Fundamentals of Periodontal Instrumentation

by Gehrig, Jill S.

• ISBN13: 9780781728607
• ISBN10: 0781728606
• Edition: 4th
• Format: Spiral Bound
• Copyright: 2000-08-18
• Publisher: Lippincott Williams Wilkins

Summary

The Fourth Editionof this detailed, instructional guide to nonsurgical periodontal instrumentation guides readers step-by-step through technique. The revised edition offers a standalone module for each major topic, with introductory outlines, flowcharts, boxed reference sheets, summary sheets, tables, key terms, and rhyming reminders to emphasize key points and instrumentation techniques. New content includes: theory and technique for ultrasonic instrumentation; concepts in periodontal debridement; musculoskeletal disorders and neutral position for the clinician; and instrument selection and treatment planning for calculus removal.

Table of Contents

BASIC SKILLS
Mathematical Principles and Anatomic Descriptors	1	(8)
Mathematical Principles	2	(3)
Anatomic Descriptors	5	(3)
Skill Building Activity	8	(1)
Principles of Positioning	9	(40)
Musculoskeletal Disorders	11	(4)
Neutral Position for the Clinician	15	(3)
Patient Position	18	(2)
Clinician Stool and Patient Chair	20	(7)
Relationship to Patient and Dental Unit	23	(4)
Position for RIGHT-Handed Clinician	27	(8)
Positioning for the RIGHT-Handed Clinician	34	(1)
Position for LEFT-Handed Clinician	35	(8)
Positioning for the LEFT-Handed Clinician	42	(1)
Activity, References, and Evaluations	43	(6)
Instrument Grasp	49	(14)
Parts of the Periodontal Instrument	50	(1)
Modified Pen Grasp	51	(5)
Modified Pen Grasp	55	(1)
Glove Use	56	(2)
Effective Glove Use Fact Sheet	57	(1)
Improving Muscle Strength	58	(3)
Evaluation	61	(2)
Mirror and Finger Rests in Anterior Sextants	63	(54)
The Dental Mirror	65	(5)
Wrist Position for Instrumentation	70	(2)
The Fulcrum	72	(5)
Basic Intraoral Fulcrum	73	(4)
Skills for RIGHT-Handed Clinician	77	(19)
Handle Placement for Mandibular Anteriors	77	(1)
Mandibular Anterior Teeth	78	(8)
Handle Placement for Maxillary Anteriors	86	(1)
Maxillary Anterior Teeth	87	(8)
Anterior Sextants (RIGHT-Handed Clinician)	95	(1)
Skills for LEFT-Handed Clinician	96	(19)
Handle Placement for Mandibular Anteriors	96	(1)
Mandibular Anterior Teeth	97	(8)
Handle Placement for Maxillary Anteriors	105	(1)
Maxillary Anterior Teeth	106	(8)
Anterior Sextants (LEFT-Handed Clinican)	114	(1)
Evaluation	115	(2)
Mirror and Finger Rests in Mandibular Posterior Sextants	117	(26)
Technique Practice With Mirror	118	(3)
Retracting the Cheek	118	(2)
Sequence for Establishing a Fulcrum	120	(1)
Skills for RIGHT-Handed Clinician	121	(10)
Handle Placement Mandibular Posteriors	121	(1)
Mandibular Posterior Teeth	122	(8)
RIGHT-Handed Clinician	130	(1)
Skills for LEFT-Handed Clinician	131	(10)
Handle Placement Mandibular Posteriors	131	(1)
Technique Practice:Mandibular Posterior Teeth	132	(8)
LEFT-Handed Clincian	140	(1)
Evaluation	141	(2)
Mirror and Finger Rests in Maxillary Posterior Sextants	143	(26)
Wrist Position for Maxillary Posterior	144	(1)
Skills for RIGHT-Handed Clinician	145	(10)
Maxillary Posterior Teeth	146
Handle Placement for Maxillary Posteriors	145	(9)
RIGHT-Handed Clinician	154	(1)
Skills for LEFT-Handed Clinician	155	(10)
Handle Placement for Maxillary Posteriors	155	(1)
Maxillary Posterior Teeth	156	(8)
LEFT-Handed Clinician	164	(1)
Checklist, Activities, and Skill Evaluation	165	(4)
Body Breakers Risk Assement Questionnaire	165	(4)
Design of Hand-Activated Instruments	169	(14)
The Periodontal Instruments	170	(8)
Working-Ends	178	(4)
Skill Building Activity	182	(1)
Instrument Classification	183	(34)
Terminology	184	(2)
Working-End Utilization	186	(1)
Assessment Instrument	187	(8)
Debridement Instruments	195	(20)
Sickle Scaler	197	(2)
Periodontal File	199	(3)
Universal Curet	202	(5)
Area-Specific Curet	207	(6)
Design Analysis of Sickle Scalers and Curets	213	(1)
Use of Hand-Activated Instruments	214	(1)
Evaluation	215	(2)
ELEMENTS OF INSTRUMENT STROKE
Adaptation and Angulation	217	(12)
Adaptation	218	(4)
Adaptation	220	(1)
Adaptation	221	(1)
Angulation	222	(5)
Angulation	225	(2)
Evaluation	227	(2)
Activation, Pivot, and Handle Roll	229	(12)
Moving the Working-End	230	(3)
Hand-Forearm Activation	231	(1)
Digital Motion Activation	232	(1)
Maintaining Adaptation	233	(4)
