Grasp, Fulcrum, Periodontal Instruments, & Periodontal Probing Flashcards
1
Q
What is the modified pen grasp?
A
- Grasp for holding periodontal instruments
- Allows precise control of the working-end
- Permits a wide range of movement
- Facilitates good tactile conduction
2
Q
How do you do the modified pen grasp?
A
- Thumb and index finger hold the instrument
- Middle finger stabilizes
- Ring finer used to fulcrum (hinge/pivot)
- Thumb is used to roll the instrument
- Fingers maintain contact and work together to adapt the instrument
- Movement is in the wrist
3
Q
Where is the index and thumb for the modified pen grasp?
A
on the instrument handle
4
Q
Where is the middle finger for the modified pen grasp?
A
rests lightly on the shank
5
Q
Where is the ring finger for the modified pen grasp?
A
on oral structure; often a tooth surface
6
Q
Where is the pinky for the modified pen grasp?
A
near ring finger, held in a relaxed manner
7
Q
What is the function of the index and thumb for the modified pen grasp?
A
holds the instrument
8
Q
What is the function of the middle finger for the modified pen grasp?
A
- helps to guide the working-end
- feels vibrations transmitted from the working-end to the shank
9
Q
What is the function of the ring finger for the modified pen grasp?
A
stablilizes the hand for control and strength
10
Q
What is the function of the pinky finger for the modified pen grasp?
A
no function
11
Q
What is a fulcrum?
A
Stabilizing point for clinician’s hand during instrumentation
12
Q
What are the 3 types of fulcrums?
A
Intraoral fulcrum
Extraoral fulcrum
Advanced fulcrum
13
Q
What type of fulcrum provides best stability for the clinician’s hand?
A
Intraoral fulcrum
14
Q
What does the intraoral fulcrum allow?
A
- provide best stability for the clinician’s hand
- decreases the likelihood of injury to the patient or clinician
- provides the best leverage and strength during instrumentation
15
Q
What is an intraoral fulcrum?
A
- A stabilizing point inside the patient’s mouth against a tooth surface
16
Q
What is an extraoral fulcrum?
A
- A stabilizing point outside the patient’s mouth (e.g., against the patient’s chin or cheek)
17
Q
What is the handle of the instrument?
A
used for holding the instrument
18
Q
What is the shank of the instrument?
A
rod-shaped length of metal located between the handle and working-end of an instrument
19
Q
What is the working-end of the instrument?
A
the part of the instrument that does the work of the instrument
20
Q
A
21
Q
What is the functional shank?
A
the part of the shank that allows the working-end to be adapted to the tooth surface; begins below the working-end and extends to the last bend in the shank nearest the handle
22
Q
What is the terminal shank?
A
the portion of the functional shank nearest to the working-end
23
Q
What is a simple shank?
A
- A shank that is bent in one plane (front-to-back)
- Simple shank=straight shank
- Used primarily on anterior teeth
24
Q
What type of shank is primarily used on anterior teeth?
A
simple
25
What is a complex shank?
* A shank that has been bent in two planes (front-to-back and side-to-side)
* Complex shank=angled/curved shank
* Used on posterior teeth
26
What type of shank is primarily used on posterior teeth?
complex shank
27
How do you determine if the shank is simple or complex?
* Hold the instrument so that the working-end toe is facing you
Instrument A, when viewed from the front appears to be straight, therefore, simple shank design
Instrument B, when viewed from the front appears to be bent from side-to-side, therefore this instrument has a complex design
28
What type of shank is this?
simple
29
What type of shank is this?
complex
30
The function of an instrument is determined, primarily, by the design of the...
working-end
31
What are the 2 main types of periodontal hand instruments?
Sickle Scalers
Curettes
32
What does a sickle scaler look like?
Triangular cross-section of the blade
33
What type of scaling do you do with a sickle scaler?
Supragingival scaling
34
How many cutting-edges does a sickle scaler have?
2 cutting edges
35
What is the shape of a curette?
Rounded cross-section of the blade
36
What type of curette instruments are there?
Universal and area-specific instruments
36
What type of scaling do you do with a curette?
supra- and subgingival scaling
37
How many cutting edges does a universal curette have?
2 cutting edges
38
How many cutting edges does a area-specific curette have?
1 cutting edge
39
What are these areas of a instrument?
40
sickle scaler
41
universal curet
42
area-specific curet
43
What is the end of the sickle scaler?
pointed toe
44
What is the end of universal and area-specific curettes?
rounded toe
45
What is the angulation of a sickle scaler?
