Flashcards in Quiz 5 exploring Deck (46):
What is the explorer tip?
Working end which is 1-2 mm long
What is the explorer tip made of?
Flexible metal to detect tactile senation
What part is used to detect calculus
The side of the tip, not the actual tip
How do you find the working end?
Lower/terminal shank should be parallel to tooth surface
Place on distal of premolar
What is the shepard hook/straight explorer used for?
Supragingival exam of margins and restoration or to assess sealant restoration(definite hard tissues)
What is the curved explorer used for?
Calculus detection in normal sulci or shallow pockets
What is a pigtail and cowhorn explorer used for?
Calculus in normal sulci or shallow pockets no deeper than cervical third of root
What is orban explorer used for?
Insertion into narrow pockets.
Assessment of anterior root surfaces and F and L surfaces of posterior teeth
Difficult to adapt to proximal surfaces of posterior
What is 11/12 explorer used for?
Assessment of root surfaces on anterior and posterior, equally useful
What is the composition of subgingival calculus
Often flattened due to pressure of pocket wall against tooth
Deposit built up layer by layer, near CEJ rather than JE
Usually under contact area at line angle or midline of tooth
Larger spicule type w/ a crusty or spiny surface
long ridge running parallel to gingival margin, common on all tooth surfaces
Ridge running parallel to gingival margin
thin, smooth coating w/ shield like shape on potion of root surface
Long, narrow deposit running parallel or oblique to long axis of root
What is the mm of stroke for explorer?
What are the errors associated with explorers?
Too much pressure
Not deep enough in the pocket (need to be at base)
What are we looking for with the 11/12 explorer
What happens if too much pressure is applied?
You feel tooth topography and will continue to take off cementum
Why is the explorer thin?
To disseminate between tooth and calculus
Basic instrumentation of explorer
Insertion, angulation, and adaptation is one fluid motion
What's the movement under the gum?
Always done w/ motion, follow terminal shank so always adapted
What happens if your instruments aren't sharp?
With dull blades comes increased pressure, Not able to remove calculus even though everything else is sound
Where does the hypersensitivity come from?
Removing the cementum
How do you adapt to the tooth w/ the explorer?
Roll the back of the instrument away from the tooth to maintain adaptation
Motion Activation, helps prevent RSD
Handle roll, Wrist knock, Pivot knock
Subgingival Assessment w/ 11/12 explorer
Adapt 1-2mm of working end at tooth surface and slide under gingival margin, down to JE or base keeping 1-2mm in constant contact w/ root surface
Subgingival Assessment w/ 11/12
Active stroke w/ wrist activation to move tip forward, apical and oblique w/ overlapping strokes
Control stoke w/ 2-3mm to remain in sulcus and maintain 1-2 mm working end in contact
Subgingival Assessment w/ 11/12
1-2mm tip will always lead stroke while in contact driven by wrist activation
Exploring proximal will require strokes to cover more than 1/2 the interproximal
Vertical assessment stroke
used on F, L and proximal surface
Vertical assessment stoke
Used primarily on mesial and distal surfaces
Oblique assessment stroke
Strokes across F or B surface
Down, up and over stroke produced at a slight angle
Strokes made in a perpendicular direction to long axis of tooth
11/12 Exploring anterior teeth
Need to flip handle to do either surfaces towards or away for each aspect,
Sequence follows 1/2 of surfaces towards then surfaces away
Overlap at midline each time you enter
What does the explorer do to the anterior teeth?
Wrap around each of the surface
Sequence of exploring
Adapt explorer to mesial to find correct working end
Start at distal
Enter at DLA and continue w/ vertical and oblique strokes into col area
Reenter at DLA and move forward w/ vertical and oblique stokes to mesial col
Type 0 Health
No clinical changes from health in gingival color, form, position and surface appearance. No bleeding upon probing. No connective tissue loss. No bone loss, 0-3mm present
Type 1 Gingivitis
Gingival inflammation characterized clinically by changes in color, gingival form position and surface appearance. Bleeding upon gentle probing. No connective tissue attachement loss. No bone loss. 0-3 mm sulci present
Type 2 Early Periodontitis
Progression of gingival inflammation into deeper perio structures and bone crest. Bleeding upon gentle probing. Slight connective tissue lost. Slight bone loss. 3-4 mm sulci present. (CSN will use this type to classify cases w/ >3mm resulting from inflammation)
Type 3 Moderate Periodontitis
More advanced stage of type 2 w/ increased destruction of perio structures. Bleeding upon gentle proving. Moderate connective tissue attachment loss. Moderate bone loss. Possible mobility. Possible furcation involvement. 4-6mm pocket present. Refer to specialist
Type 4 Advanced Periodontitis
More advances of type 3 w/ advanced destruction of perio structures.Bleeding upon gentle probing. Advanced connective tissue attachment loss. Advanced bone loss. Mobility. Furcation involvement 7+ pockets. Refer
Grainy and/or light calculus in localized areas in posterior teeth and/or light to moderate calculus on anterior (Type 1 or 2)
Moderate deposits readily discernable-auditory click and visible jump of explorer. Minimum of 6 posterior deposits and at least 2 must be molar proximals
Heavy deposits that cover the majority of the surface line angle to line angle and may conjoin w/ addition surfaces. Minimum of 9 posterior deposits at least 4 must be molar proximals