Ultrasonic Intrumentations

Question 1

what instruments should be used supragingivially?

Answer 1

scalers, and mcalls

Question 2

what is the mcalls 13/14 used for?

Answer 2

bicuspids

Question 3

what is the mcalls 17/18 used for?

Answer 3

molars

Question 4

what can the ultrasonic be used for?

Answer 4

calculus
necrotized ulcerative gingivitis
overhanging restorations
excess cement 
stains

Question 5

what types of powered scalers are there?

Answer 5

sonic and ultrasonic

Question 6

whats the frequency of the powered scalers

Answer 6

sonic: 6000 hz

ultrasonic: 20-50000 Hz

Question 7

what types of ultrasonic scalers are there?

Answer 7

magnetostrictive and peizoelectric

Question 8

what direction does the tip of an sonic scaler move?

Answer 8

elliptical

Question 9

what are some disadvantages of the sonic scaler?

Answer 9

heats the tissue so needs to be cooled and cant remove heavy deposits

Question 10

how is the peizoelectric scaler powered?

Answer 10

alternating current to reactive crystals

Question 11

what direction do peizoelectric scalers tips move?

Answer 11

linear, therefore only two sides are active

Question 12

magnetostrictive tip moves in what direction?

Answer 12

elliptical

MS scaler similar to sonic, makes heat, elliptical

Question 13

how is the MS scaler powered

Answer 13

ferromagnetic stacks

Question 14

how do ultrasonic scalers clean teeth?

Answer 14

1) by disrupting bioflim, otherwise known as deplaquing

2) cavitation bubbles: expansion and collapse of bubbles a formation of radicals

Question 15

what are some advantages of ultrasonic scalers over hand scaling?

Answer 15

less time
more comfort
less stress on the hand
technically less demanding 
no sharpening

Question 16

what are some advantages of hand scaling over ultrasonic scalers?

Answer 16

more visibility 
more tactile sensitivity
no aerosols
better subgingivally 
easier on the roots 
no irrigation

Question 17

the water suppy can be easily contaminated, what are some things that can be one to prevent contamination?

Answer 17

self-contained reservoir
point-of-use filter
flushing the tube

Question 18

how should the tube be flushed?

Answer 18

2 min at the start of the day and 30 sec before each use

Question 19

why is the ultrasonic handpeice filled with water before inserting the scaler?

Answer 19

to remove air bubbles; air bubbles can cause it to overheat

Question 20

how do you adjust the water setting?

Answer 20

make sure the power is on a low setting

Question 21

what is the out of phase setting and when should it be used?

Answer 21

its a steady drip of water and it should be used on light deposits

Question 22

would should be the water setting for heavy deposits?

Answer 22

maximum efficiency: mist

Question 23

T or F

water level must be changed every time the power setting is changed AND when the tip is changed.

Answer 23

true

Question 24

when should the USS be used on the high setting?

Answer 24

pretty much never, medium power is good enough

Question 25

The boost mode increases ______ by _____ percent water flow amplitude frequency power 10 15 20 25

Answer 25

power (technically amplitude and frequency is good enough too) 25

Question 26

T or F the proper way to use the USS is to apply pressure against the calculus.

Answer 26

F applying too much pressure dampens the vibrations, use light strokes

Question 27

what kind of tips are there for USS?

Answer 27

``` thin for light deposits heavy for heavy deposits subgingival implants: PLASTIC TIP furcations ```

Question 28

what are the surfaces for the tip?

Answer 28

lateral face back point

Question 29

what surfaces are used to remove calculus?

Answer 29

lateral and back

Question 30

which surface is most effective? lateral face back point

Answer 30

lateral

Question 31

whats the power distribution of the surfaces? lateral face back point

Answer 31

point>face>lateral>back

Question 32

when can the point be used?

Answer 32

to fracture large deposits

Question 33

how is the USS and curette similar when it comes to adaptation?

Answer 33

Transverse orientation: lateral surface adapted above or just below the gingival margin

Question 34

how is the USS and probe similar when it comes to adaptation?

Answer 34

vertical orientation: lateral surface adapted below the gingival margin

Question 35

How is the USS and currette used differently when it comes to removing calculus

Answer 35

curettes remove bottom up, USS remove by crushing it top down

Question 36

how does the tip remove calculus?

Answer 36

by creating microfractures

Question 37

match: tapping stroke sweeping motion light deposit heavy deposit deplaquing

Answer 37

tapping stroke= heavy sweeping= light sweeping= deplaquing

Question 38

where are the aerosols getting contaminated from?

Answer 38

usually rebounded off the patient

Question 39

what can be done to reduce contamination from the patient?

Answer 39

preprocedural rinse barrier protection for both you AND the patient high volume evacuation

Question 40

the power knob adjusts _____ amplitude frequency both (overall power)

Answer 40

amplitude: length of the stroke

Question 41

what is a sign of inadequate water being used?

Answer 41

heated handpeice

Question 42

T or F | its better to use more water than less water

Answer 42

T

Question 43

what is the advantage of using a 30k Hz over a 25k Hz magnetostrictive scaler? more efficient in removing deposits more efficient in power usage creates less noise

Answer 43

creates less noise practically no difference overwise

Question 44

which one of these are NOT patient contraindications to the use of USS? ``` unshielded pacemaker uncontrolled diabetes TB immunosuppressed chronic pulmonary disease asthma children difficulty breathing all are contraindications ```

Answer 44

uncontrolled diabetes

Question 45

which one of these are NOT tooth contraindications to the use of USS? ``` porcelain gold amalgam composite demineralized teeth implants all are contraindications ```

Answer 45

all are contraindications

Question 46

how much wear must the tip wear out for it to be thrown out?

Answer 46

2 mm

Question 47

how less effective is 1 mm or wear? 2 mm of wear?

Answer 47

25% - 50%

Question 48

where is the power concentrated in the handpeice?

Answer 48

last 2-4 mm of the tip

Question 49

how do you measure the wear of the tip?

Answer 49

Hu-Freidy guide

Question 50

T or F | the beavertail tip is used supra and subgingivally and is used to remove large deposits and stains.

Answer 50

F, not subgingivally everything else is true

Question 51

T or F | the standard Diameter universal tip is used supra and subgingivally near the margin.

Answer 51

T

Question 52

T or F slim diameter straight tip can be used throughout any depth in a pocket but does not adapt well to the curved surfaces of posterior teeth?

Answer 52

F, only to a depth of 4 mm, rest is true

Question 53

what can be used to adapt to the curvature of post. teeth?

Answer 53

the curved slim tip

Question 54

which tip can be used a depths greater than 4 mm?

Answer 54

the curved slim tip

Question 55

which tip is best used for furcations? slim diameter straight tip curved slim tip beavertail tip standard Diameter universal tip

Answer 55

curved slim tip

Question 56

T or F | for best tactile feedback, the instrument should be on

Answer 56

F

Question 57

T or F | its better to used a ball tip rather than a curette to remove calculus in furcations.

Answer 57

T, adapts to the curvature better

Question 58

how is the fluid controlled during the use of instrumentation?

Answer 58

widen vestibule for posterior | pull lower lip for anterior teeth