90 degrees
46
What is the angulation of a universal curette?
90 degrees
47
What is the angulation of an area-specific curette?
70 degrees
48
Is the blade straight or curved on sickle scalers?
straight
49
Is the blade straight or curved on universal curettes?
straight
50
Is the blade straight or curved on area-specific curettes?
blade curved away from cutting-edge
51
Why is adaptation important?
- Important for maintaining contact of working-end and tooth structure during instrumentation
- Incorrect adaptation results in ineffective calculus removal and tissue laceration
52
Why is activation important?
- Important for efficient plaque and calculus removal
- Wrist, hand, and forearm work as a unit; finger pulling is not effective and causes operator fatigue
53
What are the components of activation?
* Blade adaptation
* Instrument angulation
* Blade insertion
* Lateral pressure
* Working stroke
54
What is angulation?
Refers to the angle between the face of a bladed instrument and the tooth surface
55
What is the meaning of probe?
to search into and explore very thoroughly
56
What is a probe used to measure?
- Probing depth
- Clinical attachment level
- Amount of attached gingiva
- Gingival recession
- Furcation involvement
- Bleeding on probing
- Size of pathologic lesions
- Distance between teeth
- Overbite/overjet
57
What is the shape of a perio probe?
The periodontal probe is a slender, tapered, blunt instrument with millimeter markings on it
58
How does probing inaccuracy occur?
Probing inaccuracy is related to probe design, pressure applied,
contour of the tooth, etc.
59
Probing depth usually correlates to...
attachment loss
60
What is a probing depth?
an objective measure of the distance between the base of the pocket and the crest of the gingiva regardless of the degree of attachment loss
60
What is a nabers (furcation) probe used for?
Used to evaluate the bone support in the furcation areas of bifurcated and trifurcated teeth
61
How do you use a nabers probe?
The correct working-end of the probe is when the lower (terminal) shank is positioned parallel to the tooth surface being examined
62
What is probing of a tooth?
act of walking the tip of a probe along the junctional epithelium(JE) within the sulcus or pocket for the purpose of assessing the health status of the periodontal tissues
63
What is a walking stroke?
the movement of a calibrated probe around the perimeter of the base of a sulcus/pocket
64
Why is it essential to evaluate the entire "length" of the pocket base?
because the JE is not necessarily at a uniform level around the tooth
65
What direction should the probe face?
Probe should be parallel to the long axis of the tooth around all proximal surfaces, except when probing the interproximal spaces
66
How much pressure should you use when probing?
10-15 grams of pressure
67
Where will the probe stop in health?
junctional epithelium
68
Where will the probe go in disease?
probe will go into the connective tissue
69
Keep the probe _________ as you move along the tooth
subgingival
70
How should you probe a tooth?
Begin at the distal line angle and back into the distal aspect of the tooth; move forward toward the mesial
71
Probing measures six sites per tooth. These are...
1. distofacial
2. facial
3. mesiofacial
4. distolingual
5. lingual
6. mesiolingual
72
only one reading per site is recorded; if probing depths vary within a sire, the _______ reading obtained in that site is recorded
deepest
73
What is the pocket/probing depth?
Base of pocket to gingival margin
74
What is the attachment level?
CEJ to base of pocket
75
What is recession?
CEJ to Gingival Margin (GM)
76
What is the PD, GM (recession), and attachment loss for this tooth?
PD - 2 mm
GM - 3 mm
Attachment loss - 5 mm
77
If the measurement for the
gingival margin is (+)...
recession is present
78
If the measurement for the
gingival margin is (-)...
the gingival margin is coronal to the CEJ- no recession
79
What is the PD, GM (recession), and attachment loss for this tooth?
PD - 5 mm
GM - -3 mm
Attachment Loss - 2 mm
80
What is the equation for clinical attachment loss (CAL)?
PD + GM = CAL
probing depth + gingival margin
81
What is the PD, GM (recession), and attachment loss for this tooth?
PD - 5 mm
GM - 0
Attachment loss - 5 mm
82
What is the PD, GM (recession), and attachment loss for this tooth?
PD - 2 mm
GM - 3 mm
Attachment loss - 5mm
83
PD = 3
GM = (-3)
CAL = 0
Does this tooth have periodontitis?
No
84
PD = 5
GM = (-3)
CAL = 2
Does this tooth have periodontitis?
Early periodontitis
85
PD = 4
GM = (-1)
CAL = 3
Does this tooth have periodontitis?
Yes
Progression of periodontitis
86
PD = 5
GM = +2
CAL = 7
Does this tooth have periodontitis?
Yes
