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HOES
used to dislodge heavy supramarginal calculus deposits
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FILES
used to crush and remove heavy calculus deposits
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CHISELS
used to dislodge brides of calculus on anterior mandibular teeth
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what are 6 design features for a HOE
- 1. single, straight cutting edge
- 2. cutting edge beveled at a 45 degree angle to the end of the blade
- 3. blade turned at 99-100 degree angle to the shank
- 4. strong, straight, rigid shank used for adaptation in anterior
- 5. curved shank used for adaptation in posterior sextants
- 6. paired instrument; set of 4 working ends of 4 areas
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what are some of the purposes of a HOE
1. removal of heavy, tenacious SUPRAgingival calculus
2. removal of heavy, tenacious SUBgingival calculus in easily accessible areas, above the junctional epitherlium
3. most effective on the facial and lingual surfaces OR on proximal surfaces next to edentulous areas.
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Where do you only use the HOE
only in easily accessible areas
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what kind of stroke is used for a HOE
VERTICAL PULL STROKE toward the incisal/occlusal
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How do you hold a HOE
hold instrument in a modified pen grasp utilizing a fulcrum near the tooth surface to be instrumented
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HOEAdapt the of cutting edge to the tooth surface
full width
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Shank section of instrument adjacent to the blade is to the long axis of the tooth placing the cutting edge at a 90 degree angle to the tooth surface when dealing with a HOE
parallel
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Contraindications for HOE
1. NOT for use on proximal surfaces EXCEPT in edentulous areas
2. Can gouge cemental surface
3. NOT adaptable to curved root surfaces
4. NOT to be used subgingivally unless tissue is SPONGY and FLEXIBLE bc blade size and shape will tear pocket wall
5.ALL instrumentation must be followed by curets
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What are some design features of the FILE?
1. Multiple cutting edges, like a series of hoe scalers
2. each blade is at a 90-105 degree angle to the shank
3.shank comes in various angles. curved shanks are designed for the posterior and straight shanks are for the anterior
4. base can be round, rectangular or oval
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What are 4 the purpose of the FILE?
1. calculus removal through crushing or fragmentation prior to definitive scaling with curets
2. SUBgingival use of the file must be away from the junctional epithelium
3. most effective on the facial /buccal and lingual surfaces OR on proximal surfaces next to edentulous areas
4. Smooth overhanging restorations
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Where do you use a FILE?
only in easily accessible areas
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Entire cutting edge is placed against area to be treatedfile
FLAT
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fileshank is to the long axis of the tooth
parallel
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what kind of contact do you want to maintain when using a FILE
a two-point contact between the instrument shank and the cutting edge to provide stability
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What kind of stroke is used with a FILE
VERTICAL PULL STROKE toward the incisal/occlusal.
Pressure applied allows cutting edge to grasp surface
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List contraindications when using FILE
1. Can gouge tooth surface and traumatize tissue
2. Inaccessible areas
3. lack of tactile sensitivity
4. Base of pocket inaccessible without trauma
5. Proximal use is difficult
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what do u use when wanting to remove burnished calculus?
FILE
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what are 3 design features of the CHISEL
1. single, straight, flat cutting edge
2. Blade is continuous with slightly curved shank
3. Cutting edge is bevealed at a 45 degree angle
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What are some of the purposes of the CHISEL?
1. extremely limited to areas where interdental papilla are missing
2. Removal of heavy supragingival calculus that bridges mandibular anteriour teeth and premolars where the lip allows access.
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Where do you want to establish a finger rest when using the CHISEL?
on the facial surface of teeth adjacent to tooth being instrumented
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chiselPosition instrument shank to the long axis of the tooth
perpendicular
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what edge of the cutting edge is adapted
full width
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what is the stroke of the CHISEL
HORIZONTAL PUSH (thrusting) motion from facial to lingual
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List the contraindications for the chisel
1. must utilize entire cutting surface or sharp corners will gouge tooth surface
2. all instrumentation must be followed by curets
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How do you sharpen a HOE
- stationary stone, moving instrument
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maintain 45 degree bevel, establish finger rest on stone
2. PULL toward the cutting edge, use a short stroke
3. Round the corners by gently rolling stone across corner
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How do you sharpen a FILE?
1. use professional sharpening service or BUY a new one
2. too difficult and time-consuming with limited results
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How do you sharpen a CHISEL?
- stationary stone, moving instrument
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Maintain 45 degree bevel
2. PUSH instrument foward, toward the cutting edge
3. round corners by gently rolling stone over corners
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Maxillary Canine description
*Root surfaces are broad and flat in faciolingual direction
*longitudinal groove possible, more common on distal surface
*concavity exists with longitudinal groove
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what is the adaptation technique for maxillary canine?
roll handle to direct toe third of cutting edge into concavity
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maxillary first premolar description
most commonly bifurcated in apical or middle third, forming facial and lingual roots
2 kinds BIfurcated and SINGLE rooted
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maxillary first premolar that is bifurcated
mesial surface has deep developmental groove running from bifucation to crown, causing a concave mesial surface.
distal surface has a groove reduced in depth and length, causing a convex or flat distal surface at the cervical third
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maxillary first premolar single rooted
mesial and distal surfaces have longitudinal grooves similar to the grooves on the root trunk of a two rooted tooth.
