Periodontics | Non-Surgical Therapy | INBDE, ADAT
TLDRIn this informative video, Ryan delves into the world of non-surgical periodontal therapy, focusing on the essential procedures of scaling and root planing. These techniques aim to restore gum health by eliminating bacterial plaque and calculus. Ryan explains the use of various instruments, including sickle scalers for above-gingival calculus and curettes for sub-gingival calculus, with a focus on their design and application. The video also covers ultrasonic scalers, which are effective for tenacious calculus but have contraindications for certain patients. Ryan emphasizes the importance of understanding the different types of ultrasonic vibrations and their functions, such as lavage and cavitation. He provides a detailed guide on the proper use of hand instruments and ultrasonic devices, including the correct strokes and angles for effective treatment. Finally, he discusses the importance of a thorough prophylaxis to remove any remaining plaque and the use of fluoride treatments to protect the enamel. This comprehensive overview serves as a valuable resource for understanding periodontal therapy and its significance in dental health.
Takeaways
- 🦠 **Non-Surgical Periodontal Therapy**: The focus is on removing bacterial plaque and calculus to restore gingival health.
- 🔍 **Scaling and Root Planing**: Scaling involves removing both super gingival and sub gingival plaque and calculus, while root planing specifically targets embedded calculus and roughened cementum.
- ⚔️ **Instruments Used**: Sickle scalers are used for super gingival calculus, while curettes with a rounded tip are used for sub gingival calculus to prevent gingival injury.
- 🔢 **Gracy Instruments**: There is a pattern to the numbering of these instruments, which correspond to specific areas of the mouth, ranging from anterior to posterior regions.
- 📡 **Ultrasonic Scalers**: These are used for tenacious calculus that is harder to remove with hand instruments and come in two types: magnetostrictive (elliptical vibration) and piezoelectric (linear vibration).
- ❌ **Contraindications**: Ultrasonic scalers are not suitable for patients with pacemakers, those with infectious diseases spread by aerosol, and individuals at risk for respiratory diseases.
- 💦 **Ultrasonic Functions**: They include lavage (water flushing), cavitation (air bubble collapse for debris removal), mechanical vibration (for deposit removal), and acoustic turbulence (disrupting bacterial cell walls).
- 🔄 **Stroke Techniques**: Different strokes are used for different instruments; exploratory for probing, scaling stroke for hard deposit removal, root planing for smoothing, and light intermittent for ultrasonic devices.
- 📏 **Curette Angulation**: When using a curette, start with a closed angle (0 degrees) for insertion and adjust to an open angle (45-90 degrees) for effective calculus removal.
- 🧼 **Prophylaxis**: After scaling and root planing, a prophylaxis is performed to remove any remaining super gingival plaque using a prophy cup and brush or a prophy jet.
- 🍀 **Fluoride Application**: It is beneficial to apply fluoride after prophylaxis to protect the freshly exposed layer of enamel, which may have been slightly abraded during the cleaning process.
Q & A
What is the primary goal of non-surgical periodontal therapy?
-The primary goal of non-surgical periodontal therapy is to restore gingival health by removing bacterial plaque, calculus, and other local factors that contribute to the accumulation of these harmful substances.
What are the two main components of non-surgical periodontal therapy?
-The two main components of non-surgical periodontal therapy are scaling and root planing. Scaling involves the removal of both super gingival and sub gingival plaque and calculus, while root planing focuses on the removal of embedded calculus and smoothing of rough cementum.
What is the difference between a sickle scaler and a curette?
-A sickle scaler has a very sharp tip and a triangular cross-section, designed for the removal of super gingival calculus only, to avoid injuring the gingiva. A curette, on the other hand, has a rounded tip and a semi-circular cross-section, allowing it to be used sub gingivally without causing damage to the gingival tissue.
What are the specific uses of the Gracey curettes in periodontal therapy?
-Gracey curettes are designed for specific areas of the mouth. The numbers 1/2 or 3/4 are used in the anterior region, number 5/6 for the anterior teeth and premolars, 7/8 and 9/10 for facial and lingual surfaces in the posterior, 11/12 for mesial interproximal surfaces, and 13/14 for distal interproximal surfaces, following a numerical order from front to back.
Why are ultrasonic scalers contraindicated for patients with pacemakers?
-Ultrasonic scalers are contraindicated for patients with pacemakers because they use electrical impulses that can potentially interfere with the pacemaker's function, which is to maintain proper heart rhythm.
What are the two main types of ultrasonic scalers and how do their vibration patterns differ?
-The two main types of ultrasonic scalers are magnetostrictive and piezoelectric. Magnetostrictive scalers vibrate in an elliptical pattern, while piezoelectric scalers vibrate in a linear pattern.
What is the purpose of lavage and cavitation in ultrasonic scaling?
-Lavage is the process of flushing out the pocket with water to clean the area. Cavitation involves the collapse of air bubbles which releases energy to help remove debris. Both processes contribute to effective plaque and calculus removal.
What is the correct angulation for inserting a curette into a periodontal pocket?
-The correct initial angulation for inserting a curette into a periodontal pocket is a closed angle, which means the blade of the curette should be parallel to the tooth surface, with an angle of zero degrees between the tooth surface and the face of the instrument.
What is the difference between a scaling stroke and a root planing stroke?
