Calculus Removal Strokes Subgingival Calculus Deposits

HU-Patient Treatment
9 Apr 201904:57
EducationalLearning
32 Likes 10 Comments

TLDRThe video script provides a detailed demonstration on the proper technique for removing subgingival calculus using a Columbia Universal curette. It emphasizes the use of a biting stroke rather than a shaving stroke, with a focus on the 'toe one-third' of the curette for effective calculus removal. The process involves inserting the instrument subgingivally with minimal face and tooth contact, detecting the calculus deposit, and then using a short biting stroke with lateral pressure to dislodge the deposit. The importance of maintaining the correct angle of the instrument, between 70 to 80 degrees, is highlighted to prevent injury to the sulcus and ensure effective removal without burnishing the calculus. The demonstration aims to educate viewers on the meticulous and gentle approach required for safe and effective subgingival calculus removal.

Takeaways
  • 🦷 **Use a Biting Stroke**: When removing subgingival calculus, employ a biting stroke rather than a shaving stroke.
  • 🔍 **Zero-Degree Contact**: Insert the curette with minimal (near zero-degree) face and tooth contact to access the area.
  • 🔨 **Locking the Toe**: Lock the toe one-third of the instrument onto the calculus deposit to effectively remove it.
  • 🏠 **Subgingival Access**: The curette must be inserted under the gingiva to access and remove the calculus deposit.
  • ⭕ **Universal Curette**: The Columbia Universal curette is suitable for both supra and subgingival use anywhere in the mouth.
  • 📏 **Instrument Positioning**: Position the working end of the curette apical to the calculus deposit before locking on.
  • 🔄 **Short Biting Stroke**: Utilize a short biting stroke with lateral pressure to dislodge the calculus deposit.
  • 👆 **Fulcrum Finger**: Use the fulcrum finger to apply downward pressure while using the biting stroke.
  • 📐 **Angle of Instrument**: Open the instrument to an angle of about 70 to 80 degrees when performing the biting stroke.
  • ❌ **Avoid Full 90 Degrees**: Opening the instrument to 90 degrees risks injuring the sulcus by using the cutting edge.
  • ✅ **Check and Repeat**: After the biting stroke, loosen the grasp and check if the deposit is removed; repeat if necessary.
Q & A
  • What is the main difference in technique between removing subgingival calculus and supragingival calculus?

    -The main difference is that for subgingival calculus, a biting stroke is used instead of a shaving stroke, which is used for supragingival calculus.

  • What type of curette is recommended for removing subgingival calculus?

    -A Columbia Universal curette is recommended, as it has a rounded toe that allows it to go subgingival and can be used anywhere in the mouth.

  • How should the face and tooth contact be positioned when inserting the curette under the gingiva?

    -The face and tooth contact should be as close to zero degrees as possible to ensure proper access to the calculus deposit.

  • What part of the curette is used to remove the calculus deposit?

    -The toe one-third of the working end of the instrument is used to remove the calculus deposit.

  • How should the curette be positioned to remove the calculus deposit?

    -The curette should be inserted so that the toe one-third is positioned right above the calculus deposit, and then locked onto it.

  • What type of stroke is used to remove the calculus deposit after locking the curette in place?

    -A short, biting stroke is used to pop the calculus deposit off after locking the curette in place.

  • Why is it important to ensure the grasp is loosened after the biting stroke?

    -Loosening the grasp allows the practitioner to feel whether the deposit has been removed, and if not, to reapply the technique without causing injury.

  • What is the correct angulation to use when performing the biting stroke to remove the calculus deposit?

    -The correct angulation is about 70 to 80 degrees to avoid injuring the sulcus or only shaving the top layer of the deposit.

  • What is the term used for when the calculus deposit is only partially removed and becomes more difficult to take off?

    -This is called 'burnishing' the deposit, which makes it very difficult to remove.

  • Why is it important to use a fulcrum finger when applying lateral pressure with the curette?

    -Using a fulcrum finger provides stability and control, allowing for effective removal of the calculus without causing damage to the tooth or gingival tissue.

  • What is the purpose of using lateral pressure when removing subgingival calculus?

    -Lateral pressure helps to secure the curette against the tooth and effectively lifts the calculus deposit from the tooth surface during the biting stroke.

  • How does the technique described help prevent injury to the soft tissues of the mouth?

    -By using a controlled biting stroke at a specific angulation (70 to 80 degrees) and ensuring minimal face and tooth contact, the technique minimizes the risk of injury to the gingival tissues and sulcus.

