Beruflich Dokumente
Kultur Dokumente
Overview
KEY TERMS
This module presents (1) the manual scaling and root planing; and (2) the sonic
and ultrasonic scaling.
Manual scaler
Curetes
Ultrasonic scaler
Goals
Using manual scaler, demonstrate the calculus removal for phase 1 therapy.
DEFINITION
Scaling is the process by which biofilm and calculus are removed from
both supragingival and subgingival tooth surfaces. No deliberate attempt is
made to remove tooth substance along with the calculus.
Root planing is the process by which residual embedded calculus and
portions of cementum are removed from the roots to produce a smooth, hard,
INSTRUMENT SET
Clean table tray
2 pcs mouth mirror
1 pcs calibrated probe
Set of periodontal scalers
Universal curetes
Gracey curetes (if available)
clean surface.
DETECTION SKILLS
Visual examination of supragingival and subgingival calculus just below the
gingival margin is not difficult with good lighting and a clean field. Light deposits
of supragingival calculus are often difficult to see when they are wet with saliva.
Compressed air may be used to dry supragingival calculus until it is chalky white
and readily visible. Air also may be directed into the pocket in a steady stream to
deflect the marginal gingiva away from the tooth so that subgingival deposits near
the surface can be seen.
Tactile exploration of the tooth surfaces in subgingival areas of pocket depth,
furcations, and developmental depressions is much more difficult than visual
examination of supragingival areas and requires the skilled use of a fine-pointed
explorer or probe. The explorer or probe is held with a light but stable modified pen
grasp. This provides maximal tactile sensitivity for detection of subgingival calculus
and other irregularities. The pads of the thumb and fingers, especially the middle
finger, should perceive the slight vibrations conducted through the instrument shank
and handle as irregularities in the tooth surface are encountered.
The sickle or curette is held with a modified pen grasp, and a firm finger
rest is established on the teeth adjacent to the working area. The blade
is adapted with an angulation of slightly less than 90 degrees to the
surface being scaled.
2.
The cutting edge should engage the apical margin of the supragingival
4.
5.
The final portion of the deposit is engaged and removed. Note how the
procedure is performed in an interdental space by entering facially and
lingually.
PLEASE REMEMBER
Hoes, files, and standard large
ultrasonic tips are all more hazardous
than the curette in terms of trauma to
the root surface and surrounding tissues.
Subgingival scaling and root planing are accomplished with either universal
or area-specific (Gracey) curettes using the following basic procedure.
1.
The curette is held with a modified pen grasp, and a stable finger rest is
established. The correct cutting edge is slightly adapted to the tooth, with
the lower shank kept parallel to the tooth surface.
2.
The lower shank is moved toward the tooth so that the face of the blade is
nearly flush with the tooth surface. The blade is then inserted under the
gingiva and advanced to the base of the pocket by a light exploratory
stroke.
3.
When the cutting edge reaches the base of the pocket, a working angulation
of between 45 and 90 degrees is established, and pressure is applied
laterally against the tooth surface. Calculus is removed by a series of
Principles Of Instrumentation
1. Ultrasonic technique is different from instrumentation with hand scalers. A
modified pen grasp is used with an ultrasonic scaler along with an extraoral
fulcrum. The purpose of the extraoral fulcrum is that it allows the operator to
maintain a light grasp and easier access physically and visually to the oral
cavity.
2. Alternate fulcrums of cross arch or opposite arch fulcrums are acceptable
alternatives.
3. Light pressure is needed with a power instrument. The tip is traveling at a set
frequency in a set stroke pattern. Increased clinician pressure on the tip causes
decreased clinical efficacy.
2.
Avoid brushing or flossing the treated area for 12 hours. However, after 12
hours it is very important that you continue to brush well. Please be careful
brushing and use a toothbrush with soft bristles. You may moisten the
brush with warm water if tissues are tender.
3.
4.
Highly nutritious food is necessary for the healing process. Avoid foods
that require excessive chewing, also, sticky, crunchy or coarse foods.
5.
6.
You may also gently massage the areas treated with your washed fingers.
This will increase circulation and promote healing.