Lectures 9 & 10 Flashcards
(134 cards)
1
Q
Phase 1 perio therapy:
A
remove issues that accumulate plaque
2
Q
Phases of Periodontal Therapy:
A
Phase I, Reevaluation, Phase II (perio surgery), Phase IIII (restorative), Phase IV (maintenance)
3
Q
Phase II perio therapy?
A
perio surgery
4
Q
Phase III perio therapy:
A
restorative
5
Q
Phase IV perio therapy:
A
maintenance
6
Q
During maintenance of perio therapy, how often should the recall visits be?
A
every 3 mo
7
Q
Why is restorative work after Phase II?
A
bc the gingival margin location will change
8
Q
TF? Root planing has to be subgingival.
A
F. does not need to be
9
Q
Instruments for root planing:
A
curettes
10
Q
what is required to get healing after perio therapy?
A
eliminate biofilm, calculus, and altered cementum
11
Q
Microbial Reservoirs:
A
calculus, biofilm, planktonic plaque, scratches from insturmunets, resorption lacunae, accessory root canals and dentinal tubuli, pocket epithelium, intercellular and intracellular, within and upon cementum
12
Q
Scaling is instrumentation of:
A
crown and root surfaces to remove plaque, calculus, and stain
13
Q
Root planing is instrumentation of:
A
root surfaces,remove rough cementum or surface dentin impregnated with calculus, toxins or microorganisms. A.k.a. root surface instrumentation or root debridement.
14
Q
Instrument to remove biofilm, calculus, and infected/contaminated cementum and dentin:
A
Gracey curette
15
Q
TF? It is easier to remove plaque from a smooth surface.
A
T
16
Q
What is the only clinical indicator of calculus removal?
A
root smoothness
17
Q
TF Less plaque accumulates on smooth surfaces.
A
T
18
Q
Why Remove Cementum?
A
Calculus is frequently embedded, Scaling can’t remove it, Root debridement is needed to remove cementum with embedded calculus
19
Q
Goal of removal of cementum:
A
creation of a biologically compatible surface
20
Q
How do we want oral microflora to change after SRP, antibiotics, and flossing?
A
Shift microflora back to gram positive cocci and rods
21
Q
Plaque takes about ___ weeks to form to final conclusion
A
8 weeks
22
Q
Effects of removing gram negative oral bacteria:
A
resolve inflammation, reduce pocket depth (2mm on average), increase clinical attachment
23
Q
TF? Movement (?) of pocket from bottom up is histologic change.
A
F. Clinical attachment, not histologic, tissue gets tighter and can not push probe as deep
24
Q
How long does bacteremia last after dental extraction
A
10 min
25
What type of immune response is there to bacteremia?
both local and systemic host response
26
% of pts with bacteremia, dental extraction:
100
27
% of pts with bacteremia, SRP
70%
28
% of pts with bacteremia, third molar surgery:
55%
29
% of pts with bacteremia, endodontic treatment:
20%
30
% viridans group steptococci, dental extraction:
85%
31
% viridans group steptococci, SRP:
55%
32
% viridans group steptococci, third molar surgery:
40%
33
% viridans group steptococci, endodontic treatment:
20%
34
% anaerobes, dental extractions:
75%
35
% anaerobes, SRP:
65%
36
% anaerobes, third molar extraction:
45%
37
% anaerobes, endo treatment:
5%
38
Driving bacteria into __here__ leads to bacteremia.
tissue
39
TF A pt may have constant bacteremia if they have loose teeth.
T, movement of teeth while chewing
40
How do you measure the level of bacteremia:
draw blood from arm
41
When to Rx antibiotics before SRP:
prosthetic heart valves (any prosthesis, right?)
42
Where is removing calculus harder?
posterior, interproximals, and deeper pockets
43
If pockets are too deep to clean out effectively during dental cleaning this may need to be done:
Open flap debridement (surgery)
44
TF? Calculus can form on dentures and fixed bridges
T
45
What fraction of the surfaces can be cleaned for pockets greater than 8mm?
about half of the surfaces
46
Where will the biggest reduction in
| pocket depth be seen?
deep pockets
47
Typical Sequence of Instrumentation:
probe, explorer, ultrasonic, scaler, curette, polisher
48
Scalers are used for:
large supragingival calculus
49
Curettes are used for:
smaller deposits and subgingival debridement
50
Stains are removed via this process:
polishing
51
Instrument to locate calculus and caries:
explorers
52
#__ is a combination of #23 and #17:
5
53
This is the Old Dominion University explorer:
#11/12
54
Explorer with three angles:
#17
55
Typical looking explorer with a slightly longer tip:
#23
56
Straightest explorer:
11/12
57
Explorer with a slight curve at end, not a full hook:
#3
58
Angled, hook explorer:
#3CH Pigtail
59
What are ultrasonic and sonic instruments used for?
scaling and root debridement – large deposits
60
5 scalers for supragingival calculus and stain removal:
curette, sickle, file, chisel, and hoe
61
Sickle scalers are for:
large calculus deposits, 2 cutting edges
62
Which aspects of the tooth can sickles be used on?
all aspects
63
Which instrument is triangular in cross section, double-cutting edge, and pointed tip?
sickle scaler
64
lateral surface should meet face of the sickle scaler at an internal angle of:
70 to 80 degrees
65
What type of area is the Jacquette scaler good for reaching?
interproximals, pointed tip, especially mandibular anteriors
66
3 parts to a perio instrument:
handle, shank, blade
67
Instruments with 2 cutting edges:
scalers
68
Instruments with 1 cutting edge:
curettes
69
TF? The lower shank includes the tip of the explorer.