Outlines
00:00
🦷 Removing Subgingival Calculus with a Columbia Universal Curette

This paragraph explains the process of removing subgingival calculus using a Columbia Universal curette, a tool with a rounded toe that can be used subgingivally. The key technique involves a biting stroke rather than a shaving stroke. To access the calculus, the curette is inserted with minimal face and tooth contact (close to zero degrees). The 'lock on' method is used where the toe one-third of the instrument is used to engage the calculus deposit. The deposit is then 'cupped' and removed with a short biting stroke, applying lateral pressure and using the fulcrum finger for support. The importance of angling the instrument to 70-80 degrees is emphasized to avoid injury to the sulcus or ineffective removal of the deposit.

Mindmap
Keywords
💡Subgingival calculus
Subgingival calculus refers to the hardened plaque that forms below the gum line. In the video, it is the primary focus as the speaker discusses the technique for removing these deposits, which is crucial for maintaining oral health and preventing periodontal disease.
💡Biting stroke
A biting stroke is a specific dental procedure technique used to remove subgingival calculus. It involves a short, controlled movement of the dental instrument to 'bite' into the calculus and dislodge it. The video emphasizes the use of this stroke over a 'shaving' stroke for effective calculus removal.
💡Columbia Universal curette
The Columbia Universal curette is a dental instrument with a rounded toe, designed for use both above and below the gum line. It is highlighted in the video as the tool of choice for accessing and removing subgingival calculus due to its versatility and design.
💡Fulcrum finger
The fulcrum finger is the finger that dentists or dental hygienists use to stabilize the hand and provide counter-pressure when using a dental instrument. In the context of the video, applying pressure with the fulcrum finger is a critical part of the biting stroke technique for calculus removal.
💡Lateral pressure
Lateral pressure is the force applied to the side of the tooth with the instrument during a dental procedure. In the video, it's mentioned as a key component of the biting stroke technique, where lateral pressure helps to effectively remove the calculus without causing damage to the tooth or gums.
💡Calculus deposit
A calculus deposit is a hardened mass of plaque that has mineralized on the tooth surface. The video script discusses the process of detecting and removing these deposits, which is a fundamental aspect of dental hygiene and periodontal care.
💡Zero-degree contact
Zero-degree contact refers to the angle at which the dental instrument is placed in relation to the tooth surface. In the video, it is emphasized that the instrument should be inserted with as close to zero-degree contact as possible to access the calculus deposit under the gingiva.
💡Instrument toe
The instrument toe refers to the working end of the dental curette. The video script specifies using the 'toe one-third' of the instrument for calculus removal, indicating the precision required when engaging with the calculus deposit.
💡Cup and lock technique
The cup and lock technique involves positioning the curette to 'cup' over the calculus deposit and then 'locking' it in place before applying a biting stroke. This method, as described in the video, is essential for effectively removing the calculus without causing injury to the surrounding tissue.
💡Angulation
Angulation in the context of dental procedures refers to the angle at which the instrument is positioned relative to the tooth. The video emphasizes opening the instrument to about 70 to 80 degrees during the biting stroke to avoid injury to the sulcus or ineffective removal of the calculus.
💡Burnishing
Burnishing is the process of smoothing a surface, in this case, the top layer of a calculus deposit, which can make it more difficult to remove. The video warns against using an instrument at less than 45 degrees as it may result in burnishing rather than effectively removing the calculus.
Highlights

Removing subgingival calculus deposits requires a different technique than removing supragingival calculus.

Use a biting stroke rather than a shaving stroke for subgingival calculus removal.

The Columbia Universal curette is a universal tool with a rounded toe, suitable for subgingival and supragingival use.

To remove calculus deposits, insert the instrument under the gingiva with the face and tooth contact as close to zero degrees as possible.

Detect calculus deposits by inserting the back of the instrument under the gingiva.

Only use the toe one-third of the instrument's working end to remove the deposit.

Lock the toe one-third above the calculus deposit before applying the biting stroke.

Cup the calculus deposit and pop it off with a short biting stroke.

Push down on the fulcrum finger and apply lateral pressure with the instrument toe during the biting stroke.

After removing the deposit, loosen the grasp and feel for any remaining calculus.

If the deposit is not fully removed, repeat the process by locking the toe one-third above the deposit and applying the biting stroke.

Ensure the angulation is about 70 to 80 degrees when performing the biting stroke.

Avoid opening the instrument to 90 degrees as it may injure the sulcus.

Opening the instrument less than 45 degrees results in shaving the top layer of calculus, leading to burnishing.

Maintaining the correct angulation is crucial for effective calculus removal without damaging the tissue.

Transcripts
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