PERIO lab

• Parts of a Periodontal Instrument

  • Handle for holding the instrument
  • Shank connects the handle to the working-end
  • Working-end does the work of the instrument
• Handle

  • Lightweight
  • Large in diameter
  • Texturing
• Shank

  • Connects the handle to the working-end
  • Types: Simple, Complex
  • Lower shank lengths: Standard shank, Extended shank
• Working-end

  • Does the work of the instrument
  • Parts: Face, Back, Lateral surface, Cutting edges, Toe, Tip
  • Kinds: Single-ended, Doubled-ended
• Classification of Periodontal Instruments

  • Assessment Instruments: Periodontal probes, Explorers
  • Calculus Removal Instruments: Sickle scaler, Curettes, Periodontal Files
• Techniques in Instrument Sharpening

  1. Moving instrument technique

  2. Moving stone technique
• Armamentarium

  • Flat and conical arkansas stone
  • Sharpening oil
  • Acrylic stick (or plastic tip of ballpen)
• Tray set-up

  • Mouth mirror
  • Explorer
  • Cotton plier
  • Spoon excavator
  • UNC probe 15
  • Naber’s probe
  • Universal scaler
  • Standard Gracey curettes
• The Wrist-rocking Motion

  1. Rotate hand and wrist as one unit

  2. Maintain neutral body posture

  3. Keep workload on the forearm and wrist

  4. No force from the hand and fingers

  5. Skill comprised of small movements

  6. Brain, nervous system, and muscles work in coordination

  7. Requires repeated practice
• Digital Motion Activation

  Move the instrument by flexing the thumb, index, and middle fingers
• Adaptation of the Working-end

  1. Leading third is the anterior portion of the working-end is always in contact with the tooth surface

  2. Adapt the tip-third to the midline of the tooth

  3. Adapt the tip-third to the line of the angle of the tooth
• Stroke Direction

  • Vertical and oblique strokes
  • Horizontal stroke
  • Multidirectional stroke
• Instrumentation Strokes

  • Assessment or Exploratory stroke
  • Calculus Removal Stroke
  • Root Debridement Stroke
• Activation of the Working-end

  1. Toe to tooth and TWIST

  2. The twist applies the force coming from the arm

  3. TWIST should not come from fingers
• Ergonomics

  Is an applied science concerned with making products and tasks comfortable and efficient for the user
• Causes of Injury
• Twist

  Applies the force coming from the arm
• Twist should not come from fingers
• Causes of Injury (dentist)

  • Awkward Postures
  • Fixed working positions (static postures)
  • Force
  • Repetitive movements
• Ergonomics

  An applied science concerned with making products and tasks comfortable and efficient for the user
• Sequence for Establishing Position

  1. ME. (Clinician) Assume the clock position for the treatment area

  2. MY PATIENT Establish patient chair and head position

  3. MY EQUIPMENT Adjust the unit light. Pause and self-check the clinician, patient, and equipment position

  4. MY NONDOMINANT HANDS Place the fingertips of my nondominant hand as shown in the illustration for the clock position

  5. MY DOMINANT HAND Place the fingertips of my dominant hand as shown in the illustration for the clock position
• Sharpening dental scalers and curettes

  1. Sharp dental instruments are crucial for efficient procedures

  2. Materials required: flat Arkansas stone, conical stone, sharpening oil, and an acrylic stick for testing sharpness

  3. Process involves using the face of a clock as a reference for sharpening

  4. Demonstrated techniques for scalers and curettes, ensuring sharp edges and tips

  5. Sharpening technique involves keeping the shank at 12 o'clock and the stone at 1 o'clock or 11 o'clock

  6. Use gentle up-and-down motions to sharpen the instrument

  7. Test the sharpness by seeing if the instrument catches on the acrylic stick

  8. Remove any burrs with a conical stone after sharpening

  9. Regular sharpening maintains instrument efficacy

  10. Options for sharpening: personal, seeking guidance from dental hygienists, or outsourcing to professional services
• Adaptation, Angulation & Activation

  1. Adaptation Technique: Focus on keeping the toe third of the instrument in direct contact with the tooth

  2. Avoid using the entire instrument and concentrate only on the toe third

  3. Incorrect adaptation may lead to discomfort or injury to the gum

  4. Angulation: Maintain proper angle to ensure the toe third remains in contact with the tooth surface

  5. Incorrect angulation can cause the toe to penetrate
• Instrument adaptation

  1. Avoid using the entire instrument and concentrate only on the toe third

  2. Incorrect adaptation may lead to discomfort or injury to the gum
• Angulation

  • Maintain proper angle to ensure the toe third remains in contact with the tooth surface
  • Incorrect angulation can cause the toe to penetrate into the gum, potentially causing pain
  • Practice above the gum line if necessary to avoid painful contact
• Activation Method

  1. Utilize a rocking motion involving hand and wrist movement, rather than just finger strength

  2. Emphasize lateral pressure and movement toward the toe of the instrument to effectively remove deposits

  3. Avoid hand fatigue and limited flexibility by maintaining proper thumb position and executing the twisting motion
• Fulcrum and Thumb Position

  • Ensure the correct fulcrum position to maintain control and prevent hand fatigue
  • Avoid dropping the thumb during movement, which can hinder the twisting motion necessary for effective cleaning
• Patient Position for the Mandibular Arch
• Patient Position for the Mandibular Arch

  • Body - The patient's feet should be even with or slightly higher than the tip of his or her nose
  • Chair Back - The chair back should be slightly raised above the parallel position at a 15°-20° angle to the floor
  • Head - The top of the patient's head should be even with the upper edge of the headrest. If necessary, ask the patient to slide up in the chair to assume this position
  • Headrest - Raise the headrest slightly so that the patient's head is in a chin-down position, with the patient's chin lower than the nose
• Patient Position for the Maxillary Arch

  • Body - The patient's feet should be even with or slightly higher than the tip of his or her nose
  • Chair Back - The chair back should be nearly parallel to the floor for maxillary treatment areas
  • Head - The top of the patient's head should be even with the upper edge of the headrest. If necessary, ask the patient to slide up in the chair to assume this position
  • Headrest - Adjust the headrest so that the patient's head is in a chin-up position, with the patient's nose and chin level
• Clock positions for Anterior and Posterior teeth
• Anterior teeth segments

  • Facing you - 8-10 O'clock
  • Facing away - 11-1 O'clock
• Posterior teeth segments

  • Facing you/closer - 9 O'clock
  • Facing away - 10-11 O'clock