Quiz 5. Fundamentals of Deposit Removal

Question 1

What’s the difference between periodontal debridement and SRP?

Answer 1

Removal of calculus from all tooth surfaces and removal of cementum from root surfaces

Question 2

Difference b/w PERIODONTAL DEBRIDEMENT and scale/rootplaning?

Answer 2

Removal of calculus as well as toxins and microorganism (loosely attached)

Question 3

What’s the primary objective of periodontal debridgement?

Answer 3

Stop/Interrupt progress of disease
Induce positive change in bacterial flora
Create a healing env
Increase effectiveness in OH
Prepare for advanced therapy (surgery)
Prevent reoccurance through maintenance

Question 4

What are the goals of periodontal debridement?

Answer 4

Conservation of cementum

Question 5

What is the systematic approach for instrumentation?

Answer 5

Identify process of care
Sequence appointments w/ the treatment plan
# of appts and possible sequences

Question 6

What are the clinical factors that guide instrumentation

Answer 6

Location, Extent, Tenacity of deposits
Depth and width of pocket
Special considerations (can’t open wide, TMJ problems)

Question 7

What is problem associated with gross scaling?

Answer 7

Pus forming, Only partially healing and patient never comes back
Can’t remove all desposits
Periodontal abscess forming

Question 8

Process of calculus formation

Answer 8

Pellicle formation -> Biofilm maturation -> mineralization

Question 9

What is the average time that calculus forms?

Answer 9

12 days

Question 10

What are the different calculus attachment modes?

Answer 10

Enamel surface:weak
Root surface: in microscopic surface irregularities, strong
Root surface: interlocked w/ organic crystals of tooth, extremely strong

Question 11

How does calculus contribute to disease?

Answer 11

It attracts biofilm which continues to further disease

Question 12

What leads to burnished calculus?

Answer 12

Insufficient pressure, angulation of blade, loss of control (poor lateral pressure leads to slipping)

Question 13

How does burnished calculus contribute to disease?

Answer 13

The disease isn’t removed therefore it is still active

Question 14

How is burnished calculus created?

Answer 14

Only taking off the outside layer instead of the whole thing
Poor angulation 90

Question 15

What role do radiographs play?

Answer 15

They help see interproximal calculus unless there is overlapping
Otherwise it isn’t helpful

Question 16

How do you scale around restorations?

Answer 16

Remove restoration
If implant have to use different tools in order to not scratch it
Avoid scratching gold or porcealin

Question 17

What’s the difference b/w assessment/exploratory store and working stroke?

Answer 17

Assessment: Light grasp, light pressure, more flowy, (detect irregularities, 2-3 mm at time)
Working: More controlled grasp, moderate to heavy pressure (locked in and committed)

Question 18

Vertical stroke

Answer 18

Parallel to the long axis of the tooth, rocking up toward yourself

Question 19

Oblique stroke

Answer 19

Diagonal across surface being treated

Question 20

Horizontal stroke

Answer 20

Parallel w/ occlusal surfaces

Must be short stoke b/c constant change of tooth topography (not doing right now)

Question 21

What is the blade angle during insertion?

Answer 21

40 degree or less
want instrument face to hug tooth
Doesn’t harm tissue

Question 22

What is correct blade angulation in removing calculus

Answer 22

Can be between 60-80 although 70-80 is ideal

Actual stroke is called biting stroke

Question 23

What are curets used for?

Answer 23

Subgingival

Question 24

Root debridement

Answer 24

Removal subgingival plaque, residual calculus deposits, wanting to preserve cementum
Less aggressive stroke than calculus (light to moderate)
60-70 degree

Question 25

Root planing

Answer 25

One of the heaviest, heavy to light as surface becomes smoother

Question 26

Scaling

Answer 26

Scaling coronal to CEJ, | Removing from surfaces of teeth

Question 27

What is the procedure for the assessment stroke of calculus removal

Answer 27

Assess Cup Stroke

Question 28

What is the procedure for the engagement stroke of calculus removal

Answer 28

Reassess grasp Lock toe-third against the tooth surface Activate stroke 70-80 degree Short biting strokes, rocking and rolling and pivoting from base of the pocket (JE)

Question 29

When removing calculus what's the overall process

Answer 29

Once you pull a moderate stroke, have to relax and go back down into sulcus lightly, cup and repeat

Question 30

What are things that would increase pocket depth?

Answer 30

Inflammation, bolbous

Question 31

How to remove large supragingival calculus

Answer 31

Start with the first section and keeping cracking until gone and then work across to weaken it as a whole

Question 32

What is channel scaling?

Answer 32

If there are deep pockets, can't take 6 mm stroke Break into sections from 6-3 thenfrom 3-0 Start at base and always work way up If furcation treat each root as it's own

Question 33

What strokes are used on the root surface for root debridement?

Answer 33

Vertical and oblique strokes and light lateral pressure can help eliminate grooves after scaling (topography is irregular so it goes many different ways in order to get clean surface)

Question 34

What does excessive lateral pressure cause?

Answer 34

``` excess removal of tooth structure gouging of root surfaces loss of instrument control patient discomfort clinical fatigue ```