Detection of Morphology & Deposits DTH23 Part 1 PDF

Detec%on of Morphology & Deposits Part 1 Founda%ons of Clinical Skills and Prac%ce Sarah Balian GDC Learning Outcomes Intended Learning Outcomes By the end of this session students should be able to: Explain the di.erent methods of deposit detec5on on the tooth surface. Discuss limita5ons...

Detec%on of Morphology & Deposits Part 1 Founda%ons of Clinical Skills and Prac%ce Sarah Balian GDC Learning Outcomes Intended Learning Outcomes By the end of this session students should be able to: Explain the di.erent methods of deposit detec5on on the tooth surface. Discuss limita5ons and pros and cons of each method. Recognise that detec5on of deposits on the tooth surface is not isolated to one method but mul5ple methods combined. Discuss the characteris5cs of e.ec5ve probing technique in terms of hand grasp, adapta5on angula5on, pressure and stroke. Discuss the limita5ons of probing and how clinicians can mi5gate against errors in probing. Types of deposits & morphology PaEerns of Calculus Forma%on Spicules Ledges Rings Methods of deposit detec%on Floss Radiograph Disclosing Probing Detec%on of deposits Air Vision Tissue changes Radiographs 7  Radiographs -X-rays Ops- Extra oral Image Intra cral Image Bitewings Intra oral Periapical Bitewing holder calculus a Present X-ray - Now you try…. j 000 o O 000 00 000  2 dimensional P Dosage of radia5on Choice of radiograph Clinician experience R Pa5ent tolerance Frequency? O Overlaps Interpreta5on See subgingivally Fault with image S Good quality radiographs o.er good contrast C Mobile Able to have there and then O Image to show pa5ent Educa5onal tool N Radiographs 11 S Vision 12  Looking at hard * and soft tissues Vision for abnormalities - Eyes E · need good lighting  P Ligh5ng Access dependent R Time Operator skill O Subjec5ve Immediate Show to pa5ent S Indicator at home for C monitoring Quick Cost free O N Vision 14 S Tissue Changes 16 Methods of Detec%on – Tissue Changes Dealcuus on Root surface- 1 2 secession 0 n 3 4 inflammation abnormal  P Ligh5ng Access dependent R Time Operator skill Subjec5ve O Shade subjec5ve Immediate What is normal for pa5ent? Show to pa5ent S Indicator at home for C monitoring Quick Tissue Cost free changes O Good monitoring tool N 18 S Compressed Air - 3 in) 19  to remove tooth · SinI to Dry Spicules of Compressed air Saliva hiding calculus. sirt  P Ligh5ng Access dependent R Time Operator skill O Subjec5ve Immediate Only supra-gingival Show to pa5ent S Quick C Cost free O N Air 21 S Detec%on of Morphology & Deposits Part 2 Founda%ons of Clinical Skills and Prac%ce Sarah Balian Intended Learning Outcomes By the end of this session students should be able to: Explain the di.erent methods of deposit detec5on on the tooth surface. Discuss limita5ons and pros and cons of each method. Recognise that detec5on of deposits on the tooth surface is not isolated to one method but mul5ple methods combined. Discuss the characteris5cs of e.ec5ve probing technique in terms of hand grasp, adapta5on angula5on, pressure and stroke. Discuss the limita5ons of probing and how clinicians can mi5gate against errors in probing. Probing Probing 2 4 1 3 5 Clinician Requires skill Apprecia%on of ReHec%on Lots of limita%ons dependent how technique sensi%ve and mi%gate against it  inserted into Prob being Gingivall Sulcus Probing  Probing Evalua%ng Screening Measuring Baseline /Monitoring informa%on Depth mm pocket Recession Diagnosis Detec%on condition. bleeding/plaane I crown morsin Ergonomics is key! What do you need to take into considera%on with yours and the pa%ents posi%on? Refer to Ergonomics Lecture Revise Gingival Histology Choosing the right tool probe probe probe so markhase Williams Pressure on grasp - light grip - X Too tight felt & Tighter grip Less can be more pressure in sulcus- Tac%le Sensa%on Enhancement r Pen Grasp ModiQed Pen Grasp Posi%on of probes in a healthy sulcus Line angles Mesial Mid Distal Tooth planes a me Line angles Mesial Mid Distal Adapta%on / Posi%oning your probe sundial epithellum Probe %p is kept in contact with The probe %p should not be held tooth surface away from tooth surface Parallelism Probe parallel to long axis of tooth Probe NOT parallel to long axis of