-A scaling stroke is a short, strong pull stroke used to remove hard deposits like calculus. In contrast, a root planing stroke is a light to moderate pull stroke used for the final smoothing of the tooth surface after removing embedded calculus and rough cementum.
Why is it important to apply fluoride after a prophylaxis treatment?
-It is important to apply fluoride after a prophylaxis treatment because the treatment may remove a microscopically small layer of enamel. Fluoride helps to strengthen this new layer of enamel and protect it from further decay.
What is the role of the prophylaxis treatment in non-surgical periodontal therapy?
-The role of the prophylaxis treatment is to remove any remaining super gingival plaque on the tooth enamel after scaling and root planing. It helps in stain removal and provides access to subgingival areas for a thorough clean.
Outlines
😀 Introduction to Non-Surgical Periodontal Therapy
Ryan introduces the topic of non-surgical periodontal therapy, discussing the factors leading to periodontal disease and the importance of addressing these factors to restore health. The primary focus is on local periodontal therapy, which aims to eliminate bacterial plaque and calculus. Scaling and root planing are highlighted as key components of this therapy, with definitions provided for each. Scaling involves the removal of both super gingival and sub gingival plaque and calculus, while root planing specifically targets embedded calculus and roughened cementum. The video also covers the instruments used in these procedures, such as sickle scalers for super gingival calculus and curettes with rounded tips for sub gingival calculus. Universal and Gracey curettes are mentioned, each with specific uses and design features.
🛠️ Hand Instruments and Ultrasonic Scalers in Periodontal Therapy
The second paragraph delves into the use of hand instruments like sickle scalers and curettes, as well as ultrasonic scalers for tenacious calculus that is harder to remove. Ultrasonic scalers are noted to be contraindicated for patients with pacemakers, infectious diseases spread by aerosol, and those at risk for respiratory disease due to the water spray they produce. Two main types of ultrasonic scalers are discussed: magnetostrictive (elliptical vibration pattern) and piezoelectric (linear vibration pattern). The paragraph also explains the functions of ultrasonic scalers, including lavage, cavitation, mechanical vibration, and acoustic turbulence, all contributing to effective plaque and calculus removal. Different strokes used by operators with hand instruments and ultrasonic devices are described, emphasizing the importance of these techniques for the board exam and clinical practice.
🦷 Proper Technique and Post-Procedure Care in Periodontal Therapy
The final paragraph focuses on the correct technique for using a curette in a periodontal pocket, emphasizing the transition from a closed angle (zero degrees) for insertion to an open angle (45 to 90 degrees) for scaling and root planing. The importance of avoiding tissue damage and effectively removing calculus is stressed. After scaling and root planing, the video discusses the importance of providing a prophylaxis for the patient to remove any remaining super gingival plaque. Tools such as a prophy cup and brush are used for this purpose, with the cup providing access to sub gingival areas and the brush aiding in reaching occlusal grooves and interproximal spaces. The use of a prophy paste with grit helps in stain removal and the potential for minimal enamel abrasion, which is why fluoride application is often paired with prophylaxis. The video concludes with an overview of the next topic, surgical therapy.
Mindmap
Keywords
💡Periodontal Disease
💡Non-Surgical Periodontal Therapy
💡Scaling
💡Root Planing
💡Sickle Scaler
💡Curette
💡Ultrasonic Scalers
💡Prophylaxis
💡Gingival Health
💡Pocket Depth
💡Clinical Attachment Level
Highlights
The video discusses non-surgical periodontal therapy, focusing on removing bacterial plaque and calculus to restore gingival health.
Scaling and root planing are the core procedures in periodontal therapy, defined as the removal of both super gingival and sub gingival plaque and calculus, and the removal of embedded calculus and rough cementum, respectively.
Sickle scalers are used for removing super gingival calculus and have a sharp tip that should be used above the gingival margin to avoid injury.
Curettes have a rounded tip for sub gingival calculus removal, designed to prevent damage to the gingival tissue.
Universal curettes can be used in any area of the mouth, while Gracey curettes are adapted for specific areas.
Gracey instruments are categorized by two numbers and are used in a specific order from anterior to posterior regions of the mouth.
Ultrasonic scalers are used for tenacious calculus that is harder to remove and come in two types: magnetostrictive and piezoelectric, vibrating in elliptical and linear patterns, respectively.
Ultrasonic scalers are contraindicated for patients with pacemakers, infectious diseases spread by aerosol, and those at risk for respiratory disease due to the potential for interference and aerosol spread.
Ultrasonic scalers have multiple functions including lavage, cavitation, mechanical vibration, and acoustic turbulence for effective plaque and calculus removal.
Different strokes are used for hand instruments and ultrasonic devices, such as exploratory, scaling, root planing, and light intermittent strokes.
When using a curette, the initial angulation should be zero degrees (closed angle) for insertion and 45 to 90 degrees (open angle) for effective calculus removal.
After scaling and root planing, a prophylaxis is performed to remove any remaining super gingival plaque using a prophy cup and brush.
The prophy cup is used with a slow speed handpiece and loaded with prophy paste for stain removal and pocket access.
The brush is used for better access to occlusal grooves and interproximal areas.
Prophylaxis paste has a grittiness that helps remove extrinsic stains and a microscopically small layer of enamel.
Fluoride application is often paired with prophylaxis to benefit the fresh layer of enamel.
The ProFee Jet is an alternative to the traditional cup and brush technique, delivering a slurry for stain and deposit removal.
Transcripts
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