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Flashcards in Module 2 Deck (89):
1

What is the main action of ultrasonic and sonic scalers?

mechanical

2

what other factors of ultrasonics and sonics play a role in debridement

irrigation and cavitation

3

What is the mechanical action of ultra and sonics?

-coverts electrical energy or air pressure into high frequency sound waves

4

What do the sound waves produce?

rapid vibrations

5

What happens to the calculus when sonic or ultrasonics are used?

calculus shatters

6

What is required to dissipate heat produced at the vibrating tip

water

7

what is cavitation

action created by formation and collapse of bubbles in the water by high frequency sound waves surrounding an US tip

8

what is the effect of cavitation?

cable of destroying bactera and can remove endotoxins from the root surface

9

What is irrigation

the water spray penetrates base of the pocket and flushes out debris microorganisms and endotoxinx

10

what is believed to have a disruptive effect on surface bacteria

acoustic turbulence

11

what is the amplitude?

distance of tip measured in micrometers

12

what determines the power output of the instrument

the distance of tip/amplitude

13

what is frequency

speed of movement, cycles per second

14

What are the 2 types of US scaling devices?

-magnetostrictive US
-piezoelectric US

15

What is the composition of magnetostrictive US scalers?

-conventional magnetostrictive units- long stack of metal strips
-ferromagnetic units- fragile ferric rod, generates less heat

16

What is the activation of the magnetostrictive US?

-vibrations occur when electric current is applied
-there is expansion and contraction of metal strips

17

what is the tip motion of a magnetostrictive US?

-conventional moves in an elliptical pattern
-ferromagnetic rotates 360*

18

What is the tip shape of a magnetostricive US?

round

19

What is the compositoin of a Piezoelectric US?

ceramic rod

20

What is the activation of a piezoelectric US?

dimensional changes in quartz or metal alloy crystal transducers housed in the handpiece

21

what is the tip motion in piezoelectric US?

linear pattern, only forward and backward

22

what surfaces are active on the tip of a piezoelectric US?

lateral surfaces

23

What is the technique for a piezoelectric US?

-lateral surface of tip in contact w tooth
-only the terminal 2-3 mm of tip
-keep lateral surface adapted

24

what is the tip shape of a piezoelectris US?

varies from trapezoidal with angular edges to round to bladed

25

What is the tip motion in a sonic scaling device?

-driven by compressed air
-moves in an elliptical
-all surfaces of tip are active

26

does a sonic have more or less amplitude than an US?

less

27

Is calculus removal easier or harder with a sonic scaler?

harder

28

What is the water used for in sonic scaling?

cool the friction, heat is not generated by tip

29

What are the indications for use of power driven scalers?

-removal of calc and tenacious stains
-subgingival perio debridement
-initial debridement
-debridement of a furcation, deposits before oral surgery
-removal of ortho cement and overhanging margins

30

What are the contraindications for the use of a power driven scaler in people with systemic health conditions?

-communicable disease
-susceptibility to infection
-respiratory risk
-swallowing difficulty
-cardiac pacemaker

31

What are the contraindications for the use of a power driven scaler in people with oral conditions?

-avoid demineralized areas
-exposed dentinal surfaces
-children

32

what can vibrations do to children?

-developing tissues are sensitive
-vibrations and heat may cause damage to pulp

33

What are precautions for using a power driven scaler with restorations?

-porcelain- fracturing, loss of marginal integrity
-amalgam- surface defects, loss of marginal integrity
-composite- surface alterations

34

Should an US be used on titanium implants?

yes it can be sued with a specially designed plastic shealth

35

What are the risk considerations for using a power driven scaler for the clinician?

-cumulative trauma (can help reduce risk of carpal tunnel)
-magnetic fields

36

What are the risk considerations for using a power driven scaler for the patient?

Heat production- may damage pulp if water and moving arent used
-hearing shifts- extended exposure to noise may be damaging

37

What is another name ofr a conventional or standard tip?

universal

38

What are universal tips generally used for?

-moderate to heavy deposit supra or sub

39

What is periodontal or narrow profile tip used for?

better access to subgingival surfaces, superior coverage of deep pockets and furcations

40

magnetostrictive thin tips must be used on what power

low to medium

41

piezoelectric thin tips may be used on what power

high

42

What kind of narrow profile tips remove calc rapidly

beveled and bladed

43

what kind of thin tip are effective for fine scaling and root planing

diamond coated tips on low power

44

What is plastic or carbon composite tip used for?

to protect vulnerable restorative surfaces such as implants or esthetic materials

45

What is the universal shape of an instrument?

slightly curved, to be used throughout dentition

46

what is the contra-angle shape of an instrument?

