Periodontology

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¶ INSTRUMENT ACTIVATION:-

1-Adaptation:-

the manner in which the working end of aperiodontal instrument is placed against the surface of atooth.

"to make the working end of the instrument conform to the contour of the tooth surface".

2-Angulation:-

the angle between the face of a bladed instrument and the tooth surface.

A: For insertion beneath the gingival margin, the face to tooth surface angulation should be an angle between
0 to 40 degrees.

B: For calculus removal, angulation should be between 45 to 90 degrees.

3-Lateral pressure:-

-It refers to the pressure created when force is applied against the surface of a tooth with the cutting edge of a bladed instrument.

4-Stroke:-

There are four types of strokes:
1. Placement stroke.
2. Exploratory stroke or assessment stroke.
3. Scaling stroke.
4. Root planing stroke.

-Pull strokes may be made in vertical, oblique or horizontal directions.

¶ Finger Rest:-

-The finger rest serves to stabilize the hand and the instrument by providing a firm fulcrum, as movements are made to activate the instrument.

-A good finger rest prevents injury and laceration of the gingival and surrounding tissues.

-The ring finger is preferred by most clinicians for the finger rest.

-Maximal control is achieved when the middle finger is kept between the instrument shank and the fourth finger.

-This built-up fulcrum is an integral part of the wrist-forearm action that activates the powerful working stroke for calculus removal.

-Finger rests may be generally classified as intraoral finger rests or extraoral fulcrums.

¶ Intraoral finger rest:-
1-Conventional finger rest.
2-Cross-arch finger rest.
3-Opposite-arch finger rest.
4-Finger-on-finger rest.
5-finger–reinforced rest.

¶ Extraoral finger rest:-
1-palm up
2-palm down

¶ INSTRUMENT STABILIZATION

-Stability of the instrument and the hand is the primary requisite for controlled-instrumentation.

-Stability and control is essential for effective instrumentation and to avoid injury to the patient or clinician.

-The two factors that provide stability are, instrument grasp and finger rest.

¶ Instrument Grasp

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

-The most effective and stable grasp for all periodontal instruments is the modified pen grasp.

-This grasp allows precise control of the working end, permits a wide range of movements and facilitates good tactile conduction.

-The palm and thumb grasp is useful for stabilizing instruments during sharpening and for manipulating air and water syringes.

¶ MAINTAINING A CLEAN FIELD

-Despite good visibility, illumination and retraction, instrumentation can be it y hampered if the operative field is obscured by saliva, blood and debris.

-Adequate suction is essential and can be achieved with a saliva ejector or, an aspirator.

-Blood and debris can be removed from the operative field with suction and by wiping or blotting with gauze squares.

-The operative field should also be flushed occasionally with water.

-Compressed air and gauze square can be used to facilitate visual inspection of tooth surfaces just below the gingival margin during instrumentation.

-Retractable tissue can also be deflected away from the tooth by gently packing the edge of gauze square into the pocket with the back of a curette.