34 Questions
What is the primary objective of scaling and root planing?
To restore gingival health by removing etiologic factors
What is the definition of scaling?
Removal of both super gingival and substantial plaque and calculus
What is the primary use of the sickle scaler?
Removal of super gingival calculus
What is a characteristic of the sickle scaler?
It has a very sharp tip and a triangular cross section
Why is the sickle scaler only used above the gingival margin?
Because it has a very sharp tip that could injure gingiva
What is the definition of root planing?
Removal of embedded calculus and rough cementum
What is the purpose of local periodontal therapy?
To remove bacterial plaque and local factors that favor its accumulation
What is the outer layer of the tooth root surface?
Cementum
What is the primary function of lavage in ultrasonic scaling?
To flush out debris and bacteria
What is the purpose of an exploratory stroke in periodontal probing?
To measure pocket depth
Which type of stroke is used for scaling with ultrasonics?
Light intermittent stroke
What is the purpose of acoustic turbulence in ultrasonic scaling?
To agitate fluids in the mouth
What is the angle of the instrument when inserting into a periodontal pocket?
0 degrees
What is the primary function of cavitation in ultrasonic scaling?
To release energy to flush out debris
What is the purpose of root planing?
To smooth out the root surface
What is the angle of the instrument when scaling with a curet?
45 degrees
What is the purpose of the scaling stroke?
To remove hard deposits
What is the function of the mechanical vibration in ultrasonic scaling?
To remove hard deposits
What is the main difference between a universal curet and a Gracey curette?
The area of the mouth they are used in
What is the characteristic of the cross section of a universal curet?
Semi-circular
Which of the following Gracey curettes is used for the anterior teeth and premolars?
Gracey 5-6
What is the main indication for using ultrasonic scalers?
Tenacious calculus removal
Which of the following is a contraindication for using ultrasonic scalers?
Pacemakers
What is the characteristic of the vibration pattern of a magneto-restrictive ultrasonic scaler?
Elliptical
What is the main difference between magneto-restrictive and piezo-electric ultrasonic scalers?
Their vibration patterns
Which of the following instruments is used for calculus removal in the posterior region for facial and lingual surfaces only?
Gracey 9-10
What is the main advantage of using hand instruments for calculus removal?
They are more gentle on the gingival tissue
Why are ultrasonic scalers contraindicated for patients with infectious diseases spread by aerosol?
They create aerosols
What is the main reason for having the best angulation when scaling and root planing?
To avoid damaging tissue and remove calculus effectively
What is the function of the prophy paste used in the prophylaxis?
To remove a microscopically small layer of enamel
What is the benefit of the perfect cup flexing on slight pressure?
It enables extra extrinsic stain removal and pocket access
What is the purpose of the brush in the prophylaxis?
To access occlusal grooves and interproximal areas
What is unique about the prophy paste used in the prophylaxis compared to normal toothpaste?
It has some grittiness to it
What is the goal of scaling and root planing?
To remove all calculus if possible
Study Notes
Non-Surgical Periodontal Therapy
- Non-surgical periodontal therapy is designed to remove bacterial plaque and local factors that favor its accumulation.
Scaling and Root Planing
- Scaling is the removal of both supragingival and subgingival plaque and calculus.
- Root planing is the removal of embedded calculus and rough cementum, which is the outer layer of the tooth root surface.
- The primary objective of both scaling and root planing is to restore gingival health by removing etiologic factors.
Instruments Used in Scaling and Root Planing
- Sickle scalers are used for removal of supragingival calculus and have a very sharp tip with a triangular cross section.
- Curettes are used for subgingival calculus and have a rounded tip, either universal or adapted for specific areas of the mouth (Gracey curettes).
- Universal curettes have a semi-circular cross section and a rounded tip, allowing for use in any area of the mouth.
- Gracey curettes have a semi-circular cross section and are adapted for specific areas of the mouth, with one cutting edge.
Gracey Curettes
- Gracie 1-2 is used for the anterior region of the mouth.
- Gracie 5-6 is used for the anterior teeth and premolars.
- Gracie 7-8-9-10 is used in the posterior for facial and lingual surfaces only.
- Gracie 11-12 is used in the posterior for mesial and interproximal surfaces.
- Gracie 13-14 is used in the posterior for distal interproximal surfaces.
Ultrasonic Scalers
- Ultrasonic scalers are used for tenacious calculus and are contraindicated for patients with pacemakers, infectious diseases spread by aerosol, and at risk for respiratory disease.
- There are two types of ultrasonic scalers: magneto-restrictive (Cavitron) and piezo-electric.
- Magneto-restrictive ultrasonics vibrate in an elliptical pattern, while piezo-electric ultrasonics vibrate in a linear pattern.
- Ultrasonic scalers have several functions, including lavage, cavitation, mechanical vibration, and acoustic turbulence.
Strokes Used in Scaling and Root Planing
- Exploratory stroke: a light feeling stroke used with probes and explorers to measure pocket depth and detect calculus.
- Scaling stroke: a short, strong pull stroke used for scaling.
- Root planing stroke: a light to moderate poststroke used for final smoothing.
- Ultrasonic stroke: a light, intermittent stroke with a tip parallel to the tooth surface.
Angulation of Curettes
- When inserting a curette into the pocket, the angulation between the blade and the tooth should be zero degrees (closed angle).
- When scaling and root planing, the angulation should be 45 to 90 degrees (open angle).
Prophylaxis
- After scaling and root planing, a prophylaxis is provided to remove any supragingival plaque that remains on the tooth enamel.
- A prophy cup and brush are commonly used for prophylaxis.
- The prophy cup flexes on slight pressure to the contours of the teeth, and the brush enables better access to select occlusal grooves and interproximal areas.
This video explores non-surgical periodontal therapy, focusing on removing bacterial plaque and local factors to return to a state of health, including scaling and root planing.
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