ or _______ transducers
nickel alloy or ferrite
85
Piezoelectric ultrasonic scalers use ______ or ______ transducers
ceramic disk or quartz crystal
86
Magnetostrictive ultrasonic scalers have ______ or ______ tip movement pattern
elliptical or rotational
87
Piezoelectric ultrasonic scalers have ______ tip movement pattern
linear
88
Magnetostrictive ultrasonic scalers are active on ______ surfaces
all 5
89
Piezoelectric ultrasonic scalers are active on _______ surfaces
lateral
90
the portion of the ultrasonic scaler handpiece that converts electrical energy into mechanical energy
Transducer
91
PROCEDURE - Preparing for Magnetostrictive Ultrasonic Scaling Unit
1. Plug electrical cord into outlet
2. Run water through handpiece for min of 2 min > flushes biofilm from inside handpiece + cable > draining into sink
3. Disinfect handpiece
4. Hold handpiece upright/perpendicular to floor + step on pedal > completely fill handpiece with water
5. Choose tip design
6. Remove foot from pedal > slide insert into handpiece > stop when resistance met at rubber "O" ring > gently twist as the insert is completely seated
7. Insert screw-in tip > tighten with supplied wrench
□ Only if using unit with screw-in tip
8. Hold handpiece parallel to floor > adjust power to low-medium > adjust water to a spray
□ Use the lowest power setting that will accomplish the task
9. Put on gloves, mask, and face shield/goggles
10. Place gauze or a lap sponge in back of patient's throat
11. Protect patient's eyes > lubricate + cover
12. Check ET cuff for leakage > make adjustments if needed
Flush patient's mouth with chlorhexidine (0.12%)
92
PROCEDURE - Instrumentation of Magnetostrictive Ultrasonic Scaling Unit
1. Wrap cord around forearm or pinky, or drape over neck > reduces pulling weight of cord
2. Hold handpiece lightly with a pen or a modified pen grasp
3. Establish comfortable finger rest
4. Retract patient's cheeks, tongue, lips > prevent contact with any portion of the metal tip
5. BEFORE touching tooth or calculus > activate tip
6. Adapt the side of the tip of the tooth similar to using a periodontal probe > 0-15º angle
7. With light pressure > move tip in a sweeping motion (as if using a pencil eraser) > keep the end 2 mm of the tip in constant contact with tooth surface
8. Move tip in direction beginning on the crown > advance toward the apex of the tooth > bottom of sulcus or pocket
9. Assess the surface of the tooth for smoothness > use tip without activating vibrations
10. If stubborn piece of calculus > use light tapping motions against surface of calculus OR increase power setting
11. Check for remaining residual calculus > use compressed air from air/water syringe on dental unit > missed calculus appears chalky white
12. Rinse mouth with chlorhexidine > flush any loose debris from tongue, cheek, lip vestibules
13. Remove gauze from throat > check for debris before extubating
14. Wipe unit, handpiece, and cords with federally approved non-immersion type disinfectant > follow manufacturer's instructions for sterilizing handpieces + tips
93
adjusts the amplitude of a power scaler
Power Knob
94
the distance the power scaler tip is moving back and forth in one cycle
Amplitude
95
What power setting is used for subgingival tips? Why?
Low power > prevent tip from breaking
96
_____ power is satisfactory to remove plaque
Low
97
adjusts the flow of water through the handpiece of a power scaler
Water Knob
98
____ prevents ____ damage by heat from the ultrasonic scaler
Fluid prevents pulp damage
99
Pressure from the water supply line to the unit must be a minimum of ____ psi
25 psi
100
Hot/warm handpiece means there's not enough _______
water pressure
101
Magnetostrictive scalers > turn knob until water exits tip in _____
a mist
102
Piezoelectric scalers > turn knob until water exits tip in _____
a steady drip for periodontal tips
103
contains a dental instrument's identification, description with abbreviations of designer, manufacturer, classification type, and design number
Handle
104
Examination instruments include _______
probes and explorers
105
Scaling instruments include _______
curettes
sickles
files
hoes
106
connects the handle to the working end of a dental instrument
Shank
107
_____ determines the best location to use an instrument
curvature
108
Curvature is based on the relation to the _______
long axis of the handle
109
shank used for rostral teeth
Straight Shank
110
shank used for caudal teeth
Angled Shank
111
the portion of a bent shank that is closes to the working end
Terminal Shank
112
shank useful for accessing deeper pockets and reaching farther into the mouth
Elongated Shank
113
shank useful for removing heavy tenacious calculus
Thick, Rigid Shank
114
shank useful for removing light calculus deposits or plaque
Thick, Flexible Shank
115
Probes have _____ working ends
blunt
116
Explorers have _____ working ends
pointed
117
Scaling instruments have _____ working ends
sharp cutting
118
the working end of a scaling dental instrument
Blade
119
Give the 5 parts of a blade
1. Lateral sides (x2)
2. Face
3. Back
4. Heel
5. Toe/Point
120
What type of shank is this?