The mesial surface groove is more pronounced than the distal and therefore more concave on mesial surface.
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Maxillary first molar description
three roots are lingual, mesiobuccal, distobuccal
short root trunk
grooves ar epresent from trifurcation to cervical line on mesial, distal, and facial surfaces
lingual surface of lingual root has longitudinal groove more pronounced at cervical third
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mesiobuccal root is concave on distal surface
distobuccal root is concave on mesial surface
maxillary first molar
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mandibular canine description
longitudinal groove usually present on mesial and distial surfaces, making them concave in the faciolingual direction
sometimes this root is bifurcated in the apical third
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mandibular first molar description
bifurcation in cervical third forms mesial and distal roots
developmental depression on facial and lingual root trunk extends from bifurcation to CEJ, becoming more shallow toward CEJ
each root has longitudinal grooves on the mesial and distal root surfaces, which are more prominent on mesial roots
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what are some limitations when using after-five mini gracey curet
extension to the midline of proximal surfaces
and longevity is limited by sharpening often
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working blade is half the length and thinned for ease of insertion and reduced tissue distention for narrow deep pockets, convexites and concavites.
3 mm longer in lower shank
after-five mini gracey curet
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where are after five gracey's helpful?
for narrow facial and lingual surfaces of anterior teeth
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standard gracey usage.....
light to moderate calculus
fine scaling, root planing, debridement
adjuction to ultrasonic scaling
more flexible shank that bends under pressure
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what are rigid and extra rigid shanks used for?
heavy scaling
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list advantages of using a rigid or extra rigid shank
does not dissipate the power used in generating a working stroke
does not diminish tactile sensitivity
enhances control and energy needed
available in mini, traditional, and after five series
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indications for use of rigid and extra rigid curet
moderate to heavy calulus
scaling and debridement
periodontal surgery
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design for R or E curets
wider shank
same shank angulation as standard Gracey Curette
same blade width as standard Gracey Curette
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What are SOH curettes used for?
to smooth root surfaces and remove small residual deposits after ultrasonic scaling
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What curette is described as disc shaped and look like a small spoon excavator?
O'hehir curettes
SOH 1/2, SOH 3/4 SOH 5/6 SOH 7/8
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blade design that enables a push or pull stroke in ALL directions
SOH (o'hehir)
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list some features of the diamond file scaler
360- degree diamond coating
thin tips and unique bends
active in both push and pull motion
medical grade diamond coating
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what are some benefits of the diamond scaler
scaling efficiency
superior access
provides accessto scale in small and narrow pockets
ensures consistency of coated surface
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DIAMOND Scalers style
paried ends R/L
universal application
access for class III furcations
extended shank and pronounced curvature
large diameter handle
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who designed vision curvettes?
Barbara Long RDH from Saskatchewan
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Blade tip of a vision curvette is to the handle and shank is closer to with the handle.
perpendicular
parallel
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vision curvette compared to standard gracey
50% shorter blade
straight shank permits insertion into narrower deeper pockets especially anterior.
improved adaptation at line angles, and for removal of deposit once it had been dislodged
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subzero curvette design
long shank, facial and lingual line angles on anterior and premolars
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1/2 curvettes
anteriors, premolars, and interproximal surfaces
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11/12 curvette
mesial of molars and furcations
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13/14 curvette
distals of molars and furcations
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what marker indicates the right cutting edge?
small "X"
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List the mm marks on a shank
5 mm
10 mm
helps clinician visually assess pocket depth during instrumentation, to compare with perio charting and tactile sensation
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What are some disadvantages of curvettes
1. short working end limits extension to midline of proximal surfaces
2. upward curve could gouge if not adapted properly
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who designed the langer curettes
Dr. Burton Langer
periodontist
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what two features does the langer curette have
combines best features of the gracey and universal curette blade
allows you to scale the mesial and distal surfaces with the same instrument
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langer vs gracey
langers have a slightly shorter, thicker terminal shank making them less flexible
shank is not parallel to long axis of tooth when a good working blade angulation is achieved
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langer 1-2
similar to 11/12
mandibular posterior mesial and distal
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langer 3-4
maxillary posterior
similar to 13/14
but suitable for both mesial and distal of surfaces of maxiallary teeth
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langer 5-6
anterior and premolar teeth
similar to gracey 5-6
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langer 17/18
posterior
advantageous when scaling 2nd and 3rd molars
angled shank allows for a more horizontal hand position
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Morse sickle
scaler has a miniature sickle with a straight shank
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morse curet
has a straight shank with miniature curet
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index finger reinforcement
used to gain additional stability and control
non-dominanthand is used for additional support, additional lateral pressure, and longer pull strokes
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furcation curets
designed for scaling root concavities and furcations:
available in: buccal-lingual or mesial-distal
- blade width is 2 sizes either
- .9mm 1.3 mm
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name the 8 different kinds of finger reinforcement
- 1. extraoral palm up hand rest
- 2. extraoral palm-up reinforced hand rest
- 3. intraoral finger on finger rest
- 4. intraoral opposite arch finger rest
- 5. intraoral opposite arch reinforced finger rest
- 6. cross arch finger rest
- 7. horizontal strokes in anterior and using an 11/12 on the distal of most posterior tooth
- 8. opposite end of 13/14 for horizontal strokes with toe down
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