N137 (scaler and curet), N135(scaler), 204SD (scaler), Columbia 13/14 (curet), gracey 11/12 (curet) and Gracey 13/14 (curet)
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Stabilization = correct grasp and fulcrum
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more bends in the shank, more area specific
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instruments ADAPTATION, ANGULATION, ACTIVATION
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# indicates the specific design of the working end and the are of the dentition indicated for use
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area specific
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only adapts to certain surfaces in certain areas of the mouth
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universal
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used on any area of the mouth (both anterior and posterior)
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weight
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lighter handles enhance TACTILE SENSITIVITY and lessen fatigue related to a tighter grasp, ideally less than 15.0g
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diameter
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6.5mm- 10mm. thin handles can lead to RSI (repetitive stress injury). ergonomic instruments have 10mm diameter
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texture
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textured provide better control, increase tactile sensitivity
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shape
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straight: anterior teeth. angled complex: proximal surfaces of posterior teeth
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length
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most instruments: 35-40mm
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rigidity
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stronger: remove calculus. flexible: remove fine deposits of calculus
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Design, Characteristics
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calibrated in millimeter increments (NOT all probes have the same marking patterns)
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blunt, rod-shaped working that may be circular or rectangular in cross section
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working-end and the shank meet in defined angle that is >90 degrees
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stainless steel, titanium or plastic
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Function
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MAIN detect periodontal pockets to determine the health status of the periodontist
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measure clinical attachment loss
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measure extent of recession of the gingival margin
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measure the width of the attached gingiva
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measure the size of intramural lesions
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assess bleeding on probing
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determine mucogingival relationship
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monitoring the response of the periodontium to treatment
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Probing depth
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the distance in millimeters from the gingival margin to the base of the sulcus or periodontal pocket as measures with a probe
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Base of sulcus is at the junctional epithelium
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round up to nearest full millimeter
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Healthy State
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1-3 mm
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the probe touches the tooth near the CEJ at the JE
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Disease State
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greater than 3 mm
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probe tip touches somewhere below the CEJ
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function of the mirror
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1. indirect vision
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to see tooth surfaces or intramural structures that CANNOT be seen using direct vision
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2. retraction
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hold the pt's cheek, lip or tongue see tooth surfaces
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3. indirect illumination
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reflect light onto a tooth surface in a dark area o the mouth
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4. transillumination
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directing light off to the mirror surface and through the ANTERIOR TEETH (helps aid in detection of inter proximal caries) LOOKING DIRECTLY ON THE TOOTH
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assessment
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mirror, explorer, probes
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treatment
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scalers, hoes, chisels, files, curets (universal/area specific), powered scalers
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crowns ONLY
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Universal in design, area specific in use
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anterior ONLY (sextant 5 mostly)
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all surfaces (BEST in proximal surfaces)
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BOTH crowns and roots
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Universal in design, area specific in use
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Anteriors
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ALL SURFACES
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Scaler
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Crowns ONLY
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Universal
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BOTH anterior and posterior
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ALL SURFACES ( BEST in proximal premolar and anterior)
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scaler
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crowns ONLY
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universal
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BOTH posterior and anterior
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ALL SURFACES (BEST in proximal of posterior)
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curet
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crown and roots
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universal
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BOTH posterior and anterior
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ALL surfaces
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curet
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crowns and roots
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area specific
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posterior ONLY
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lingual, medial, buccal (everything but the distal)
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outer working edge- fattest from the handle
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curet
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crowns and root
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area specific
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posterior ONLY
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distal surfaces ONLY
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inner edge- closest to the handle
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Gingival enlargement and coronal migration of the gingival margin
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No loss of clinical connective tissue attachment
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Junctional epithelium has not migrated apically
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A gingival sulcus that has been deepened by disease; depth is greater than 3mm
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Forms from apical migration of the junctional epithelium and of periodontal fibers
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Function
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determine the health of the periodontal tissues, tooth anatomy and the texture of tooth surfaces.
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detect by TACTILE means, the texture and character if tooth surfaces debone during and after periodontal instrumentation to assess the programs and completeness of instrumentation
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Design
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flexible metal conduct vibrations form the working end to the clinicians fingers.
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working- end is 1 to 2 mm in length and referred to as the explorer tip
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11/12 Explorer
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side of the explorer tip is applied to the tooth surface
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Surface Assessment
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supragingival (above the gingival) subgingival (below the in the gingival margin)
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Explorer Types
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Shepard hook, straight, curved, pigtail and cowhorn, orban-type, 11/12 type
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