Scaling And Root Planing On Model 2006

Scaling and root planing on model

2006/11/1 王英斌雅康牙醫診所

www.oral-health.com.tw

oral.health@msa.hinet.net

General principles of instrumentation

* 位置 Accessibility (position of operator & patient)

* 視野 Visibility, illumination and retraction

* 器械狀況 Condition of instruments

* 能見度 Maintaining a clean field

* 穩定度 Instrument stability

* 操作方式 Instrument activation

正確的坐姿側面觀 :頸放鬆、頭略為前傾 ;手臂自然下垂 ;大腿放鬆，平行地面；腳掌著地；眼睛到手指的距離，跟日常看錶的距離同。

Patient --- mouth is close to resting elbow of operator

maxi. --- raise the chin slightly

mand. --- lower the chin until mandible is parallel to floor

Position of operator & patient

General principles of instrumentation

* 位置 Accessibility (position of operator & patient)

* 視野 Visibility, illumination and retraction ----善用口鏡

* 器械狀況 Condition of instruments---- sharp

* 能見度 Maintaining a clean field

* 穩定度 Instrument stability

* 操作方式 Instrument activation

General principles of instrumentation

* 位置 Accessibility (position of operator & patient)

* 視野 Visibility, illumination and retraction

* 器械狀況 Condition of instruments

* 能見度 Maintaining a clean field

* 穩定度 Instrument stability

* 操作方式 Instrument activation

Instrument grasp

Modified pen grasp

-- Tripod effect, enhance control -- enhanced tactile sensitivity

Finger rest --

to use wrist-arm motion to activate strokes Serves to stabilize the hand and instrument by providing a firm fulcrum as movement are made to activate the instrument.

Intraoral finger rests

(1) Conventional (2) Cross arch

Intraoral finger rests

(3) Opposite arch

(4) Finger on finger

b. Finger rest

* Extraoral fulcrum

(1) Palm up

(2) Palm down

General principles of instrumentation

* 位置 Accessibility ( position of operator & patient)

* 視野 Visibility, illumination and retraction

* 器械狀況 Condition of instruments

* 能見度 Maintaining a clean field

* 穩定度 Instrument stability

* 操作方式 Instrument activation

*Visual examination--- good light and a clean field. Compressed air

supra-gingival calculus chalky white sub-gingival calculus dark shadow * Tactile sensation --- light exploratory strokes are

activated vertically up and down on root surface

Detection skillsDetection skills

* Instrument activation

1. Adaptation

2. Angulation --- Different angulation

position will cause different effective

3. Lateral pressure

4. Strokes

* Adaptation

The lower third of the working end must be kept

in constant contact with the tooth while it is moving over varying tooth contours

*Angulation : the angle between the face of a bladed inst

rument and tooth surface, also called “ tooth-blade relationship ”

0 degree : insertion <45 degree : not for Sc/RP 45-90 degree : Sc/RP >90 degree : gingival curettage

• Lateral pressure :

the pressure created when force is applied against the surface of a tooth with the cutting edge of a blade instrument The exact amount of pressure applied must be varied according to the nature of the calculus and according the stroke is intended

* Determine cutting edge of Gracey curette

1. Hold face of curette blade parallel with floor and looking down on the face 2. Notice the blade curve 3. Larger, outer curve is the correct cutting edge

Principles for Gracey curettes usage

Finger rest

lower shank is parallel lower shank is parallel with root surfacewith root surface

lateral lateral pressurepressure

Scaling stroke is a short, powerful pull stroke

*The wrist and forearm motion, pivoting in an arc on the finger rest, produce a more powerful stroke --- for scaling

*Finger flexing--- for precise control over stroke length in areas such as line angles and when horizontal strokes are used on the lingual or facial aspects narrow-rooted teeth

Root planing stroke:

-- moderate to light pull stroke for final smoothing and planing of root surface

-- continuous series of long, overlapping shaving stroke is achieved

To avoid over-instrumentation, a delicate

transition from short, powerful scaling strokes

to longer, lighter root planing strokes must be

made as soon as calculus and initial roughness have been eliminated

Practice makes perfect!!