part ii: periodontal debridement. routine prevention or necessary treatment? dental prophylaxis or...

Part II:Periodontal Debridement

Routine Prevention or Necessary Treatment?

Dental prophylaxis OR periodontal therapy Removal of deposits from supragingival and

subgingival surfaces of the teethUses nonsurgical instrumentationTo prevent OR arrest infection General anesthesia

What does that entail? Risks Cost

Explore the Teeth

Dental explorer – has a slender, wire-like working end that tapers to a sharp point and is used to explore the topography of the tooth surface (crowns)

Explore caries Acid producingbacteria demineralization of enamel and dentin What is the most common surface affected?

Looking for pulp exposure

Check for Attachment Loss

Periodontal probe Round, blunt instrument Miniature intraoral ruler measures:1. Attachment levels (gingival recession and sulcus depths)

2. Loss of bone in furcation areas

Used to assess mobility of teeth and the presence of gingival bleeding.

What is normal sulcus depth for a canine? Feline?

Periodontal Probe

Williams’ markings have millimeter increments at 1,2,3,5,7,8,9 and 10mm.

Calculus Removers

Removes gross calculus, supragingivally

Which teeth do you think need this tool the most?

Scaling Above the Gingiva

Hand scaler – used to remove tartar / calculus supragingivally

Modified pen grasp technique Gives precise control of the instrument; limits wrist

motion Where should all of your fingers be?

Working end

Shank

Handle

Scaling Below the Gingiva

Curette-used to remove tartar subgingivallyModified Pen Grasp*Tip is more round/dull than the hand scaler.

Periodontal Debridement Using Machines

Ultrasonic scaler- uses vibrations and irrigation to remove tartar from surface of tooth. Steady stream of water (strong mist) flushes out the

sulcus AND can disrupt bacterial cell walls

Ultrasonic Scaler

Water through the tip also acts as a coolant; this machine can get very hot!

Move tip from the sulcus, down the Crown, to the apex.Time line/tooth?

Ultrasonic Scalers: Two Options

1. Magnetostrictive- magnetic field in the hand piece is created by zinc and nickel, sends vibrations to the tip in an elliptical pattern

All surfaces of the tip vibrate! Most vibrations are on the tip

Use least amount of vibrations Found on the lateral surfaces

Magnetostrictive Scaler

INCORRECT Distal third of tip should be

held at 0-15° from long axis of the tooth.

Ultrasonic Scalers: Two Options

2. Piezoelectric- ceramic discs or crystal that produces linear movements

Only lateral surfaces vibrate More skill required

More fragile/breakable Expensive

Periodontal Debridement

Polishing – VERY IMPORTANT The scaler microscopically scratches the tooth surface

and creates more surface area quicker bacterial build up

1-3 seconds/toothProphy angle- attachment that is connected

to the hand piece Removable rubber cup holds polish, or prophy paste

Patient Position/Safety

Comfortable for you and the patientPlenty of lightElevate neck; nose downOpening of mouth

Oral speculumSuction/gauzePreemptive rinsePPE

Feline Mouth Gags

Cornell StudyMaxillary artery

blockedBlindness

Periodontal Debridement Safety-PPE

Dental Radiographs

Manual Processing: uses film and developing solutions

Computed RadiographyDigital Radiography

Manual Processing

Dental Radiology Techniques

Parallel TechniqueBisecting Angle Technique