Scaling And Root Planing On Model 2006

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Scaling And Root Planing On Model 2006

  1. 1. 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]
  2. 2. General principles of instrumentation <ul><li>* 位置 Accessibility (position of operator & patient) </li></ul><ul><li>* 視野 Visibility, illumination and retraction </li></ul><ul><li>* 器械狀況 Condition of instruments </li></ul><ul><li>* 能見度 Maintaining a clean field </li></ul><ul><li>* 穩定度 Instrument stability </li></ul><ul><li>* 操作方式 Instrument activation </li></ul>
  3. 3. 正確的坐姿 <ul><li>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。 </li></ul>
  4. 4. <ul><li>Patient --- mouth is close to resting elbow of operator </li></ul><ul><li>maxi . --- raise the chin slightly </li></ul><ul><li>mand . --- lower the chin until mandible is parallel to floor </li></ul>
  5. 5. <ul><li>Position of operator & patient </li></ul>
  6. 6. General principles of instrumentation <ul><li>* 位置 Accessibility (position of operator & patient) </li></ul><ul><li>* 視野 Visibility, illumination and retraction ---- 善用口鏡 </li></ul><ul><li>* 器械狀況 Condition of instruments---- sharp </li></ul><ul><li>* 能見度 Maintaining a clean field </li></ul><ul><li>* 穩定度 Instrument stability </li></ul><ul><li>* 操作方式 Instrument activation </li></ul>
  7. 7. General principles of instrumentation <ul><li>* 位置 Accessibility (position of operator & patient) </li></ul><ul><li>* 視野 Visibility, illumination and retraction </li></ul><ul><li>* 器械狀況 Condition of instruments </li></ul><ul><li>* 能見度 Maintaining a clean field </li></ul><ul><li>* 穩定度 Instrument stability </li></ul><ul><li>* 操作方式 Instrument activation </li></ul>
  8. 8. <ul><li>Instrument grasp </li></ul>Modified pen grasp -- Tripod effect , enhance control -- enhanced tactile sensitivity
  9. 9. <ul><li>Finger rest -- </li></ul><ul><li>to use wrist-arm motion to activate strokes </li></ul><ul><li>Serves to stabilize the hand and instrument </li></ul><ul><li>by providing a firm fulcrum as movement are </li></ul><ul><li>made to activate the instrument. </li></ul>
  10. 10. Intraoral finger rests (1) Conventional (2) Cross arch
  11. 11. <ul><li>Intraoral finger rests </li></ul><ul><li>(3) Opposite arch </li></ul>(4) Finger on finger
  12. 12. <ul><li>b. Finger rest </li></ul><ul><li>* Extraoral fulcrum </li></ul><ul><li>(1) Palm up </li></ul>(2) Palm down
  13. 13. General principles of instrumentation <ul><li>* 位置 Accessibility ( position of operator & patient) </li></ul><ul><li>* 視野 Visibility, illumination and retraction </li></ul><ul><li>* 器械狀況 Condition of instruments </li></ul><ul><li>* 能見度 Maintaining a clean field </li></ul><ul><li>* 穩定度 Instrument stability </li></ul><ul><li>* 操作方式 Instrument activation </li></ul>
  14. 14. <ul><li>*Visual examination- -- good light and a clean field. Compressed air </li></ul><ul><li> supra- gingival calculus chalky white </li></ul><ul><li>sub- gingival calculus dark shadow </li></ul><ul><li>* Tactile sensation --- light exploratory strokes are activated vertically up and down on root surface </li></ul>Detection skills
  15. 15. <ul><li>* Instrument activation </li></ul><ul><li>1. Adaptation </li></ul><ul><li>2. Angulation --- Different angulation </li></ul><ul><li>position will cause different effective </li></ul><ul><li>3. Lateral pressure </li></ul><ul><li>4. Strokes </li></ul>
  16. 16. <ul><li>* Adaptation </li></ul><ul><li>The lower third of the working end must be kept </li></ul><ul><li>in constant contact with the tooth while it is moving over varying tooth contours </li></ul>
  17. 17. <ul><li>* Angulation : </li></ul><ul><li>the angle between the face of a bladed instrument and tooth surface, also called “ tooth-blade relationship ” </li></ul>0 degree : insertion <45 degree : not for Sc/RP 45-90 degree : Sc/RP >90 degree : gingival curettage
  18. 18. <ul><li>Lateral pressure : </li></ul><ul><li>the pressure created when </li></ul><ul><li>force is applied against the surface of a tooth </li></ul><ul><li>with the cutting edge of a blade instrument </li></ul><ul><li> The exact amount of pressure applied </li></ul><ul><li>must be varied according to the nature </li></ul><ul><li>of the calculus and according the stroke </li></ul><ul><li>is intended </li></ul>
  19. 19. <ul><li>* Determine cutting edge of Gracey curette </li></ul><ul><li>1. Hold face of curette blade parallel with </li></ul><ul><li>floor and looking down on the face </li></ul><ul><li>2. Notice the blade curve </li></ul><ul><li>3. Larger, outer curve is </li></ul><ul><li>the correct cutting edge </li></ul>
  20. 20. <ul><li>Principles for Gracey curettes usage </li></ul>Finger rest lower shank is parallel with root surface lateral pressure
  21. 21. <ul><li>Scaling stroke is a short, powerful pull stroke </li></ul><ul><li>* The wrist and forearm motion , pivoting in an arc on the finger rest, produce a more powerful stroke --- for scaling </li></ul><ul><li>* 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 </li></ul>
  22. 22. Root planing stroke: <ul><li>-- moderate to light pull stroke for final smoothing and planing of root surface </li></ul><ul><li>-- continuous series of long , overlapping shaving stroke is achieved </li></ul>
  23. 23. <ul><li>To avoid over-instrumentation, a delicate </li></ul><ul><li>transition from short, powerful scaling strokes </li></ul><ul><li>to longer, lighter root planing strokes must be </li></ul><ul><li>made as soon as calculus and initial roughness have been eliminated </li></ul>
  24. 24. Practice makes perfect!!
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