How do ultrasonic and sonic instruments work? - ANS These powered instruments use a non
audible range of acoustic vibrations from the instrument tip to:
-dislodge calculus from the tooth surface disrupt plaque biofilm
-flush out bacteria from the periodontal pocket
What does research say about the effectiveness of electronically powered instrumentation? -
ANS Research investigations indicate that electronically powered devices are "not only as
effective as hand instrumentation but also have some advantages over hand instrumentation".
What does ultrasonic and sonic instruments do? - ANS 1. Removal of calculus (just as effective
as manual instruments)
2. Removal of plaque (especially effective in disruption of sub ging cal)
3. Access to furcations (more effective in treating class II & III furcations)
4. Pocket penetration (penetrate deeper into perio pockets)
5. Irrigation (fluid lavage "acoustic microstreaming")
6. Shorter appointments
7. Bactericidal effect (destructive to bacteria)
What is fluid lavage "cavitation"? - ANS Formation of tiny bubbles in the water stream.
When these tiny bubbles collapse, they produce shock waves tha may alter or destroy bacteria
by tearing the bacterial cell wall.
Name the tree modes of action: - ANS 1. Mechanical action (vibration of instrument tip)
2. Caviatation (formation and collapsing of bubble in the water)
3. Acoustic microstreaming or turbulence (agitation of fluids surrounding tip destroy/disrupt
bacteria)
What are the limitation of powered instrumentation? - ANS 1. Aerosol production (contaminated
aerosols with microorganisms)
2. Reduces tactile sensitivity (clinician has less tactile sensitivity)
3. Infection control (infection control can be compromised due to components that cannot be
strilized)
What are the advantages of powered instrumentation? - ANS -increased efficiency
, -multiple surfaces can be cleaned at once
-no need to "sharpen" so no cutting edge
-less chance of repetitive stress injuries
-less tissue distention (slimmer)
What are the disadvantages of powered instrumentation? - ANS -more precautions and
limitations
-client comfort (water spray)
-aerosol production
-temporary hearing shifts
-noise
-less tactile sensation
-reduced visibility
What are the "contraindications" for use of powered instruments? - ANS Not recommended for
use on all clients.
Review client's medical & dental history thoroughly
Precaution: have client turn hearing aids "down" or "off "
1. Communicable Disease (hepatitis, tuberculosis, respiratory infections)
2. High susceptibility to infection (immunal compromised)
3. Respiratory risk (emphaysema, cystic fibrosis, active asthma)
4. Cardiovascular disease with secondary "pulmonary" disease
... - ANS 5. Cardiac pacemakers and defibrillators (unshielded pacemakers & defribrillators
should NOT be exposed to magnetostrictive ultrasonic devices
6. Difficulty swallowing (Dysphagia) or prone to gagging ( multiple sclerosis, amytrophic lateral
sclerosis, muscular dystrophy, Parkinson desease, or paralysis may experience difficulty in
swallowing or be prone to gaggin.
7. Age ( pramary & newly erupted teeth/young children- large pulp chambers susceptible to
damage by heat & vibration)
... - ANS 8. Oral conditions ( avoid contact of tip with hypersensitive teeth, porcelain crowns,
composite resin restorations, demineralized enamel surfaces or exposed dentinal surfaces.
Not for use on titanium implants, unless the working-end of powered instrument is covered with
a specially designed plactic sleeve.
What are the "indications" for use of powered instrumentation? - ANS -Supragingival
debridement of dental calculus & instrinsic stain
-Subgingival debridement of calculus, oral biofilm, root surface constitients, and periodontal
pathogens
-Removal of orthodontic cement
-Gingival and periodontal conditions and diseases
-Surgical interventions
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