NSPT 3 PDF - Non-Surgical Periodontal Therapy 3 04/06/2021

04/06/2021 Non-Surgical Periodontal Therapy 3 1 Intended Learning Outcomes By the end of this session students should be able to: ▪ Recap previous concepts on gingival anatomy, morphology, ergonomics, probing, instruments, adaptation, fulcrums, pressure mani...

04/06/2021 Non-Surgical Periodontal Therapy 3 1 Intended Learning Outcomes By the end of this session students should be able to: ▪ Recap previous concepts on gingival anatomy, morphology, ergonomics, probing, instruments, adaptation, fulcrums, pressure manipulation and stroke direction. ▪ Demonstrate the correct sequence for instrumentation of a multirooted tooth with area-specific curettes. ▪ Explain the factors that can contribute to burnished calculus. ▪ Explain the impact of burnished calculus on patient outcomes. 2 2 1  04/06/2021 Recap of gingival histology, ergonomics, probing & charting 3 3 Revision of morphological complexities 4 4 2  04/06/2021 Look the following images – which teeth are they? What differences do you notice? 1 2 3 5 Grooves – natural local factor How does this extensive natural groove impact you as a clinician? How does this extensive natural groove impact your patient? Respond on NSPT 3 Padlet board 6 3  04/06/2021 Mind-map for instruments learnt so far 7 7 Mind-map for NSPT 1& 2 8 8 4  04/06/2021 Adaptation & correct end Why do you start at the mid-point? 9 9 4 motion components Wrist motion activation Pivot Digital motion activation Handle roll 10 10 5  04/06/2021 Pressure Pinch pressure Fulcrum Lateral pressure 11 11 Why do we cross hatch? Stroke direction 2 12 12 6  04/06/2021 Adaptation, Angulation Activation Insertion Removal Follow bulbosity T T O O & O O EXPLORATORY T T GRIP & H H ‘PRESSURE’ 13 Angulation of instruments for insertion & removal 14 7  04/06/2021 Furcations 15 15 Local Anatomic factors of furcations ▪ Root trunk length ▪ Root length ▪ Root form ▪ Interradicular dimensions ▪ Anatomy for furcation ▪ Cervical enamel projection 16 16 8  04/06/2021 Complexity in Anatomy 17 17 Apical view of upper and lower furcations 18 18 9  04/06/2021 Natural concavities 19 19 Look again at high risk stagnation points 20 20 10  04/06/2021 Radiographs of the dentition Impact on you & your patient PADLET board 1 3 2 21 Occlusal view of furcation access points for upper side 22 22 11  04/06/2021 Furcations – treat each root as a separate tooth (as if it were single rooted) Root trunk distal / mesial curette / 9/10 Middle of root is ‘new midline’ Debride mesial portion of each root Middle of root is ‘new midline’ Debride distal portion of each root D M 23 24 24 12  04/06/2021 Incorrect Technique: Remove Outer Layer. ▪ Burnished deposits are more difficult to detect and to remove. ▪ Burnished deposits retain plaque biofilms that are associated with continuing inflammation of periodontal tissues. 25 25 Recommended Reading ▪ Scheid RC, Weiss G. Woelfel’s Dental Anatomy. 8th ed.Philadelphia, PA: Jones & Bartlett Learning, LLC; 2012 ▪ Bower RC. Furcation morphology relative to periodontal treatment. Furcation root surface anatomy. J Periodontol. 1979:50(7):366-374 ▪ Gher ME, Verino AR. Root morphology-clinical significance in pathogenesis and treatment of periodontal disease. J Am Denta Assoc. 1980;101(4):627-633 ▪ Costley SM. Mastering apical orientation of the tip. Dimens Dent Hyg. 2013;11(2):38-39,43-44 26 26 13  04/06/2021 Image references ▪ https://dimensionsofdentalhygiene.com/article/the-challenge-of-furcations/ ▪ https://www.jendodon.com/article/S0099-2399(18)30002-5/fulltext ▪ https://www.back2health4you.com/muscle-skeletal-nerve-disorders-dental-team/ ▪ https://sciforschenonline.org/journals/dentistry/IJDOH337.php 27 27 14