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Scaling And Root Planing On Model 2006
 

Scaling And Root Planing On Model 2006

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    Scaling And Root Planing On Model 2006 Scaling And Root Planing On Model 2006 Presentation Transcript

    • Scaling and root planing on model 2006/11/1 王英斌 雅康牙醫診所 www.oral-health.com.tw [email_address]
    • 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 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 instrument 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 with root surface lateral pressure
      • 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!!