F. area just proximal to tip
70
The lower shank is aka:
terminal shank
71
This scaler is good to flick off big chunks of calculus in the mandibular linguals
Towner scaler, facial of mandibular as well? Yes
72
Curettes are fine instruments for:
subgingival removal of calcified deposits, altered cementum from root surfaces, and debride soft tissue lining the pocket
73
Numbers for anterior, posterior, mini anterior, and mini posterior explorer:
5530, 5532, 5534, 5536
74
These remove tenacious subgingival calculus and altered cementum. Limited to certain situations:
hoe, chisel, and file
75
Cleansing and polishing instruments:
rubber cups, brushes, and dental tape
76
Oral (Dental) Prophylaxis:
Procedures to remove plaque, calculus, materia alba and extrinsic stain from the crowns and roots of teeth using hand instruments or ultrasonic instruments or electric polishers.
77
TF Both adults and children get oral prophylaxis.
T
78
What kind of a shank does a right-angle have?
a straight shank
79
What type of right-angles are reusable?
metal
80
Webbed cups:
flexible, less abrasive paste than ribbed cups
81
Ribbed interior cup
flexes and follows tooth contour
82
What is used to remove stains from the pits and fissures of occlusal surfaces?
Bristle brush attachments
83
TF Bristle brush attachments can be used on facial, lingual, mesial, distal, or occlusal surfaces.
F. only oclusal
84
What is used to remove extrinsic stains from the crowns of the teeth?
rubber cup filled with polishing agent
85
Universal curettes:
2 cutting edges, blade 90 degree angle to terminal shank
86
Degree angulation for curettes:
70 degrees
87
Numbering for Gracey curettes:
#5-6, 7-8, 11-12, 13-14
88
Scalers are angled at __ d's and curettes are angled at __ d's:
90 (remember: double edged, makes sense to be at 90d), 70
89
Which are narrower, scalers or curettes?
curettes
90
Flat surface of the curette is called:
the face
91
Surfaces of a curette starting from the cutting end and working around to the face as the last side:
cutting edge, side, back, non-cutting edge, face
92
Purpose of the exploratory stroke:
detect calculus and irregularitites
93
Working stroke:
remove calculus and altered cementum
94
3 basic strokes:
vertical, oblique, horizontal
95
TF The cavitron is typically used subgingivally.
F
96
Gross superficial debridement is done with:
ultrasonic
97
Are curettes ever used supragingivally or only sub?
can be used for both
98
Adverse Effects of Scaling and Root Debridement:
Gingival recession (“black triangle”), increased clinical crown length, poor esthetics, root sensitivity, toothbrush abrasion, root surface caries
99
TF The size of the anatomical crown can increase after SRP.
F. clinical crown, not anatomical
100
Will root sensitivity go away after SRP?
usually, if they clean
101
Calculus will be visible as:
chalky deposits, need to dry teeth completely
102
Subgingival calculus is visible at the gingival margin as:
a dark shadow
103
What explorer should we use to detect subgingival calculus?
11/12
104
Most common locations of calculus:
buccal of maxillary molars (Stenson's duct) and lingual of lower anterior (Wharton's duct), mineral deposition
105
Patterns of subgingival calculus:
spicules, ledge, ring, veneer
106
Start scaling with this type of motion:
vertical motion
107
What would happen if you use a downward stroke when trying to remove calculus?
Impact gingiva, swollen mouth, calculus lodged subgingivally
108
Why is subgingival calculus dark?
iron deposits in calculus from blood, tobacco, and red wine
109
What will happen if you cut off circulation in one area of the mouth?
collateral circulation will form
110
What is the nutrient base for biofilm to form?
calculus
111
Which mouthwash should I use?
Look for the ADA seal
112
What mouthwashes can stain teeth?
chlorhexidine or cetyl pyridinium chloride (CPC – Crest procare mouth rinse, CPC: abbreviation for both)
113
What instrument should you start with to remove calculus?
Towner/Jacquette, McCalls then Gracey's
114
Is Gracey’s a scaler or curette?
most often in reference to curette, but can also be scaler
115
What is the Towner OR Jacquette used for?
big chunks, supragingivally only
116
This explorer looks like Cpt. hooks hook:
U15 Towner
117
McCall 17/18 is used for:
Distal posterior
118
Where might we remove tooth structure when scaling?
subgingivally
119
What is McCall 13/14 used for?
Bicuspids, mesial posterior:
120
Scaler that is in the shape of half of a benzene ring
jacquette
121
TF We can remove enamel when scaling.
F
122
TF The Towner U15 can be used for subgingival calculus.
F
123
What is the pointed tip of the Towner U15 used for?
interproximals
124
Blade width of the Towner U15:
1mm
125
Sickle scaler with a straight, flat face and two cutting edges that come to a point, removes calculus supragingivally and interproximally, not for subgingival calculus
30 Jacquette
126
Scalers are for ___ calculus while curettes are for ____ calculus.
breaking, shaving
127
This instrument is used for medium to heavy calculus, not for use on root surfaces, 80° angulation fractures calculus from tooth, breaks chunks of calculus, not shaving calculus as when using a curette
U15 Towner / 30 Jacquette
128
TF. The scaler should be at a 90 degree angle to the long axis of the tooth.
F, 80 degrees
129
All __ facing surfaces, then all __ facing surfaces
Rt, Lt
130
Designed for most areas by changing finger rest, fulcrum, and hand position, parallel cutting edges on either side of the face:
McCalls 13/14 and 17/18
131
McCalls #13/14 best for ____ and #17/18 best for ___.
bicuspids and mesial surfaces, molars and distal surfaces
132
Shank parallel to distal surface when correct working-end is selected?
lower shank
133
What shank goes up and over the tooth?
functional shank
134
How to know which shank is the lower shank?
ask
