Periodontal Instrumentation Short And Long Essay Question And Answers

Periodontal Instrumentation

Periodontal Instrumentation Important Notes

1. Differences between Gracey curette and universal curette

2. Gracey Curettes

3. Extended shank curettes

• Example: After five curettes
• The shank is extended 3 mm than the standard Gracey which allows extension into deeper periodontal pockets
• They are available in all standard Gracey numbers except 9 and 10

4. Minibladed curettes

• Example: Mini five curettes
• These are modified after five curettes with the blade length half of that of conventional curettes
• The shorter blade allows easier insertion and adaptation in deep, narrow pockets and furcation
• They are available in all standard Gracey numbers except 9 and 10

5. American gracey curettes

• These are four mini-bladed curettes
• The blade length is 50% shorter than that of conventional curettes
• The blade has been curved slightly upward
• This allows the curettes to adapt more closely to the tooth surface, especially on the anterior teeth and online angles

Read And Learn More: Periodontics Question and Answers

6. Langer and mini langer curettes

• This set of 3 curettes combines the shank design of the standard Gracey 5-6, 11-12, and 13-14 curettes with a universal blade angled at 90 degrees rather than the offset blade of the Gracey curettes
• This allows the advantage of the area-specific shank to be combined with the versatility of a universal curette blade

7. Angles in instrumentation

8. Sharpening of instruments

• During the sharpening of instruments
• The face of the blade is parallel to the floor and the stone makes a 100-110° angle with the face of the blade
• This automatically preserves an angle of 70-80° angle between the face and the lateral surface

9. Sharpness of instruments can be tested by

• Keeping the cutting edge under light, a dull instrument would reflect light while a sharp instrument does not
• The instrument is lightly drawn across an acrylic rod called a test stick. A dull instrument will slide smoothly but a sharp one would raise a light shaving

10. Angulation

• It refers to the angle between the face of the bladed instrument and the tooth surface
• Correct angulation is essential for effective calculus removal
• For subgingival insertion of a bladed instrument such as a curette, the angulation should be close to 0°
• During scaling strokes on heavy calculus angulation should be just less than 90° so that the cutting edge bites into the calculus
• An angulation of less than 45° and greater than 90° will cause the instrument to slide over calculus and causes burnishing of calculus

11. Mounted rotary stones are not recommended because

• They are difficult to control precisely and can ruin the shape of the instrument
• They tend to wear down the instrument quickly
• Generates frictional heat which may affect the temper of the instrument

12. Hoes

• They are used for removing ledges or rings of calculus
• It makes two-point contact with the tooth and this stabilizes the instrument and prevents nicking of the root
• The blade is bent at 99° and the cutting edge is beveled at 45°

13. Ultrasonic and sonic instruments

• Used for scaling, curettage, and removing the stain
• They produce vibrations at the tip of the instrument which when adapted to the tooth causes dislodgement of calculus
• Vibrations range from 20,000 to 45,000 hertz
• The spray which is directed at the tip of the instrument dissipates heat and forms tiny vacuum bubbles that collapse quickly and release energy by a process called cavitation
• They contain a water knob that controls the volume of water being delivered to the insert tip
• Water contributes to 3 physiologic effects that enhance the efficacy of power scalers

• The combination of these 3 effects disrupts microflora

Types of Ultrasonic Instruments:

1. Magnetostrictive
   • The pattern of vibration is elliptical
2. Piezoelectric
   • The pattern of vibration of the tip is linear

Contraindications:

• Patients with communicable diseases that can be transmitted by aerosols
• Patients at risk of respiratory diseases
• Patients who are immunocompromised or suffering from chronic pulmonary diseases
• Patients having porcelain or bonded restorations because they can be fractured or removed

14. Modified pen grasp

• It is the most effective and stable grasp for all periodontal instruments
• It creates a tripod effect with the thumb, index finger, and the pad of the middle finger
• It ensures the greatest control over the instrument and also enhances maneuverability and tactile sensitivity

15. Palm and thumb grasp

• It is unsuitable for the precise and controlled movements
• It inhibits maneuverability and tactile sensitivity
• It is used for stabilizing instruments during sharpening and for manipulating air and water syringes

16. Rests and fulcrum

17. Chisel scaler

• It is used in the anterior part of the mouth for the proximal surfaces of teeth that are too closely spaced to permit the use of other scalers
• The instrument is activated with a push motion while other scalers are activated with pull motion

18. Adaptation

• It refers to the manner in which the working end of a periodontal blade is placed against the surfaces of a tooth
• The objective of adaptation is to make the working end of the instrument conform to the contour of the tooth surface
• Precise adaptation minimizes trauma to the soft tissues and root surfaces and ensures maximum effectiveness of instrumentation

19. Kirkland knives

• Commonly used for gingivectomy
• Used on the facial and lingual surfaces of incisors and those distal to the terminal tooth in the arch