Straight Shank
121
What type of shank is this?
Angled Shank
122
Supragingival scalers have a _____ tip
pointed
123
Subgingival scalers have a _____ tip
rounded
124
Whether a blade is universal or area specific is based on the ______ in relation to the ______
angulation of the blade face in relation to the terminal shank
125
How do you determine if a tool is universal or area specific?
Position the instrument handle with the terminal shank perpendicular to the floor > identify angle between the face and terminal shank
126
If the angle between face + terminal shank is 90º > instrument is ______.
universal
127
If angle between face + terminal shank is 60-70º > instrument is ______.
area specific
128
instrument with a sharp tip that is used to scale the crowns of teeth
Scaler
129
Scalers should not be used ______ or on ______
subgingivally or on roots
130
instrument with a blunt end used for subgingival scaling and root planing
Curettes
131
curettes adapted for use on all tooth surfaces
Universal Curettes
132
Curettes only used by advanced technicians
Area Specific Curettes
133
curettes that require several different instruments to scale each tooth in the mouth
Area Specific Curettes
134
curettes designed for use as a set, with each instrument having a complex curvature of the shank for better access to specific teeth
Gracey Curettes
135
curettes that have a combination of universal curette qualities with the Gracey curvature of shanks
Langer Curettes
136
the application of the cutting edge against the tooth
Adaptation
137
The _____ tip of instrument cutting edge should remain against the tooth
lower 1/3
138
the relationship of the instrument face to the tooth
Angulation
139
smoothing
Burnishing
140
the scaling stroke that assesses tooth surface topography by lightly feeling for irregularities
Initial / Exploratory Stroke
141
the scaling stroke that applies lateral pressure against the tooth and pulling the blade vertically, horizontally, or obliquely in a short, controlled motion
Working Stroke
142
the scaling stroke that applies light lateral pressure against the tooth and pulling the blade vertically, horizontally, or obliquely in a long, controlled motion
Root Planing Stroke
143
What are the 4 types of sharpening stones?
1. Arkansas
2. India
3. Ceramic
4. Synthetic Composition
144
______ and ______ sharpening stones require the use of sharpening oil
Arkansas and India
145
______ sharpening stones can be used dry or with water
Ceramic
146
______ sharpening stones require the use of water
Synthetic composition
147
Never sharpen the ______ on a sharpening stone because it _____
face > weakens blade and may break during debridement
148
When sharpening curved curettes, begin at the _____ and work toward the _____
heel > toe
149
The initial setup of a sharpening stone is ___º to the face of the instrument then _____ the angle to the ____º for sharpening
90º > open to 110º
150
PROCEDURE - Sharpening Dental Instruments with a Sharpening Stone
1. Perform under good lighting > reflecting off the face of the blade
2. Hold instrument in a palm grasp > blade facing you + face of the blade parallel to floor
3. Brace elbows against side of the body for stability
4. Hold stone perpendicular to blade face > then tilt stone so angle opens to 100-110º and stone is against the lateral surface
5. Using light pressure > stone is moved in short up and down strokes against lateral surface > begin at heel > work toward toe
6. When black "sludge" appears on face of the blade > finish with a few more light strokes > end with a down stroke to remove wire particles lifted from the metal
151
discolorations that accumulate on the surfaces from pigments in food, blood, and some antiplaque products like chlorhexidine rinses
Extrinsic Stains
152
_____ stains are removable by polishing
Extrinsic
153
discolorations located within the tooth substance that can be caused by exposure to certain drugs during tooth development, trauma, and developmental defects
Intrinsic Stains
154
_____ stains are not removable by polishing
Intrinsic
155
the attachment that is connected to the handpiece and holds the rubber cup in place for dental polishing
Prophylaxis Angle (Prophy Angle)
156
Use adequate paste to prevent ______ to the pulp
heat injury
157
The final polish uses _____ or _____ pumice
flour or fine
158
List the 4 types of prophy paste abrasive agents
1. Flour
2. Fine
3. Medium
4. Coarse
159
PROCEDURE - Polishing Teeth During Dental Cleaning
1. Put on personal eye protection + protect patient's eyes
2. Fill rubber cup with polishing paste > refill cup for each tooth
3. Use low rpm on handpiece
§ If no gauge > activate handpiece to full speed BEFORE touching rubber to tooth > listen for pitch clues of highest rpm > then ease off pedal to less than 1/4 max rpm
4. Apply just enough pressure to tooth so cup rim flares slightly
5. Polish each tooth for 3-5 sec
6. Gently rinse mouth with water or chlorhexidine
