Instrument Sharpening: PDF Presentation

Instrument Sharpening Foundations of Clinical Skills and Practice Sarah Balian Intended Learning Outcomes By the end of this session students should be able to: Explain the benefits of using instruments with sharp cutting edges for periodontal instrumentation. Differentiate the terms ‘shar...

Instrument Sharpening Foundations of Clinical Skills and Practice Sarah Balian Intended Learning Outcomes By the end of this session students should be able to: Explain the benefits of using instruments with sharp cutting edges for periodontal instrumentation. Differentiate the terms ‘sharp cutting edge’ and ‘dull cutting edge’. Demonstrate methods to identify if a cutting edge is sharp. Revise the micro and macro characteristics of the working end. Explain and demonstrate different methods of sharpening – table top with stone and the Nievert Whittler Describe the care of the sharpening stone Think about the periodontal treatment session – What are Care of What tools you you do you doing? need? What are you Care of trying to the achieve? patient Why should we sharpen? Reduced Increased number of comfort strokes Reduced Maintenance clinician of instrument fatigue Enhances Less detection traumatic 6 What are you trying to achieve? DULL SHARP Remove minimal metal Maintain original characteristics  What are you trying to achieve? Dull Sharp Sharp Remove minimal Cutting Face metal edge Maintain original Lateral characteristics Surface Strength Back Longevity  A dull cutting edge is created when Overall aim metal is worn away from the cutting edge. Sharp Dull Effective Ineffective Ineffective Sharpening Sharpening Sharpening How does your instrument get blunt? Stroking against a tough tooth surface causes the delicate metal edge to be worn away until it is rounded instead of a fine line  ‘Light and bite’ Assessing sharpness Magnification Bright light Be present when you are working How often should I sharpen? During session Before treatment Factory finish……BUT Armamentarium for sharpening Gauze Static work surface Magnifying glass Sharpening stone Good light Guide Lubricant PPE Sharpening Stones Common Dental Stones Care of Stones Cleaned in an ultrasonic scaler or scrubbed with brush & hot water to remove metal particles from the stone The stone should be dried on a paper towel & placed in an autoclave bag or instrument cassette to be sterilised Sharpening Methods 1. Face 2. Lateral Surface The Neivert Whittler The Nievert Whittler Loss of metal distribution Lateral Surface Face St St n o e o n e Lubrication Usually water is applied to the surface of the sharpening stone Helps prevent the metal shavings from sticking to the surface of the stone These shavings can become embedded in the stone & reduce its effectiveness Reduces frictional heat between stone & metal Lateral Surface Sharpening Sharpening guide Instrument & Stone Positions – table top The face of the instrument should be parallel with the Table top Heal Middle Toe Preserve the Curve Rounded backs and Toes Rounded toes & backs of curettes must be re-contoured Meaning removing metal from the back & toe to restore curvature Clock System Right Handed Left Handed Sickles & Sickles & Gracey Curettes Gracey Curettes Universal Universal Curettes Curettes Sickle & SHANK Universal curettes E NE STON STO Gracey S H NE A S STO T K N N O SHA K N E Training & Calibration Errors in sharpening Working end design Flattening Metal cutting removal edge Altered shape Alteration of working-end design Unnecessary metal removal Flattening cutting edge Altered shape Shape change Sharpening video https://www.youtube.com/watch?v=z05sQSYpx Js&spfreload=10 Sickle Mins: 11.21Sec Universal Curette: 16.57 Gracey: 22.34 Metal spurs from sharpening Production of minute metal burs that project from cutting edge These can cause gouging of cementum Can be avoided by finishing with a downward stroke Can be seen or cleared with cylindrical sharpening stone Wiping your instrument Metal Burs Ending on a downward stroke It is all about the angle St X X S S o to to n n n e e e Sharpen or Replace? New Remember that scalers do have limited Old use-life & must eventually be discarded Frequent sharpening combined with care during handling & sterilisation prolong life When working-end becomes thin for use, it should be discarded – possibility of fracture in the mouth Instrument Tip in Periodontal Pocket  INHALE CONFIDENCE. EXHALE DOUBT. CHANGE THE NARRATIVE.