20. Basic characteristics of scaler and curette

21. Florida probe

• It is an automated probe system
• Consists of a probe handpiece, digital readout, foot switch, computer interface and computer
• The end of the probe tip is 0.4 mm in diameter
• The probing method combines the advantages of constant probing force with precise electronic measurement and computer storage of data
• It eliminates the potential errors associated with visual reading and the need for an assistant to record the measurements

Disadvantages:

• Lack of tactile sensitivity
• Patient discomfort
• Inaccurate measurements
• Underestimation of deep probing depths by the automated probe

22. Scaling stroke

• It is a short, powerful pull stroke that is used with a bladed instrument for the removal of both supragingival and subgingival calculus
• The muscles of the fingers and hands are tensed to establish a secure grasp and lateral pressure is firmly applied against the tooth surface

23. Uses of explorer

• To locate sublingual deposits and various areas
• To check the smoothness of root surfaces after root planning

Periodontal Instrumentation Long Essays

Question 1. Classify periodontal instruments. Describe anyone in detail.
Answer:

Classification:

• According to purpose, instruments are classified as

1. Periodontal probe
2. Explorer
3. Scaling, root planning, and curettage instruments
   • Sickle scalers
   • Currencies
   • Hoe, chisel, file scalers
   • Ultrasonic and sonic instruments
4. Periodontal endoscope
5. Cleansing and polishing instruments
   • Rubber cups
   • Brushes
   • Dental tapes

Periodontal Instrumentation Short Essays

Question1. Universal Curettes.
Answer:

• As can be used for most areas of the dentition

Indication:

• Deep sub-gingival scaling
• Cementum alteration
• Removal of the soft tissue lining of a pocket

Parts:

• Removal of the soft tissue lining of the pocket
• Face-90° to lower shank
  • Adapted towards tooth surface
• Shank
• Cutting edge-Two edges
  • Both can be used

• Curvature – Blades curve upward
• Blade Angle – 90°

Question 2. Gracey Curettes/Area-specific curettes.
Answer:

• Area-specific curettes
• Angle – 60° offset
• Cutting edge – Outer end only is used Curvature
• Curves upwards and sideways
• Use – Sub-gingival scaling and root planning

Types:

• 1-2 and 3-4-For interiors
• 5-6-Anteriors, premolar
• 7-8, 9-10 – Posteriors – Facial and lingual
• 11-12 – Posteriors – mesial
• 13-14 – Posteriors – distally

Recent Advances – 15-16 and 17-18

Question 3. Corvettes.
Answer:

Types-Sub-O:

• 1-2- anterior and premolars
• 11-12-posteriors medial
• 13-14-posteriors distal

Modification From Conventional Gracey Cu- Rettes:

• 50% shorter blade length
• The curvature of the blade upwards

Importance:

• Due to curvature, there is a better adaptation to tooth surfaces

Question 4. Endoscope/Perioscope.
Answer:

Use:

• Diagnosis and treatment of periodontal diseases

Part:

• Fibre optic – Reusable
• Sterile sheath – Delivers water for irrigation
• Covering fiber optic
• Periodontal probe/ultrasonic instruments

Advantages:

• Clear visualization subgingivally
• Detects the presence and location of sub-gingival deposits
• Guides the operation
• Helpful in root debridement in inaccessible areas

Periodontal Instrumentation Short Question and Answers

Question 1. Langer’s curettes.
Answer:

• This is a set of 3 curettes
• These contain combined features of Gracey and univer- sal curettes
• Can be adapted both on the mesial and distal surfaces
• Consist of shank design of the standard Gracey #5-6, 11- 12, and 13-14 curette
• Has a universal blade angled at 90 degrees.

Question 2. Cleaning and Polishing instruments.
Answer:

1. Rubber cups: Rubber shell

• Used in handpiece

2. Bristle brushes: Wheel and cup-shaped

• Used in handpiece with paste

3. Dental tape: For polishing proximal surfaces

• Air powder polishing – Uses air-powdered slurry of warm water and sodium bicarbonate

Question 3. Prophyjet.
Answer:

Special handpiece

Use:

• Removal of extrinsic stains and soft deposits:

Method:

• Delivers air-powdered slurry of warm water and sodium bicarbonate

Disadvantages:

• Loss of tooth structure
• Transient gingival tissue damage
• Roughening of restoration

Contraindications:

• Systemic diseases
• Patients on medications that affect electrolytic balance

Question 4. Kirkland knife
Answer:

• Used for gingivectomy
• The entire periphery is cutting edge
• Shape- kidney shaped

Types:

1. Double-ended and single-ended
2. Disposable and reusable
3. Flat-bladed and interproximal

Question 5. Naber’s probe.
Answer:

• Naber’s probe is a curved blunt probe
• Color-coded markings are present at 3, 6, 9, and 12 mm It is used to detect furcation areas

Question 6. Classify periodontal instruments
Answer:

Classification:

• According to purpose, instruments are classified as

1. Periodontal probe
2. Explorer
3. Scaling, root planning, and curettage instruments
   • Sickle scalers
   • Currencies
   • Hoe, chisel, file scalers
   • Ultrasonic and sonic instruments
4. Periodontal endoscope
5. Cleansing and polishing instruments

