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FUNDAMENTALS OF INSTRUMENTATION:

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This comprehensive review focuses on the essential fundamentals of instrumentation in periodontal therapy. Key topics covered include operator and client positioning, instrument blade selection, and techniques such as grasp, fulcrum, insertion, adaptation, angulation, lateral pressure, and stroke direction. Additionally, customized instrumentation for periodontitis-affected teeth is explored using various instrument types, including regular, rigid, and mini Gracey instruments. Attention is given to effective sequencing, time management, and patient considerations to optimize treatment outcomes.

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FUNDAMENTALS OF INSTRUMENTATION:

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  1. FUNDAMENTALS OF INSTRUMENTATION: (A Review)

  2. Review Darby book pp. 386-396 • Operator and Client Positioning • Instrument Blade Selection • Grasp • Fulcrum • Insertion • Adaptation • Angulation

  3. Review Continued Darby book pp. 386-396 • Lateral Pressure • Strokes • Stroke Direction • Stroke Length • Reinforcement • Customizing Instrumentation for Periodontitis-Affected Teeth

  4. Site Specific: 1/2 7/8 11/12 13/14 Types: Regular Rigids Minis After- Fives Gracey Instruments:

  5. Please take a few minutes to read the following: Nield book: Module 16 pp. 333- 355 Darby book: pp. 419- 423 Use the following remaining slides as an adjunct to your reading.

  6. Types: Regular Rigid

  7. Notice that the Gracey instrument: has only one cutting edge already angled at 70 degrees face of instrument always slants towards the tooth

  8. 1/2 7/8 11/12 13/14 Where each instrument is used:

  9. The top row of instruments are instruments found in your cassette:

  10. Sequence: • Determine how many teeth you can complete in the time allotted • ALWAYS start with the most posterior tooth in the quadrant- Distal surface • Begin with the 13/14 and complete distal bucal surface of say- 3 teeth • Then complete the buccal to mesial surfaces with the 11/12 • NOW: with the same sequence (13/13, 11/12) complete lingual surfaces

  11. When you have completed the teeth originally planned, move onto the remaining teeth in that quadrant. • Keep in mind that you must keep an eye on the clock so that all the surfaces of a tooth are completed BEFORE you dismiss your patient. • Sometimes that means you can only complete one tooth in the given time, or you might be able to complete all the teeth in the quadrant. • Consider the following when planning: • Tenacity of the deposit (how difficult to remove?) • Patient management (are they a talker? too sensitive?)

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