DHE150 Advanced Instrumentation-fulcrums quiz 3/30

  1. What are periodontal files used for?
    • to prepare calculus deposits before removal with another instrument
    • crush or roughen a heavy deposit so that it can be removed with a sickle scaler or curet.
    • limited in use to enamel surfaces, or on outer surfaces of calculus deposits.
  2. What is this instrument?
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    • Periodontal File
    • Has a series of cutting edges lined up on a base
    • Shank is rigid and transmits limited tactile information to the clinician’s fingers
  3. Periodontal File technique?adaptation?
    • The face of the working-end should be flat against the calculus deposit so that the corners of the cutting edges do not gouge the root surface or soft tissue.
    • Two-Point Contact
    • 1. Adaptation of the working-end to a
    • calculus deposit AND
    • 2. Resting the lower shank against the
    • tooth
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  4. Posterior Periodontal File A/B and C/D application of cutting edge?
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  5. Periodontal File Hirschfeld 3/7 and 5/11 application of cutting edge?
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  6. Periodontal File Hirschfeld 9/10 application of cutting edge?
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  7. With multi-rooted teeth, the best approach is to instrument each root as a ?
    separate tooth.
  8. Steps for instrumentation of Multi-Rooted teeth?
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    • Step 1: Root trunk;
    • Begin with the root trunk
    • Distal curet from the distofacial line angle on to distal surface
    • Mesial curet from the distofacial line angle across the facial and on to the mesial surface

    • Image Upload 8
    • Step 2: Root branches;
    • Treat each root branch as if it were the root of a single rooted tooth.
  9. What are Horizontal instrumentation strokes used for?
    • to remove deposits from rootconcavities and depressions.
    • *Vertical strokes are not effective because the working-end often “spans across” the root concavity, missing the deposit.
    • *The correct working-end to make a vertical stroke on the mesial surface is NOT the correct working-end to make a horizontal stroke on that same surface.
  10. For DISTAL surfaces, if the G13 is used for vertical strokes, use the __ for horizontal strokes, and visa versa.
  11. For MESIAL surfaces, if the G11 is used for vertical strokes, use the __ for horizontal strokes, and visa versa.
  12. The standard intraoral fulcrum provides?
    • The best stability for the clinician’s hand
    • Decreases the likelihood of injury to the patient or clinician
    • The best leverage during instrumentation
  13. Are advanced fulcrums intended to replace standard intraoral fulcrums?
  14. Which fulcrum places the least amount of strain on the clinician’s fingers?
    The standard intraoral fulcrum
  15. Can poor skills or bad habits in using a standard intraoral fulcrum be corrected by the use of an advanced fulcrum?
  16. Types of Advanced Intraoral Fulcrums?4
    • 1. Modified Intraoral Fulcrum
    • 2. Cross Arch
    • 3. Opposite arch
    • 4. Finger-on-finger
  17. Modified Intraoral Fulcrum?
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    • Intraoral fulcrum with an altered point of contact between the middle and ring fingers in the grasp
    • NOT the same as a split fulcrum, where the ring finger does not touch the middle
    • Here the point of contact is lower against the middle finger.
  18. Cross Arch Intraoral Fulcrum?
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    • Intraoral finger rest in which the finger rest is established on the opposite side of arch from the treatment area
    • Example: Clinician fulcrums on the left posteriors while working on the right posterior teeth
  19. Opposite Arch Intraoral Fulcrum?
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    • Intraoral fulcrum established on the opposite
    • arch from the treatment area
    • Example: Fulcrum on mandibular teeth while working on maxillary teeth
  20. Finger-on-Finger Intraoral Fulcrum?
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    • Intraoral fulcrum in which a finger
    • of the nondominant hand (mirror
    • hand) serves as the resting point
    • for the dominant hand
    • Example: Right-handed clinician 
    • The fulcrum finger of the right hand rests on the index finger of the clinician’s left hand.
  21. Advantages of Extraoral Fulcrums?
    • Easier access to maxillary 2nd and 3rd molars
    • Easier access to deep pockets
    • Improved parallelism of lower shank to molar teeth
    • Facilitates neutral wrist position for molar teeth
  22. Disadvantages of Advanced Extraoral Fulcrums?
    • Require a greater degree of muscle coordination and instrumentation skill
    • Greater risk of instrument stick
    • Reduce tactile information to the fingers
    • Not well tolerated by patients with TMJ problems
  23. In Advanced Extraoral Fulcrums how should a Clinician grasp instrument handle?
    farther away from the working-end
  24. Types of Advanced Extraoral Fulcrums?2
    • 1. Basic Extraoral
    • 2. Finger Assist
  25. Basic Extraoral fulcrum?
    • The dominant hand rests against the patient’s cheek or chin.
    • Palm is facing out
    • Knuckle rest technique with a basic extraoral fulcrum
    • Palm is facing out
    • Chin-cup technique with a basic extraoral fulcrum— right handed clinician
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  26. Finger Assist Extraoral Fulcrum?
    • A finger of the nondominant hand is used to concentrate lateral pressure against the shank of the instrument.
    • Right-handed clinician uses her left index finger to apply pressure behind the shank
    • Lateral pressure pushes working-end forward against the distal surface
    • Right-handed clinician’s left index finger concentrates pressure back against the mesial surface
    • Using finger assist with a horizontal stroke on the mandibular anteriors
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  27. Powered Instrumentation Technique Adapting to Palatal Root?
    • Palatal root curves in lingual
    • direction
    • Back surface of curved tip adapts
    • best
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    • Use cross arch fulcrums
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  28. Powered Instrumentation Technique Finding the Furcation Area?
    • Curved slim-diameter tips are used in furcation areas.
    • The easiest way to locate the furcation is to deactivate the instrument tip (remove your foot from the foot pedal).
    • Deactivated tip provides the most tactile information to your fingers
  29. Powered Instrumentation Technique Slim Tip with Ball End?
    • A curved slim tip with a ball end is ideal for use in a furcation area.
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  30. Powered Instrumentation Technique FOR FURCATION?
    • Step 1: Locate the Furcation
    • Deactivate the tip
    • Insert beneath the gingival margin
    • Move in an oblique direction until you detect the entrance to furcation.
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    • 2. Enter Furcation Area
    • Turn the working-end while rotating your wrist
    • Activate instrument
    • Roll the ball of the working-end back and forth across the roof of furcation.
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  31. Powered Instrumentation Technique
    Left or Right?
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    • The terms “right and left” refer only to the bend in the shank.
    • “Right and left” does NOT refer to a location in the mouth.
    • *To decide if a tip is a right or a left tip:
    • Rotate the insert so the point is facing away from you
    • And the back is toward you.
    • If the shank bends to the left, this is the left tip. Bend to the right, it is the right tip
  32. Powered Instrumentation Technique
    Right Tip: Transverse Orientation
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  33. Powered Instrumentation Technique
    Left Tip: Transverse Orientation
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  34. Powered Instrumentation Technique
    Right Tip: Vertical Orientation
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  35. Powered Instrumentation Technique
    Left Tip: Vertical Orientation
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  36. Piezoelectric Instruments?
    • Use electrical energy to activate crystals within the handpiece to vibrate the tip
    • Tips screw on and off with a wrench
    • Only the lateral surfaces of the tips are active. Used a lot like hand instruments.
Card Set
DHE150 Advanced Instrumentation-fulcrums quiz 3/30
DHE150 Advanced Instrumentation-fulcrums quiz 3/30