• • Rubber cups
  • Brushes
  • Dental tapes

Question 7. Sharpening stones
Answer:

• It is obtained from natural mineral deposits or artificially
• Its surface is made up of abrasive crystals

Types:

1. Based on crystal size:

1. Coarse stones:
   • Have larger particles
   • Cut more rapidly
   • Used for dull instruments
2. Finer stones
   • Have smaller crystals
   • Cut more slowly

2. Method of use:

1. Mounted rotary stones:
   • Mounted on a metal mandrel/handpiece
2. Unmounted stones:

Examples: Carborundum, ruby, and ceramic stones

Question 8. Excisional and incisional instruments
Answer:

1. Periodontal knives
2. Interdental knives
   • Ex-Orban knife
   • Used for interdental areas
   • They are pear-shaped knives
   • Cutting edges are present on both sides of the blade
3. Surgical blades
   • Used for periodontal surgery
   • They are beak shaped
   • Cutting edges are present on both sides
   • Used with pushing and pulling cutting motion
   • Commonly used- 12D, 15 and 15C

Question 9. Florida probe.
Answer:

• It is a computerized periodontal probe

Consists of:

• Probe handpiece
• Footswitch
• Digital readout
• Computer
• Computer interface

Method of Use:

• The probe tip is 0.4 mm in diameter
• Insert probe tip
• Measures are made electronically
• Transfer to the computer when the foot switch is pressed
• Constant probing provided by coil springs inside the probe handpiece and digital readout

Q.ultrasonic 10. Cavitation
Answer:

• Seen with the use of ultrasonic instruments

Production

Question 11. Contraindications of ultrasonic instruments
Answer:

• Patients with
• Cardiac pacemakers
• Communicable disease
• Respiratory disease
• Gag reflex
• Porcelain crowns
• Titanium implants
• Dentinal hypersensitivity
• Newly erupted teeth
• Young teeth with the large pulp chamber

Question 12. Mechanism of ultrasonic scalers
Answer:

• Ultrasonic scalers work by converting electrical energy into mechanical energy in the form of vibrations of the working tip

Frequency Used:

• 18000-50000 cycles/sec

Types:

1. Piezoelectric

• Ceramic disc is present
• When electrical energy is applied the tip moves in a linear path creating two active surfaces

2. Magnetostrictive

• Consist of the metal stalk
• When electrical energy is applied vibration travels from the stalk to connect the body to tip
• Tip travels in an elliptical motion covering all surfaces

Question 13. Hazards of ultrasonic scalers
Answer:

• Aerosol production
• Heat production
• Damage to the restoration
• Roughening of cementum
• Enamel abrasion
• Tissue damage

Question 14. Instrument grasps
Answer:

• A proper grasp is essential for precise control of movements made during periodontal instrumentation

1. Modified pen grasp

• It is the most effective and stable grasp for all periods on- all instruments
• It creates a tripod effect with the thumb, index finger, and the pad of a middle finger
• It ensures the greatest control over the instrument and also enhances maneuverability and tactile sensitivity

2. Palm and thumb grasp

• It is unsuitable for the precise and controlled movements
• It inhibits manoeuvrability and tactile sensitivity It is used for stabilizing instruments
• during sharpening and manipulating air and water syringes

Question 15. Mini curettes
Answer:

• After five curettes have a shank 3 mm longer
• Mini-bladed curettes are modifications after five curettes
• It has a shorter blade
• This allows easier insertion and adaptation in deep pockets, furcation, developmental grooves, line angles
• Available in all standard Gracey numbers except for #9, 10

Periodontal Instrumentation Viva Voce

1. In sonic units, the tip will have the orbital type of vibrating action
2. Periotrievers are a set of two double-ended, highly magnetized instruments used for retrieval of broken tips from pockets and furcation
3. Scaling and root planning are done to restore gingival health by completely removing elements that provoke gingival inflammation
4. India and Arkansas oilstones are examples of natural abrasive stones
5. Carborundum, ruby, and ceramic stones are synthetic- locally produced
6. The primary goal of scaling and root planning is to restore the gingiva to health by removing the irritants which provoke the inflammation
7. After scaling the gingiva which is edematous and swollen undergoes shrinkage
8. The function of an explorer is to locate caries
9. The sickle scalers are used to remove supragingival calculus
10. Hoe is used for the removal of tenacious subgingival calculus and altered cementum
11. Perioscope is used to visualize deeply into subgingival pockets and furcation
12. Furcation areas are best evaluated by Naber’s probe
13. UNC 15 probe has color coding at 5, 10, and 15 mm
14. The smoothness of the root surfaces after root planning is checked by the explorer
15. Sickle scalers are used with a pull stroke
16. The cutting edge of a curette is present on both sides of a working end
17. Langer and mini Langer curettes is combination of standard Gracey and universal curettes
18. Schwartz periotrievers are designed for removal of broken instruments from deep pockets
19. The part function of a periodontal file is to fracture or crush large deposits of calculus