tooth  Proximal view Interproximal probing Occlusal view Interproximal probing technique DiVerent angles Correct angula%on Under-angling Over-angling Probing walking stroke Probing walking stroke  P Limita5ons - detail Inaccuracies R Time Pa5ent tolerance Operator varia5on O Subjec5ve Immediate Cheap S ‘Quick’ C Reproduceable to an extent Accessible Level of detail O N Probing 24 S  · comfort of PT Probing Pressure · atraumatic · accurate Readings Context Chalk 25s 27 pressure How can you calibrate with your team members? Factor aVec%ng probing – Group ac%vity There are many factors that impact probing accuracy 1. In prepara5on for your clinical ac5vity, create a mind-map with all the factors you have iden5Ped through research that impact probing. 2. Please note all comments must be jus5Ped (you need to defend your responses). 3. Make note of the references on this subject. Factors impacting Probing Tac$le sensa$on ac$vity – Detec$on Session Enhancing tac*le sensa*on Iden*fying di3erent features on teeth, restora*ons & anomalies No*ce di3erences, sensa*ons, noises and how can you enhance iden*;ca*on of these situa*ons Normal Condi$ons Do not feel any interrup*ons as the probe moves from the JE to the gingival margin. Spicules Probes transmits griCy sensa*on to ;ngers as passes over ;ne granular deposits. Ledge of Subgingival Calculus As probe moves over tooth surface it moves out & around raised bump then returns to the tooth surface Restora$on with Overhang Margin Probes path is blocked by overhang & must move away from the tooth surface & over restora*on Restora$on with DeBcient Margin Tip passes over restora*on & then dips in to trace the surface of the restora*on. Carious Lesion The probe dips & then comes out again as it travels along tooth surface. Or in soH lesions it can get stuck or feel s*cky Image references hCps://www.sciencedirect.com/science/ar*cle/abs/pii/S0047248414002541 hCps://radiopaedia.org/cases/dental-calculus-disease Silorane Adhesive System: A Case Report | jcda hCps://www.den*stryiq.com/den*stry/pathology/ar*cle/14180848/oral-pathology-case-the-common-but-notsocommon-radiopacity hCps://www.den*st-manila.com/glossary/periapical-x-ray/ Rinn XCP-DS Fit | Dentsply Sirona hCps://dimensionsofdentalhygiene.com/*ps-periodontal-probing/ The Den*st Will See You Now: But Will You See the Den*st? - Scien*;c American peridontal-disease-treatment-and-deep-teeth-cleaning-required-for-hard-plaquee-build-up.jpg (1000×662) (lakefrondamilyden*stry.com) What is gingivi*s? – K Dental Studios | Den*st in London Integração esté*ca Perio-Prótese - Face Magazine 3:1 Air and Water Aspira*ng Dental Syringe (presidental.co.uk) 4,519 Dental Calculus Stock Photos, Pictures & Royalty-Free Images - iStock (istockphoto.com) Types of Floss - Wilkinson Dental of Spring;eld, MO (wilkdental.com) As promised. The dental cleaning process. - GIFs – Imgur £3 dona*on (crossreach.org.uk) hCp://nhakhoaquocbinh.com/en/is-dental-calculus-as-harmless/ hCps://www.yourden*stryguide.com/plaque/ (4) Pinterest hCps://www.researchgate.net/;gure/Mean-distance-in-millimeters-between-several-anatomical-landmarks-at-the-external_;g1_321152588 Recommended reading Listgarten, MA, Periodontal probing: What does it mean? Journal of Clinical Periodontology (1980) Kazuki Ishihata, Noriyuki Wakabayashi, Juro Wadachi, Tatsuya Akizuki, Yuichi Izumi, Kazuo Takakuda, Yoshimasa Igarashi, Reproducibility of Probing Depth Measurement by an Experimental Periodontal Probe Incorpora*ng Op*cal Fiber Sensor, Journal of Periodontology, 10.1902/jop.2011.110047, 83, 2, (222-227), (2012). John E. Lynch, Mark K. Hinders, Gayle B. McCombs, Clinical comparison of an ultrasonographic periodontal probe to manual and controlled-force probing, Measurement, 10.1016/j.measurement.2005.12.001, 39, 5, (429-439), (2006). Garnick JJ, Silverstein L. Periodontal probing: probe *p diameter. J Periodontol. 2000 Jan;71(1):96-103. doi: 10.1902/jop.2000.71.1.96. PMID: 10695944. Arthur F. HeHi, Periodontal Probing, Cri*cal Reviews in Oral Biology & Medicine, 10.1177/10454411970080030601, 8, 3, (336-356), (2016).  inuamma*on Sub gingival Operator skill calculus Recording Angula*on of errors probe Pa*ent Probing force tolerance Operator Probe wear varia*on Probe diameter