General Characteristics of Periodontal Instruments.pptVIP

Exploratory vs Working Stroke Blade is less than 45° Grasp is lighter Tactile sensitivity is enhanced On the “down” stroke Objective is to identify depth of calculus Blade is 45-90° Calculus removal Firm grasp Engage blade by Adaptation or “bite” On the “up” stroke Vertical Oblique Adaptation Degree of “how open” or “closed” the blade is upon insertion is dependent on: Type of tissue Fibrotic vs boggy or hemorrhagic tissue Severity of disease Retractable tissue Interproximal embrasure Tenacity of calculus Difference in Technique Scaling short, precise, strokes, channeling calculus deposits Planing long even strokes Objective is to smooth the root surface Takes experience and time to obtain skill How well have we scaled? At time of S/RP appointment Exploring, probing Smoothness of tooth surface After appointment Healthy periodontium Decreased bleeding, pocket depths, marginal bleeding Limitations obscured vision from bleeding tactile sensitivity instruments selected direction length of strokes confines of soft tissue - tissue type tooth anatomy clinical findings “mental image” based on visual, mental, and manual skills Limitations Accurate treatment plan Anesthesia, number of appointments Severity of Disease progression Local factors Systemic factors Pockets, furcas, anatomical characteristics, erosion, recession, mobility Most common areas missed: most apical portion of pocket furcation areas distal surfaces primary reason: not overlapping strokes Effects of scaling root planing reduction in inflammation pocket depth reduction-- avg.. 1.36mm .8mm in recession .52 in attachment attachment - maintained or slight gain decreased mobility - fibers reduction in gram-, spirochetes, bacteroides conflicting results with A. Actinocytemcomitans Sequence to Periodontal Instrumentation Patient Assessment Local and systemic factors that influence periodontal condition Hx of smoking Periodontal Evaluation Severity of disease Periodontal tx plan Surge