Exam 3 Power Scaling

Question 1

What are powered instruments:
Instrument with a rapidly vibrating tip used to __ ___ and ___ ___ ____ from tooth and root surfaces, and to __ out bacteria from beneath the gingival margin

Answer 1

dislodge calculus
disrupt plaque biofilm
flush

Question 2

What are the benefits of power scaling?

Answer 2

• Effective calculus and biofilm removal
• Pocket penetration/accessing furcations
• Irrigation (lavage)- healing
• Shorter instrumentation time- fatigue
• Restoration recontour/cement removal
• No sharpening- no cutting edge

Question 3

2 types of powered instrumentation: ____ & _____

Classified based on ____

Answer 3

Sonic and Ultrasonic

operating frequencies

Question 4

• Operates at a low frequency of 3,000-8,000 cycles/second.

- Driven by compressed air from the dental unit.

Answer 4

Sonic

Question 5

• Operate inaudibly at a frequency of 18,000-50,000 cycles/second
• Driven by electrical current

Answer 5

Ultrasonic

Question 6

2 SUBTYPES OF ULTRASONIC

Answer 6

Piezoelectric

Magnetostrictive

Question 7

Electrical energy activates ceramic crystals or rings within the handpiece to make the tip vibrate

Answer 7

Piezoelectric

Question 8

Electronic energy is transferred to metal stacks or rods or to make the tip vibrate.

Answer 8

Magnetostrictive

Question 9

Is the power box of a powered unit

• Non-critical
• Semi critical
• Critical

Answer 9

Non critical

Question 10

Is the handpiece of a powered unit

• Non-Critical
• Semi critical
• Critical

Answer 10

Semi Critical

Question 11

Is the handpiece TIP

• Non critical
• Semi critical
• Critical

Answer 11

Critical

Question 12

Do you need to sterilize the handpeice for cavitron and peizo after evey use

Answer 12

every use

Question 13

Scaler Tip Motion:

Magnetostrictive

Answer 13

Orbital tip motion

Question 14

Scaler Tip Motion:

Piezoelectric

Answer 14

Linear tip motion

Question 15

3 Modes of Action (How it Works)

Answer 15

1. Mechanical Removal
2. Water Irrigation
3. Cavitation

Question 16

Water Irrigation:

Rapid vibrations of tip against tooth causes ___ ____- water stream cools tip

Answer 16

frictional heat

Question 17

Water stream within the pocket washes

away toxins, blood and bacteria within the pocket

Answer 17

Lavage

Question 18

Tiny bubbles formed by water
stream. Bubbles collapse, which produces
shock waves that may alter or destroy bacterial
cell walls.

Answer 18

Cavitation

Question 19

How many times the tip vibrates per second (kHz)

Answer 19

Frequency

Question 20

Which unit ??

1. 25,000-50,000
2. 25,000- 42,000 kHz.
3. 1500-8000 kHz

Answer 20

1. Piezoelectric units frequency
2. Magnetostrictive units frequency
3. Sonic units frequency

Question 21

How far the instrument tip moves back and forth during one cycle. (length of stroke)

Answer 21

Amplitude

Question 22

shorter distance = lower power

Answer 22

Lower Amplitude

Question 23

higher distance = higher power

Answer 23

Higher amplitude

Question 24

Controlled through power knob on unit. Always use lowest effective power setting. Low for soft deposit removal and medium for hard deposit removal.

Answer 24

Amplitude

Question 25

more forceful stroke = | patient discomfort. (pain)

Answer 25

Higher power

Question 26

less forceful stroke = patient discomfort. (more comfortable for patient)

Answer 26

Lower power

Question 27

less water going through tip

Answer 27

warmer water

Question 28

Use __ water for calculus removal and ___ water for deplaquing

Answer 28

more less Calculus removal halo de-plaquing drip

Question 29

Light to moderate calculus | Improved for subgingival access due to 30% thinner than powerlines

Answer 29

Slimeline 10 and 1000 (triple bend) Cavitron ultrasonic insert use pictures

Question 30

Moderate to heavy calculus | Thicker inserts with larger tips, specifically designed for efficient removal of heavier deposits

Answer 30

Powerline 10 | Cavitron ultrasonic insert

Question 31

All surfaces of the working end of the insert disperses energy ______

Answer 31

vibrations

Question 32

______- Less vibrations than face or point; OK to adapt to tooth/root.

Answer 32

Lateral surfaces/sides

Question 33

For removing supragingival medium to heavy deposits in all quadrants

Answer 33

G1

Question 34

For removing supra- and subgingival medium to heavy deposits in all quadrants (burnished calclulus)

Answer 34

P10

Question 35

For removing light calculus and plaque biofilm in deep periodontal pockets and supra in all quadrants

Answer 35

P20

Question 36

Working end of piezoelectric tips: | only the ____ surfaces/sides of the working end are active

Answer 36

lateral

Question 37

higher frequency active tip will have a shorter or longer active tip area. You should adapt __mm to the tip to the tooth surface

Answer 37

shorter | 2-3mm

Question 38

1mm of tip wear = ___ decrease in efficiency

Answer 38

25%

Question 39

2mm of wear= ___ % decrease in efficiency

Answer 39

50%

Question 40

Contaminated Aerosols. Protect yourself and your ___

Answer 40

environment

Question 41

We need to wear a level ___ mask when working with aerosols

Answer 41

level 3

Question 42

use the ___ evacuation whenever possible and __ ____ rinse

Answer 42

HVE | Pre-procedural rinse

Question 43

Contraindications and Precautions for Use

Answer 43

- Communicable diseases- Aerosol production allows for dissemination of bacterial and viral infections; Hepatitis, TB, respiratory infections. - High susceptibility to infection- Immunosuppressed patient due to disease or chemotherapy, uncontrolled diabetics, patients with organ transplants or chronic, debilitating medical conditions. - Respiratory risk- Emphysema, cystic fibrosis, asthma, cardiac disease with secondary pulmonary disease, pneumonia, breathing problems. - Unshielded cardiac pacemaker- Piezoelectric ok- only concern with magnetostrictive; may need physician consult to verify type of pacemaker present. - Dysphagia (difficulty swallowing) or prone to gagging- MS; ALS; Muscular dystrophy, paralysis - Age- Primary teeth and newly erupted teeth have large pulp chambers- more susceptible to damage from vibrations and heat. Oral conditions- hypersensitive teeth; demineralized enamel surfaces, exposed dentin -Restorations- Veneers, cast crowns, composite restorations- avoid these localized areas; place ultrasonic tip adjacent or apical to restoration- use dental chart and radiographs for guidance.

Question 44

Lateral pressure is __ like a exploere

Answer 44

light

Question 45

Adaptation is | Angulation is

Answer 45

last 2-3 mm of lateral side | 0 degree angel formed when the face of the instrument is against the tooth surface-pivot on fulcrum

Question 46

For removal of light calculus and biofilm disruption, insert like the ___

Answer 46

probe

Question 47

for removal of moderate/heavy calculus is the same as _____

Answer 47

explorer/curet style.

Question 48

What term describes the use of vertical, oblique, and vertical strokes during instrumentation?

Answer 48

Multi direcetional

Question 49

Disadvantages

Answer 49

``` Less tactile sensitivity Water control evacuation needed Production of aerosols Medical contraindications Potential occupation hazard (noise/vibration) ```