Pivoting	233	(2)
Handle Roll	235	(1)
Activation	236	(1)
Activities and Evaluation	237	(4)
Instrumentation Strokes	241	(16)
Types of Instrumentation Strokes	242	(2)
Stroke Characteristics	243	(1)
Stroke Direction and Pattern	244	(5)
Stabilization and Lateral Pressure	249	(3)
Rhyming Reminders	251	(1)
Parallelism and Shank Position	252	(2)
Stroke Production	254	(1)
Stroke Production	254	(1)
Evalution	255	(2)
PATIENT ASSESSMENT
Periodontal Probes	257	(44)
Introduction to Probing	259	(10)
Step-by-Step Technique on Posteriors	269	(4)
Step-by-Step Technique on Anteriors	273	(3)
Assessments With Probes	276	(15)
Probing and Clinical Attachment Level	290	(1)
Documentation of Measurements	291	(1)
Periodontal Screening and Recording (PSR)	292	(5)
Activities and Evaluation	297	(4)
Explorers	301	(26)
Concepts of Exploring Technique	303	(4)
Assessment Strokes	305	(1)
Inner and Outer Sides of Explorer Tip	306	(1)
Step-by-Step Technique on Anteriors	307	(4)
Visual Clues for Anterior Teeth	307	(4)
Step-by-Step Technique on Posteriors	311	(7)
Visual Clues for Posterior Teeth	311	(6)
Explorers	317	(1)
Calculus Detection	318	(5)
Common Causes of Undetected Calculus	322	(1)
Caries Detection	323	(1)
Activity and Evaluation	324	(3)
DEBRIDEMENT WITH HAND-ACTIVATED INSTRUMENTS
Anterior Sickle Scalers	327	(10)
Basic Concepts	328	(3)
Supragingival Stroke Production	329	(2)
Step-by-Step Technique	331	(4)
Anterior Sickle Scalers	334	(1)
Evaluation	335	(2)
Posterior Sickle Scalers	337	(12)
Basic Concepts	338	(5)
Step-by-Step Technique	343	(4)
Posterior Sickle Scalers	346	(1)
Evaluation	347	(2)
Universal Curets	349	(22)
Basic Concepts	350	(2)
Subgingival Stroke Production	350	(2)
Technique on Posterior Sextants	352	(7)
Technique on Anterior Sextants	359	(5)
Refining Your Technique	364	(3)
Universal Curets	366	(1)
Evaluations	367	(4)
Area-Specific Curets	371	(28)
Basic Concepts	373	(1)
Technique on Anterior Teeth	374	(4)
Visual Clues for Anterior Teeth	374	(4)
Root Surface Debridement---Anteriors	378	(4)
Technique on Posterior Sextants	382	(10)
Visual Clues for Posterior Teeth	382	(9)
Area-Specific Curets	391	(1)
Root Surface Debridement---Posteriors	392	(3)
Evaluations	395	(4)
Problem Identification: Difficulties in Instrumentation	399	(8)
Can't See the Treatment Area!	400	(1)
Can't Locate the Calculus!	401	(1)
Poor Illumination of Treatment Area!	402	(1)
Can't Adapt the Cutting Edge to Tooth Surface!	402	(1)
Can't Maintain Adaptation!	403	(1)
Uncontrolled or Weak Stroke!	404	(1)
Missed Calculus Deposits!	405	(2)
Instrument Sharpening	407	(24)
Introduction to Sharpening Concepts	408	(7)
Skill Practice: Establishing Correct Angulation	411	(4)
Equipment	415	(2)
Sharpening Guides	417	(5)
Sharpening	417	(1)
Sharpening Guides R and L	418	(2)
Technique Practice With Sharpening Guides	420	(2)
Step-by-Step Technique	422	(7)
Evaluation	429	(2)
Instrumentation Strategies	431	(12)
The Calculus Removal Game Plan	432	(5)
Skill Building Activities	437	(5)
References	442	(1)
DEBRIDEMENT WITH MECHANIZED INSTRUMENTS
Basic Concepts of Ultrasonic Instrumentation	443	(36)
Introduction to Ultrasonic Instrumentation	445	(8)
Hand Versus Ultrasonic Instrumentation	452	(1)
Treatment Considerations	453	(4)
Ultrasonic Instrument Tip	457	(7)
Tip Adaptation	464	(7)
Instrumentation Strokes	471	(3)
Instrumentation Technique	474	(3)
Principles of Ultrasonic Instrumentation	476	(1)
References	477	(2)
Ultrasonic Equipment	479	(16)
Magnetostrictive Ultrasonic Devices	480	(6)
Step-by-Step Technique: Magnetostrictive	482	(4)
Piezoelectric Ultrasonic Devices	486	(6)
Step-by-Step Technique: Piezoelectric	488	(4)
Evaluations	492	(3)
Sonic Instruments	495	(10)
Introduction to Sonic Instruments	496	(3)
Step-by-Step Technique	499	(3)
Activities and Evaluation	502	(3)
DEBRIDEMENT THEORY
Concepts in Periodontal Debridement	505	(10)
Periodontal Debridement	506	(7)
Scaling Versus Debridement	512	(1)
Activity and References	513	(2)
ADVANCED INSTRUMENTATION TECHNIQUES
Advanced Fulcruming Techniques	515	(16)
Introduction	516	(3)
Advanced Fulcruming Techniques	518	(1)
Advanced Intraoral Fulcrums	519	(6)
Basic Extraoral Fulcrums	525	(1)
Stabilized Fulcrums	526	(3)
Evaluation	529	(2)
Debridement of Dental Implants	531	(8)
Introduction	532	(1)
Technique	533	(4)
Evaluation	537	(2)
Index	539