- curvatures to left and rt to adapt to posterior surfaces of teeth

47

what is the beavertail shape of an instrument?

supragingival surfaces for removal of heavy stain, calc and ortho cement

48

What is the thin periodontal shape of an instrument?

straight or contra designed for subgingival instrumentation

49

What are the 2 ways water is delivered from an instrument?

external, internal

50

What kind of grasp is used in US scaling?

modified pen, light grasp

51

What kind of stroke is used in US scaling?

moderate to slow pace with a feather-light though to prevent tooth damage

52

What should you do following US scaling?

complete the procedure with manual instruments

53

The US scaler without power can be used as what only?

a probe

54

With each mm of tip loss there is a corresponding loss of

power

55

What happens if your stroke is too rapid?

fast movement is ineffective for deposit removal

56

What renders the vibrations ineffective?

lateral pressure

57

What do you evaluate in an immediate evaluation?

teeth and gingiva

58

What is examined of the teeth in an immediate evaluation?

-observation and exploration for a smooth surface

59

what is examined of the gingiva in an immediate evaluation

-gingival changes are not apparent immediately after instrumentation

60

When does tissue regeneration and initial healing occur after instrumentation?

a few days

61

when can the areas instrumented be probed?

2 weeks after

62

what is the objective of tx?

create an environment in which the gingival tissue can heal and be maintained in health by the patient

63

What information should be included in printed patient take home instructions?

-possible discomfort to expect
-rinsing
-toothbrushing
-eating
-where to call in case of a problem

64

What are the solutions suggested for use in rinsing?

Hypertonic salt solution
sodium bicarbonate solution

65

what directions are given for rinsing?

every 2 hours, after eating, after tb, before retiring

66

what does rinsing with a warm solution do?

sooths tissues, improves circulation which helps healing

67

WHen is chlorohexidine indicated following instrumentation?

when a patient has, NUG, necrotizing ulcerative perio, and advanced perio

68

What are the recommendations for tb after instrumentation?

soft brush is recommended

69

What should a patient eat after having tx?

-anesthesia- avoid solid until it has worn off
-if tissues are tender avoid strong, spicy seasonings
-soft or liquid diet if needed

70

What do we hope for after instrumentation?

-no bleeding on probing
-lower probe depths
-inflammation resolved
-normal gingiva
-

71

What factors effect healing?

-severity of infection
-noncompliance of pt
-tobacco use
-systemic (diabetes, lowered defense)
-incomplete debridement

72

What do we see in the resolution of imflammation?

edemarecedes, necrotic cells gone, tissue regengeration

73

what do we see in the clinical attachment in healing?

long epithelial attachment

74

What are the changes in the subgingival pocket flora?

changed from anaerobing gram negitive motile to aerobic gram positive non motile

75

what is the effect of the conversion of microorganisms?

they are changed to health producing gram positive flora

76

Without personal daily biofilm control what can happen?

microorganisms return to pretreatment levels in 42 days

77

Where do endotoxins occur?

in bacteria covering the cementum and in the cementum

78

When can a follow up appt be scheduled for patient?

2 weeks

79

What procedures should be included in the assessment iin a follow up evaluation?

perio probing
tactile evaluation- bleeding points evaluated for residual calc

80

Why do we reinstrument at a follow up appointment?

remove any remaining calculus

81

What do you do with a patient who has not responded adequately to non surgical therapy?

refer to a periodontist

82

What factors are taken into account in determining a maintenance schedule?

soft tissue response, changes/stabilization, demonstrates effective biofilm control, motivation, responsibility, psycho social factors

83

What sterilization method should be avoided with US tips?

dry heat

84

What happens with worn out US tips when instrumenting?

incapable of removing deposit, it is only burnished

85

What is the principle objective in the location of a broken instrument?

to know positively that the tip has been removed

86

what immediate action takes place in the care of a broken instrument?

-stop procedure
-don't move pt. head
-isolate
-dont use a/w syringe
-don't alarm pt

87

what should you do in the examination of an area in the care of a broken instrument?

-don't dry with air
-use careful retraction to examine immediate area
-use transilluminating
-examine sulcus, use a spoon like stroke of curet

88

what do you do in tx of a broken instrument?

-apply magnetized retrieving instrument
-consult with dentist for assistance
-prepare an x-ray

89

what do you do if you do not find the broken tip in any of the procedures?

arrange for a perio surgical procedure